Wpływ wybranych czynników na efekty rehabilitacji u chorych po udarze mózgu

Abstract

The aim of the study was to evaluate the impact of selected factors, such as: gender, age, stroke type, side of paresis, time to initiation of rehabilitation, first or successive in-patient rehabilitation and severity of paresis at admission on the final clinical status of patients and on the outcome of treatment at the department of rehabilitation, district hospital.Material and methods: All 431 post-stroke patients qualified for the treatment at the department of rehabilitation between January 2002 and December 2003 were included in the study. Patients were divided into four age groups. Results of rehabilitation were analyzed in male and female groups separately. Patients were divided according to the stroke type into four groups either suffering from an ischaemic or a hemorrhagic stroke; another selection cirterion was left-sided vs. right-sided paresis. The so-called general fitness, Barthel Index and Brunnström test were used to evaluate clinical status of the patients and the progress of rehabilitation. Statistical analysis was carried out using the t-test or – alternatively – the non-parametric Wilcoxon signed rank test, analysis of variance (ANOVA) or the nonparametric Kruskal-Wallis test, and the chi-square test.Results: Based on the obtained results, it was proven that multidimensional, complex rehabilitation in a specialist centre, carried out by rehabilitation team resulted in significant improvement of post-stroke patients’ clinical status. The improvement was observed for all measurements of fitness used in the study. Analysis of the effects of rehabilitation with regard to patients’ age indicated that an improvement in general fitness, motor activity (reduction of paresis) and independency in activities of daily living was obtained in each age group. Based on the analysis conducted in groups of patients with different stroke aetiologies, it was found that effects of the treatment in patients with haemorrhagic stroke were better than in patients with ischaemic stroke, which was observed in each of the applied measures used for the evaluation of patients’ clinical status. Mean improvement observed after the treatment was greater in patients with right-sided paresis than in patients with left-sided paresis. Gender had no significant effect on the extent of rehabilitation results.Conclusions: Results of the study indicate that in post-stroke patients, gender, advanced age, stroke location, stroke type or motor skills at admission do not constitute a criterion determining the possibility of conducting rehabilitation procedures