Impact of the physical rehabilitation onset time in early recovery period of ischemic stroke (second stage of medical rehabilitation) on the level of daily activity and independence

Abstract

Ischemic stroke (IS) is the leading cause of neurological inpatient care, readmission, and long-term disability. Until now, there is no single point of view on when the second stage of medical rehabilitation after an IS should be started and the amount of the rehabilitation activities.
Objective: to compare the effectiveness of the course of motor rehabilitation during the first 30–90 days and 91–180 days after IS.
Patients and methods. The patients were divided into two groups: group 1 included 44 patients in whom ≤3 months passed from IS onset, and group 2–39 patients in whom >3 but <6 months have passed since the IS onset. All patients included in the study received physiotherapy exercises, simulator exercises, robotic mechanotherapy, physiotherapy, massage, speech therapy, cognitive training, and secondary IS prevention.
Results and discussion. In both groups patients got a positive treatment result: a significant increase in muscle strength, gait stability, quality, and speed. The number of patients who achieved independence (≤2 points on the Rankin scale) before the start of the rehabilitation course among patients of group 1 was 9.4%, after the end of the course – 40.6%. More initially independent patients were included in the group 2 – 28.6%; after a course of rehabilitation, the proportion of independent patients increased to 35.7%.
Conclusion. Rehabilitation courses are effective in patients who have had IS, both in the first three months and in the period from the 4^th to the 6^th month. It is advisable to conduct the second stage of medical rehabilitation earlier after a stroke.