Secondary rehabilitation duration influence on functional recovery outcome and quality of life after stroke

[E. M. Biševac]

97, [3] lista

Uvod: Ova studija imala je za cilj da ispita uticaj dužine trajanja sekundarne rehabilitacije na ishod funkcionalnog oporavka i kvalitet života pacijenata nakon MU. Metod: 100 pacijenata (52 žene, 48 muškaraca, prosečne starosti 66.5±7.3 godina) koji su doživeli MU (50 IMU i 50 HMU) učestvovalo je u studiji. Pacijenti (lečeni merama sekundarne rehabilitacije u trajanju od šest meseci) ispitani su nakon jednog, tri i šest meseci. Funkcionalna sposobnost merena je pomoću FIM testa, dok je za procenu kvaliteta života korišćen upitnik EQ-5D-3L. Mentalni status pacijenata procenjen je MMSE testom, a težina MU na prijemu NIHSS skalom. Pored pomenutih testova korišćena je i SIS skala, koja služi za objektivnu procenu stanja pacijenata nakon MU. Rezultati: Pacijenti sa HMU imali su nešto niži FIM skor (motorni FIM = 29.8±11.8; kognitivni FIM = 14.4±4.6) na prijemu u poređenju sa pacijentima sa IMU (motorni FIM = 41.8±18.8; kognitivni FIM = 18.7±6.3), ali, nakon šest meseci sekundarne rehabilitacije pacijenti sa HMU dostigli su približan nivo funkcionalne nezavisnosti (motorni FIM = 53.8±14.4; kognitivni FIM = 25.8±4.7), kao i pacijenti sa IMU (motorni FIM = 67.6±16.4; kognitivni FIM = 29.2±4.0). Pored toga, dokazano je da postoji statistički značajna povezanost između funkcionalne nezavisnosti i kvaliteta života u sva četiri trenutka ispitivanja. Nakon sprovedene rehabilitacije skor MMSE testa i SIS skale statistički se značajno povećao i kod IMU i kod HMU. Zaključak: Pacijenti su nakon šest meseci dostigli najveći stepen funkcionalne nezavisnosti i najbolji kvalitet života. Tri meseca sekundarne rehabilitacije pacijentima omogućava značajan oporavak u odnosu na prijem, ali se nakon šest meseci postignu najbolji rezultati. Ključne reči: funkcionalni oporavak, kvalitet života, moždani udar, ishemijski moždani udar, hemoragijski moždani udar, sekundarna rehabilitacija

Introduction: This study aimed to examine the impact of postacute rehabilitation duration on the outcome of the functional recovery and patients’ quality of life after the stroke. Method: One hundred patients (52 females, 48 males, mean age: 66.5±7.3years) who experienced a stroke (50 with ischemic stroke (IS) and 50 with intracranial hemorrhage (ICH)) took part in the study. Patients (treated with postacute rehabilitation measures for six months) were examined after one, three, and six months of postacute rehabilitation. Functional independence was measured using the functional independence measure (FIM) test, while the EQ-5D-3L questionnaire was used to assess the quality of life. The mental status of patients was assessed with the MMSE test, and the severity of stroke on admission was assessed with the NIHSS scale. In addition to the aforementioned tests, the SIS scale was also used to objectively assess the patients' condition according to stroke. Results: Patients with ICH had a slightly lower FIM score (FIM motor = 29.8±11.8; FIM cognitive = 14.4±4.6) on admission compared to patients with IS (FIM motor = 41.8±18.8; FIM cognitive = 18.7±6.3), but, after six months of postacute rehabilitation, patients with ICH reached an approximate level of functional independence (FIM motor = 53.8±14.4; FIM cognitive = 25.8±4.7), as did patients with IS (FIM motor = 67.6±16.4; FIM cognitive = 29.2±4.0). Furthermore, there is a statistically significant connection between functional independence and quality of life at all tested times. After completion of rehabilitation, MMSE test and SIS scale scores increased statistically significantly in both IS and ICH. Conclusion: After six months, patients achieved the highest level of functional independence and the best quality of life. Three months of secondary rehabilitation allows patients to recover significantly compared to admission, but the best results are achieved after six months.

funkcionalni oporavak, kvalitet života, moždani udar, ishemijski moždani udar, hemoragijski moždani udar, sekundarna rehabilitacija

functional recovery, quality of life, stroke, ischemic, hemorrhagic, postacute rehabilitation

616.831-005.1:615.82/.84(043.3)

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