MANAGING THE EARLY PHASE OF REHABILITATION AFTER ISCHEMIC CEREBROVASCULAR ACCIDENT
2017
Objective: Ischemic cerebrovascular accident (ICA) is characterised by the rapid deterioration of brain function due to vascularization disorders. The ischemic cerebrovascular accident may arise as a consequence of ischemia or hemhorrage in brain tissue, but the optimal treatment approach is unclear. In this study, we examined ICA rehabilitation goals, implementation of rehabilitation plans, management of sensomotor deficits and functional status, improvement of independence, prevention and treatment of complications, functional status monitoring, and planning recommendations, as well as education of ICA patients and their families. Methods: This study considered 69 ICA patients who were classified as suitable for rehabilitation intervention among a total of 231 patients who were evaluated for a diagnosis of ICA following hospitalization at the Clinic of Neurology, University Clinical Center of Kosovo (UCCK) in Prishtina. From the statistical parameters, we used the structure index, whereas testing results were evaluated using the Chi-square test with significance established at p<0.05. Results: For the 69 ICA patients, most ICA incidents occurred in patients who were older than 40 y-old. Mobility decreased from 42.9% to 8.6% when rehabilitation began at release instead of admission. Meanwhile, the ability to perform daily activities decreased from 48.6% to 11.4% when rehabilitation began after release as opposed to immediately after stabilization. Transfers and balance showed similar decreases (48.6% to 11.4% and 48.6% to 11.4%, respectively Chi-test=59.7, p<0.001.). The rehabilitation of patients in the early acute stage after ICA should begin as soon as possible after the diagnosis is made and the patient's condition is stable. During rehabilitation intervention, priority should be given to preventing complications and recurrent stroke, as well as enhancing patient mobility and improving patient morale. Conclusion: ICA is a medical emergency that can cause permanent neurological lesions and other complications that may be fatal or associated with permanent disability. The most affected age group is individuals older than 40 y old. Neurological deficits can cause motor, sensory, functional and emotional disability in ICA patients. Rehabilitation after ICA should begin immediately after the patient has stabilized to minimze functional losses.
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