scholarly journals Organisational and Economic Activities for Provision of Medical Rehabilitation Services on an Outpatient Basis to Patients That Have Suffered an Acute Cerebrovascular Accident

2019 ◽  
Vol 20 (1) ◽  
pp. 73-79
Author(s):  
Lilia Badrutdinova ◽  
Olga Manerova
Keyword(s):  
Cerebrovascular Accident ◽  
Healthy Lifestyle ◽  
Central Place ◽  
Outpatient Setting ◽  
Medical Rehabilitation ◽  
Social Characteristics ◽  
Outpatient Basis ◽  
Economic Activities ◽  
Rehabilitation Process ◽  
Acute Cerebrovascular Accident

AbstractThe aim of this study was to develop legal, organizational and economic activities for providing medical rehabilitation on an outpatient basis to patients that have suffered an acute cerebrovascular accident (CVA). The study included patients who had suffered a CVA and were undergoing medical rehabilitation on an outpatient basis (400 individuals participated in a retrospective study and 400 individuals took part in a sociological survey) and medical rehabilitation specialists providing care on an outpatient basis to patients who had suffered a CVA (n = 50). All included patients received medical rehabilitation in accordance with the Guidelines of the Ministry of Health of the Russian Federation (No: 70). It should be noted that patients who suffered a CVA occupy a central place in the system of medical rehabilitation performed on an outpatient basis. Medical rehabilitation is important for their medical and social characteristics, motivation, environment, adherence to treatment and a healthy lifestyle. In accordance with the above mentioned, the following activities should be planned and implemented: a) work with doctors, b) work with patients; c) work with patients’ relatives; d) organizational aspects, and e) economic aspects. When organizing medical rehabilitation on an outpatient basis, it should be considered as a system of interaction between all participants in the rehabilitation process, in the center of which the patient is located. The main organizational activity for conducting medical rehabilitation in an outpatient setting is the implementation of a comprehensive interaction of all participants in the rehabilitation process.

STAGES OF REHABILITATION OF PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENT

2021 ◽  
pp. 56-62
Author(s):  
I. V. Kas ◽  
I. S. Petukhova ◽  
T. P. Ustymenko
Keyword(s):  
Neurological Deficit ◽  
Cerebrovascular Accident ◽  
Modern Medicine ◽  
Rehabilitation Program ◽  
The Body ◽  
Medical Rehabilitation ◽  
Multidisciplinary Teams ◽  
Physical Factors ◽  
Acute Cerebrovascular Accident ◽  
Number Of Factors

One of the urgent tasks of modern medicine is organizing the rehabilitation for patients who have suffered a stroke at different stages of rehabilitation. Restoration of impaired functions in such patients occurs in the first 3−5 months from the onset of the disease, that is influenced by a number of factors: duration of the stroke, size of the lesion and pool of lesions, active participation in the process of a patient him−/herself. The main principles of rehabilitation include its early onset in an acute period of stroke; regularity and duration; complexity and multidisciplinarity (formation of multidisciplinary teams); adequacy of rehabilitation measures, i.e. creation of individual programs taking into account the severity of neurological deficit and dysfunction; stages. Different methods of recovery are applied to each patient individually or in combination, or sequentially according to the rehabilitation program, which is based on the analysis of the patient's condition by all members of the multidisciplinary team, taking into account the results of functional testing and objective examination. Medical support, postural correction, kinesitherapy, mechanotherapy (including robotic), field therapy, hardware physiotherapy, massage, acupuncture according to the indications, functional neurotraining and cardiotraining, neuropsychological training are used. The results of research confirm that the integrated use of kinesitherapy, physical factors, balneotherapy, the methods of psychological rehabilitation of patients after stroke provides a faster recovery of neurological deficit, activates non−specific brain systems, restores mental and somatic functions of the body. Therefore, in addition to health, the patient needs to renew his ability to work and social status. Key words: acute cerebrovascular accident, medical rehabilitation, stages of rehabilitation.

