Molchanova E E, Drobyshev V A
Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russia.
Novosibirsk State Medical University of the Ministry of Health of Russia, Novosibirsk, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2020;97(4):11-16. doi: 10.17116/kurort20209704111.
All parameters of the quality of life of patients after cerebral stroke are reduced. There is relatively little information about the impact of stroke and the features of rehabilitation technologies in the acute period on the quality of life of patients in the period of residual events.
The study of quality of life indicators for patients who have suffered an ischemic stroke after three years from the onset of the condition, as well as the incidence of recurrent strokes and mortality in the residual period, depending on the rehabilitation methods in the acute period.
In order to identify the frequency of recurrent strokes and the mortality rate in the post-stroke period, a three-year prospective observation of 330 patients (220 patients of the main group, whose early rehabilitation was optimized using various methods of reflexotherapy, and 110 patients of the comparison group who underwent traditional pharmacotherapy in combination with physiotherapy and Exercise therapy) was performed. To study the quality of life (using the MOS SF-36 questionnaire), 140 people from the main group and 40 from the comparison group were selected by random sampling.
The main group showed a lower incidence of recurrent stroke episodes (3.2%) and mortality (1.8%) compared with the comparison group (12.7 and 13.6%, respectively). Comparison of quality of life indicators in the studied groups revealed higher values for all subscales of the MOS SF-36 questionnaire in the group of patients who received reflexotherapy in the acute period of ischemic stroke, and for several subscales, the differences were statistically significant: in the acute period, by subscales RP (<0.05), GH (<0.05), VT (<0.05), SF (<0.05), RE (<0.05), MH (<0.05), after three years - by subscales PF (<0.05), GH (<0.05), VT (<0.01) and MH (<0.05).
Thus, optimization of early rehabilitation by including from the first days reflexotherapy methods helps to improve the indicators of both the physical and mental components of the patients' health not only in the acute but also in the long term, and also helps to reduce the frequency of repeated strokes and the mortality rate in the post-stroke period.
脑卒中后患者生活质量的所有参数均降低。关于卒中的影响以及急性期康复技术对残留期患者生活质量的特征，相关信息相对较少。
研究缺血性卒中发病三年后患者的生活质量指标，以及残留期复发性卒中的发生率和死亡率，这取决于急性期的康复方法。
为了确定卒中后复发性卒中的频率和死亡率，对330例患者进行了为期三年的前瞻性观察（主要组220例患者，其早期康复通过各种反射疗法进行优化，对照组110例患者接受传统药物治疗并结合物理治疗和运动疗法）。为了研究生活质量（使用MOS SF - 36问卷），通过随机抽样从主要组中选取了140人，对照组中选取了40人。
与对照组相比，主要组复发性卒中发作的发生率（3.2%）和死亡率（1.8%）较低（对照组分别为12.7%和13.6%）。研究组生活质量指标的比较显示，在缺血性卒中急性期接受反射疗法的患者组中，MOS SF - 36问卷所有子量表的值更高，并且对于几个子量表，差异具有统计学意义：在急性期，按子量表RP（<0.05）、GH（<0.05）、VT（<0.05）、SF（<0.05）、RE（<0.05）、MH（<0.05）；三年后，按子量表PF（<0.05）、GH（<0.05）、VT（<0.01）和MH（<0.05）。
因此，从第一天起就纳入反射疗法方法优化早期康复，不仅有助于在急性期而且在长期改善患者身心健康的身体和心理成分指标，还有助于降低卒中后复发性卒中的频率和死亡率。
