Planning rehabilitation with elements of active movement for brain-damaged patients.

Background. Much research has been done in recent years on optimizing rehabilitation by increasing effectiveness, shortening hospitalization, and reducing cost. One of the more interesting solutions that has been proposed is rehabilitation with elements of active movement, conducted on the basis of strategic planning in cooperation with the patient. The goal of the present study was to evaluate the effectiveness of the strategic approach to the motor rehabilitation of persons with brain damage. Material and methods. We studied 36 brain-damaged patients, divided into two groups paired for age and gender. In the control group of 18 persons, traditional, comprehensive rehabilitation was used. The experimental group was rehabilitated based on an individualized strategic plan with motor elements. Outcome was evaluated by clinical observation, the Polish version of the Functional Independence Measure (FIM), and the Self-Evaluating Scale of Progress in Rehabilitation. Results. Progress was seen in both groups on many FIM parameters, which points to the effectiveness of the techniques used in the standard program; however, the results in Group E were significantly better in terms of functional independence and psycho-social functioning. The patients from Group E were much more satisfied with what they had accomplished than the controls. Conclusions. Rehabilitation planning with elements of active movement maximizes the benefits obtained from the methods used. The strategic approach helps the patient become more independent, increases patient satisfaction, and improves motivation to take an active part in exercises.