scholarly journals REMOTE REHABILITATION: ROLE AND OPPORTUNITIES

2021 ◽  
Author(s):  
Ilya V. Borisov ◽  
Valeria Alexandrovna Bondar ◽  
Mikhail M. Kanarsky ◽  
Yulia Y. Nekrasova ◽  
Natalya Vladimirovna Reutova ◽  
...  
Keyword(s):  
New Technologies ◽  
The Body ◽  
Medical Rehabilitation ◽  
Outpatient Basis ◽  
Informational Support ◽  
Life Situation ◽  
Rehabilitation Process ◽  
Successful Rehabilitation ◽  
Individual Use

Medical rehabilitation is a complex, long-term and financially costly process of restoring the physiological functions of the body after injuries and the consequences of past diseases. The need for an individual approach to each life situation necessitates the search and development of new technologies in the method of providing rehabilitation assistance. One of the principles of a successful rehabilitation process is continuity, which, in most cases, is disrupted after the transfer of patients to the outpatient stage. The 21st century, in contrast to the previous one, is distinguished by more accessible technologies for everyday and individual use. A separate category of patients are patients with the consequences of brain damage, socialization and the return of the ability to self-serve for whom is one of the most difficult in rehabilitation practice. One of these technologies is distance rehabilitation, which provides the principle of continuity, social and informational support for relatives who provide care for patients on an outpatient basis.

EVALUATION OF THE EFFECTIVENESS OF REHABILITATION OF PATIENTS WHO HAVE UNDERGONE ONMC, BASED ON THE ANALYSIS OF THE QUALITY OF LIFE OF PATIENTS

2020 ◽  
pp. 38-42
Author(s):  
Ирина Сергеевна Добрынина ◽  
Елена Юрьевна Есина ◽  
Анна Александровна Зуйкова ◽  
Елена Анатольевна Ханина ◽  
Арина Андреевна Кудинова
Keyword(s):  
Quality Of Life ◽  
Barthel Index ◽  
Cerebrovascular Accident ◽  
Sickness Impact Profile ◽  
Outpatient Basis ◽  
Acute Cerebrovascular Accident ◽  
Quality Of Life Indicators ◽  
General Improvement ◽  
First Time

В данной работе оценивалась эффективность реабилитационных мероприятий, проводимых в амбулаторно-поликлинических условиях через 2-3 недели от момента первого обращения у пациентов с перенесённым острым нарушением мозгового кровоснабжения (ОНМК), путем изучения комплекса физиологических, психологических и социальных нарушений, оказывающих влияние на их качество жизни. Было проведено обследование 43 пациентов, перенесших ОНМК, с использованием индекса Бартел и специализированного опросника «Stroke-Adapted Sickness Impact Profile». Всего в исследовании приняло участие 43 пациента с ОНМК (средний возраст 63,5±7,6 лет), находящихся на амбулаторно-поликлиническом этапе оказания медицинской помощи. В ходе исследования были выявлено, что показатели качества жизни впервые обратившихся пациентов и пациентов, уже проходящих курс реабилитации в течении 2-3 недель, существенно отличались. За период прохождения курса реабилитации отмечено общее улучшение во всех группах нарушенных функций ─ физиологических, психических и социальных, и повышение показателей качества жизни пациентов. Полученные сведения ещё раз подтверждают необходимость особого внимания к вопросам третичной профилактики среди пациентов, пострадавших от ОНМК, врачами поликлинического звена здравоохранения In this work, we evaluated the effectiveness of rehabilitation measures carried out on an outpatient basis 2-3 weeks after the first treatment in patients with acute cerebrovascular accident (stroke), by studying a set of physiological, psychological and social disorders that affect their quality of life. A total of 43 patients who underwent stroke were examined using the Barthel index and the specialized Stroke - Adapted Sickness Impact Profile questionnaire. A total of 43 patients with ONMC (average age 63.5±7.6 years) who are at the outpatient stage of medical care took part in the study. The study revealed that the quality of life indicators for first-time patients and patients already undergoing rehabilitation for 2-3 weeks were significantly different. Over 2-3 weeks of the rehabilitation course, a general improvement was noted in all groups of impaired functions ─ physiological, mental and social, ─ and an increase in the quality of life of patients. The information obtained once again confirms the need for special attention to tertiary prevention among patients affected by stroke, by doctors of the outpatient healthcare department

