CASE REPORT OF COMPLEX REHABILITATION OF PATIENT AFTER OPERATIVE TREATMENT ON THE SPINE IN CONDITIONS OF SANATORIUM WITH USE OF KINESOTHERAPY

The clinical case of the patient after operational treatment of a backbone and a rehabilitation course in the conditions of a day hospital is described. For assessment of efficiency of the held events pain scales YOURS, Rivermead Motor Assessment Scale were used. The program of a rehabilitation for by classical techniques of treatment included reflexotherapy methods with pharmakopunktura, trainings on the system of "Ekzart", electrostimulation. The patient received 2 rehabilitation courses: in 3 and 5 months after operational treatment, as a result of the executed treatment, at the patient at control survey from the moment of the beginning of therapy reduction of a pain syndrome, increase in independent daily activity, increase in insistence, normalization of indicators of the mental status is noted. The first rehabilitation course allowed to adapt the patient to house conditions, and returned her a possibility of partial self-service. The second year of rehabilitation set the reached effect and allowed the patient to move independently out of the room that significantly increased her standard of living. On the term of 4 months after an operative measure on a backbone at the patient the pain syndrome and restriction of life activity remained. The held complex of rehabilitation actions after backbone operation significantly improved indicators of quality of life and functional independence of rather initial level that speaks about its efficiency in ensuring earlier social reintegration of the patient.

CASE REPORT OF COMPLEX REHABILITATION OF PATIENT AFTER OPERATIVE TREATMENT ON THE SPINE IN CONDITIONS OF SANATORIUM WITH USE OF KINESOTHERAPY

The clinical case of the patient after operational treatment of a backbone and a rehabilitation course in the conditions of a day hospital is described. For assessment of efficiency of the held events pain scales YOURS, Rivermead Motor Assessment Scale were used. The program of a rehabilitation for by classical techniques of treatment included reflexotherapy methods with pharmakopunktura, trainings on the system of "Ekzart", electrostimulation. The patient received 2 rehabilitation courses: in 3 and 5 months after operational treatment, as a result of the executed treatment, at the patient at control survey from the moment of the beginning of therapy reduction of a pain syndrome, increase in independent daily activity, increase in insistence, normalization of indicators of the mental status is noted. The first rehabilitation course allowed to adapt the patient to house conditions, and returned her a possibility of partial self-service. The second year of rehabilitation set the reached effect and allowed the patient to move independently out of the room that significantly increased her standard of living...

Effects of sling and voluntary constraint during constraint-induced movement therapy for the arm after stroke: a randomized, prospective, single-centre, blinded observer rated study

Objective: To determine whether a combination of constraint-induced movement therapy and physiotherapy in stroke patients using different constraint regimens (sling versus voluntary constraint) changes or reduces motor deficits, the amount of functional use of the arm and whether the effects of treatment continue after 12 months. Design: Forty-seven stroke patients were stratified and randomly divided into intensive physiotherapy programmes focused on regaining arm functions. Setting: Neurorehabilitation Unit of IInd Department of Neurology at Institute of Psychiatry and Neurology in Warsaw. Subject: Patients were randomly allocated to: the sling-constraint group ( n = 24) or to the voluntary-constraint group ( n = 23). Interventions: Massed practice with the paretic arm (5 hours/day for 15 consecutive working days). Sling-constraint group had their arm immobilized in a hemi-sling during therapy. In addition, individual, 1-hour physiotherapy sessions were conducted in both groups. Main measures: Rivermead Motor Assessment (RMA) Arm scale, (0–15), Motor Activity Log – Quality of Movement (MAL-QOM) (0–5 for 30 daily tasks). Results: There was no significant difference between groups after therapy (MAL-QOM mean change for sling group 0.78, SD = 0.46 and for voluntary-constraint group 0.84, SD = 0.48; P = 0.687). All treated patients retained mean gains in real-world arm use (MAL-QOM) mean scores after 12 months follow-up compared with posttreatment values but there was no significant difference between groups (comparison of estimated mean change of MAL-QOM stated 0.23. 95% confidence interval = −0.04–0.50). Conclusion: Voluntary activity constraint in the intact arm is equivalent to sling, standard constraint during massed practice of paretic arm.

Activity limitations of patients with stroke attending out-patient facilities in the Western Cape, South Africa

A stroke can affect individuals at the levels of impairment, activity and participation. The aim of this study is to determine the activity limitations of stroke patients receiving rehabilitation at out-patient Community health Centres (ChCs). A longitudinal observational study was conducted. Activity limitations were measured using the Rivermead Motor Assessment Scale, the Barthel Index and the nottingham extended Activities of Daily living scale (neADl). The study population consisted of 100 patients with stroke consecutively admitted to the Community health Centres for therapy. The data was analysed using inferential and descriptive statistics. The majority of the participants were not able to climb stairs, travel on public transport, wash dishes, do washing, do household chores and shopping, socialize and manage the garden at six months post stroke. A significant improvement was noted in the ability of the participants to perform basic activities of daily living between baseline and two months, but not between two and six months. There was however a significant improvement in their ability to perform instrumental activities of daily living between two and six months. Although the participants were able to perform basic activities of daily living enabling them to be independent in their homes, they were unable to perform instrumental activities of daily living which limited their functioning in the community. There is a need for therapists to include activities which could facilitate re-integration into the community in their rehabilitation of patients with stroke.