Factors influencing the choice of rehabilitation measures for a disabled person with consequences of acute stroke

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Abstract

Acute cerebrovascular accident (CVD) is accompanied by a wide range of long-term disabling functional disorders and disability, necessitating an individual approach to the formation of an optimal complex of rehabilitation measures for a disabled person with the consequences of CVD in order to make rational use of resources and improve the effectiveness of rehabilitation.

An analysis of the literature data allowed us to identify factors that complicate the rehabilitation of people with disabilities with the consequences of STROKE and determine their rehabilitation potential: the main one is cognitive status; auxiliary ones are age, level of motor disorders, aphasia (in particular, the ability to understand instructions), and psychoemotional state. These factors (pre-coded into the appropriate ICF categories) were used in the algorithm for assigning a disabled person with the effects of STROKE to a specific rehabilitation group to form a set of rehabilitation measures. Measurement tools for assessing the designated categories and criteria for assigning a disabled person to a rehabilitation group are proposed.

The developed algorithm makes it possible to formulate a realistic rehabilitation goal and form an adequate set of rehabilitation measures to achieve it, corresponding to the capabilities and abilities of a disabled person. It is assumed that people with disabilities who do not have cognitive impairments have a high rehabilitation potential and a favorable rehabilitation prognosis, which makes it possible to set an ambitious rehabilitation goal and use any available rehabilitation methods with a preference for active ones. The worse the cognitive function indicators, the lower the rehabilitation potential of the disabled person is assumed and the more realistic the goal is formulated; at the same time, preference is given to passive rehabilitation methods using methods adapted to the patient’s cognitive abilities and involving the disabled person’s relatives in the rehabilitation process.

About the authors

Olga I. Khokhlova

Novokuznetsk Scientific and Practical Centre for Medical and Social Evaluation and Rehabilitation of Disabled Persons

Author for correspondence.
Email: root@reabil-nk.ru
ORCID iD: 0000-0003-3069-5686
SPIN-code: 2386-7820

MD, Dr. Sci. (Medicine)

Russian Federation, 7 Malaya st, Novokuznetsk, 654055

Elena M. Vasilchenko

Novokuznetsk Scientific and Practical Centre for Medical and Social Evaluation and Rehabilitation of Disabled Persons

Email: root@reabil-nk.ru
ORCID iD: 0000-0001-9025-4060
SPIN-code: 8910-2615

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Novokuznetsk

Yana A. Denisova

Novokuznetsk Scientific and Practical Centre for Medical and Social Evaluation and Rehabilitation of Disabled Persons

Email: root@reabil-nk.ru
ORCID iD: 0009-0005-7670-7701
SPIN-code: 3338-2163
Russian Federation, Novokuznetsk

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2. Fig. 1. Algorithm to form rehabilitation groups of disabled persons with hemiparesis according to cognitive status: 0–1 — no functioning disorders or mild functioning disorders in the format of the qualifier of the International Classification of Functioning, Disability and Health; 2–4 — moderate, severe and absolute disorders in the format of the qualifier of the International Classification of Functioning, Disability and Health; РГ-1, 2, 3, 4, 5, 6 — rehabilitation groups according to the cognitive status, level of motor disorder, psychoemotional state and age.

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