CLINICAL CASE OF ACUTE CEREBROVASCULAR ACCIDENT IN A CHILD WITH HEREDITARY THROMBOPHILIA

2020 ◽  
Vol 99 (1) ◽  
pp. 232-236
Author(s):  
P.V. Shumilov ◽  
◽  
A.Ya. Ilyina ◽  
A.L. Mishchenko ◽  
A.S. Barinova ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Acute Cerebrovascular Accident ◽  
Hereditary Thrombophilia

Progressive Early Rehabilitation Program Applied to Patients with Acute Cerebrovascular Accident

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Lung Ventilation ◽  
Rehabilitation Program ◽  
Artificial Lung ◽  
Early Rehabilitation ◽  
Gravity Gradient ◽  
Acute Cerebrovascular Accident ◽  
Artificial Lung Ventilation ◽  
Bed Days ◽  
Severity Of The Disease

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.

SOME ASPECTS OF ACUTE CEREBROVASCULAR PATHOLOGY IN POSTPARTUM WOMEN

Vestnik ◽  
2021 ◽  
pp. 51-56
Author(s):  
Д.А. Митрохин ◽  
Ж.Б. Дюсембаева ◽  
М.М. Ибрагимов ◽  
А.А. Оспанов ◽  
А.Н. Сембинова ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Postpartum Period ◽  
Cerebrovascular Accident ◽  
Hemorrhagic Stroke ◽  
Speech Disorders ◽  
Cerebral Stroke ◽  
Postpartum Women ◽  
Bioelectrical Activity ◽  
Acute Cerebrovascular Accident ◽  
Epileptiform Discharges

В данной статье, представлены результаты обследования 17 женщин, перенесших острое нарушение мозгового кровообращения в послеродовом периоде, с 2017 по 2021 годы, в возрасте от 19 до 39 лет. Показано, что у женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, выявлено преобладание ишемического инсульта над геморрагическим, что составило 64,7% и 35,3% соответственно. Неврологические признаки церебрального инсульта в послеродовом периоде характеризуются двигательными, речевыми расстройствами, нарушением чувствительности, а также часто психоэмоциональными проявлениями. Генерализованные тонико-клонические приступы чаще наблюдались у пациенток с геморрагическим инсультом (33,3%), в сравнении с ишемическим инсультом (9,1%). У женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, наиболее значимыми факторами риска являются: наличие хронических заболеваний, в том числе отягощенный акушерско-гинекологический анамнез, прием пероральных контрацептивов, а также курение. Биоэлектрическая активность головного мозга характеризовалась выраженной дельта и тета активностью, эпилептиформными разрядами в виде острых волн, спайков и комплексов «пик-волна», с преобладанием у пациенток с геморрагическим инсультом. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. Отмечено повышение интегрального индекса диапазона медленно-волновой активности и преобладание процентного отношения спектральных мощностей медленных волн (дельта, тета) к быстрым волнам (альфа, бета), особенно выраженное у больных с геморрагическим инсультом (р < 0,05), в сравнении с ишемическим инсультом. Наиболее тяжелое течение послеродового периода наблюдалось у пациенток с геморрагическим инсультом, именно в этом случае было 2 летальных исхода. This article presents the results of a survey of 17 women with acute cerebrovascular accident in the postpartum period, from 2017 to 2021, aged 19 to 39 years. It is shown that the period in women in the postpartum period, who underwent acute cerebrovascular accident, revealed the prevalence of ischemic stroke over hemorrhagic, which amounted to 64,7% and 35,3%, respectively. Neurological signs of cerebral stroke in the postpartum period are characterized by movement, speech disorders, impaired sensitivity, and often psychoemotional manifestations. Generalized tonic-clonic seizures were more often observed in patients with hemorrhagic stroke (33,3%) in comparison with ischemic stroke (9,1%). In postpartum women who have suffered acute cerebrovascular accident, the most significant risk factors are: the presence of chronic diseases, including a burdened obstetric and gynecological history, taking oral contraceptives, as well as smoking. The bioelectrical activity of the brain was characterized by pronounced delta and theta activity, epileptiform discharges in the form of sharp waves, spikes and peak-wave complexes, with a predominance in patients with hemorrhagic stroke. A more significant increase in the coherence index in the delta and theta ranges in patients after hemorrhagic stroke may indicate more severe interhemispheric disorders in comparison with ischemic stroke. An increase in the integral index of the range of slow-wave activity and a predominance of the percentage of the spectral powers of slow waves (delta, theta) to fast waves (alpha, beta), especially pronounced in patients with hemorrhagic stroke (p <0,05), in comparison with ischemic stroke. The most severe postpartum period was observed in patients with hemorrhagic stroke, in this case there were 2 deaths.

