Вплив Фізичної Терапії Та Ерготерапії На Моторні Та Сенсорні Показники Пацієнтів Після Інсульту

Introduction. The purpose of the study: to substantiate the effectiveness of physical therapy and occupational therapy methods for people after ischemic stroke in the early recovery period. Materials and Methods. Material. A review of theoretical approaches and empirical studies of the impact of physical therapy and occupational therapy after stroke on the physical condition of patients was conducted. The study involved 40 people after ischemic stroke in the early recovery period (2-4 months after stroke) at the Volyn Regional Clinical Hospital, who were divided into the main (OG) and control (CG) groups of 20 people each. The patients had moderate hemiparesis, moderate cognitive impairment, could move independently (with a cane if necessary) and participate in performing all research tasks. Research methods: analysis of scientific and methodological literature, standardized tests and scales for assessing motor functions, balance, walking, upper limb function, daily activity, cognitive functions and quality of life.. Results. Current empirical studies indicate the feasibility of starting rehabilitation within the first two weeks after stroke. Rehabilitation activities in both groups were aimed at improving motor and sensory capabilities using individually selected exercises according to the patient's condition. In patients in the main group, the standard program was supplemented with mirror therapy, virtual reality technologies and exergaming, and the volume of training in basic (ADL) and instrumental (IADL) activities of daily living was expanded to increase functional independence. An important component of the author's program was the education of patients and their families. After the intervention, both groups showed a statistically significant improvement in the Berg Balance Scale (BBS), but in the main group the increase was greater (36.8% vs. 10.0%; p < 0.001). Intergroup analysis confirmed the statistically significant advantage of the author's physical therapy and occupational therapy program in restoring balance, postural control, and functional mobility in patients after stroke (t = 4.01; df = 38; p < 0.001). Both groups showed improvement in functional mobility and walking speed, however, in the main group the positive changes were more pronounced (p < 0.001, which was confirmed by the results of the TUG (t = 4.79; df = 38; p < 0.001) and 10-meter walk test (10MWT) (t = 3.04; df = 38; p = 0.004). The absolute increase in the Barthel index (BI), which determined the level of basic activities of daily living, in the OG was 2.5 times greater than in the CG and approached the minimum limitation of independence. The analysis showed that the average BI in the OG was statistically significantly higher than in the CG (t = 9.42; df = 38; p < 0.001). The average score of the Montreal Cognitive Assessment (MoCA), covering the main cognitive domains, in the OG increased by 35.3% from the baseline level, in the CG it increased by 12.2%. The absolute increase in cognitive functions in the OG was almost 2.8 times greater than in the CG with a statistically significant advantage of the OG (t = 3.87; df = 38; p < 0.001). Analysis of the Stroke Impact Scale (SIS) indicators, which was used for a comprehensive assessment of the quality of life and functional consequences of stroke, also demonstrated positive dynamics in both groups, with the average score in the OG increasing by 29.8%, in the CG increasing by 19.3%. Intergroup comparison of results (SIS) after the completion of rehabilitation also revealed a statistically significant advantage of the OG (t = 10.38; df = 38; p < 0.001).. Conclusions. Application of the author's physical therapy and occupational therapy program in patients in the early recovery (post-acute) period after ischemic stroke provided a statistically significant improvement in balance, postural control, functional mobility, walking speed, functional independence, cognitive functions and quality of life compared to the standard rehabilitation program (p < 0.001). The results obtained confirm the effectiveness of both rehabilitation programs, but the author's program demonstrated significantly higher effectiveness in restoring the functional capabilities of patients after ischemic stroke.