scholarly journals Modern aspects of social protection of combatants depending on the severity of disability

2020 ◽  
pp. 35-40
Author(s):  
N. M. Bieliaieva ◽  
O. B. Yavorovenko ◽  
I. V. Kurylenko ◽  
L. V. Prysiazhniuk ◽  
O. V. Dziuniak ◽  
...  
Keyword(s):  
Medical Rehabilitation ◽  
Rehabilitation Services ◽  
Persons With Disabilities ◽  
Rehabilitation Process ◽  
Group Iii ◽  
Rehabilitation Programs ◽  
Social Rehabilitation ◽  
Group I ◽  
Severity Of Disability ◽  
Rehabilitation Measures

The urgency of the problem is due to the significant increase in recent years in the number of young and middle-aged people who have passed the war, the need to develop adequate measures of social assistance and protection. An important task in the organization of the rehabilitation process is to determine the structure of the needs of servicemen with disabilities in various types of medical and social care and the development of individual rehabilitation programs (IRP) based on them. The purpose of the study: to determine the structure of the needs of servicemen with disabilities in medical and social rehabilitation depending on the severity of disability. Statistical data from 25 administrative territories of Ukraine for 2018 are analyzed, the needs of participants of military service with disabilities in medical and social rehabilitation measures, their structure are calculated. The data of the information base of the centers and the bureau of medical and social examination of the regions were used. Processing of the primary material was performed using the universal statistical package "Excel". In 2018, medical and social expert commissions (MSEC) of Ukraine for the first time and re-certified and recognized persons with disabilities 7843 combatants. Of these, disability of group I (IA and IB) was established in 2.6 %, II – in 29.2 %, III – in 68.2 % of cases. All victims for MSEC were formed IRP. The dependence of the needs of combatants in medical and social rehabilitation measures on the severity of disability has been established. For persons with disabilities of groups II and III, priority is given to medical and professional rehabilitation, group I – social rehabilitation and technical means of rehabilitation with medical support. Of the medical rehabilitation services for persons with II and III groups of disability, sanatorium treatment is significant, and group I – rehabilitation therapy. Among vocational rehabilitation services, employment in production conditions is important – for persons with group III disabilities, in specially created conditions – for persons with group II disabilities, at home – for persons with group I disabilities. Vocational training was offered to a small number of people with disabilities of all groups. Among social rehabilitation services and technical means of rehabilitation, the services of social workers of territorial social service centers were significant for representatives of all disability groups, simpler means of transportation for persons of group III disability and more complex means for persons of group I. Determining the characteristics of the needs of servicemen with disabilities depending on its severity allows MSEC specialists to better form the IRP, develop targeted rehabilitation programs at the regional level, assess shortcomings in the organization of the rehabilitation process and build a rehabilitation system for combatants.

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