Gorinienė, Galinda

Цель исследования — опенка факторов, влияющих на эффективность кинезотерапии во время острого периода заболевания у пациентов, перенесших инфаркт головного мозга. Обследованы 40 больных с инфарктом головного мозга в остром периоде в возрасте от 45 до 74 лет. Пациентам 5 раз в нед проводилась индивидуальная кинезотерапия продолжительностью 30—45 мин. Эффективность кинезотерапии (динамика двигательных функций) оценивалась по тесту функциональной независимости (FIM) и шкале оценки движений (MAS) до и после курса восстановительного лечения. В протоколе исследования отмечались: пол, возраст, индекс массы тела больного, локализация повреждения головного мозга, степень пареза (гемиплегия или гемипарез), наличие афазии, перенесенные заболевания до инфаркта и их количество, продолжительность периода от развития инсульта до начала применения кинезотерапии, мотивация больного, участие близких пациента в реабилитационном процессе. Двигательные функции у пациентов с инфарктом головного мозга после процедур кинезотерапии в конце первого этапа реабилитации д

The purpose of this survey was to compare quality of life between survivors of stroke and the general population with regard to daily activities, health and emotional state. We surveyed a random group of 508 Kaunas residents, aged between 25 and 84 years, who survived the first stroke. The control group was made up of 508 sex-and age-matched stroke-free residents of Kaunas. We used the SF-12 quality of life questionnaire. Logistic regression was applied to evaluate the subjects for quality of life with regard to health, daily routine and mental state. Health was rated as very good by 1% of patients and 24,4% of controls (p=0,001) and as poor by 78,9% and 26,4%, respectively (p=0,001). The activities of 35,2% of patients and 3,5% of controls were impaired by their health (p=0,001). State of health or emotional problems restricted social relationhip in 19,3% of patients and in 1,6% of controls (p<0,05). Social activities were mostly impaired in patients after cerebral stroke (odds ratio(OR=36,7). Stroke also caused depression (OR=16) and limited domestic activities (OR=15,5).

The population of Kaunas was studied in 2004-2006. The main group included 508 patients with first-ever stroke and the control group included 508 age- and sex-matched people randomly selected from population. The SF-12 quality of life questionnaire in the domains of physical and mental health was used. The significant inverse correlation (p<0.05) between the physical health and the age was found both in patients (r=0.34) and controls (r=-0.64) and controls (r=-0.64). The scores of physical health were higher in men (p<0.001) as compared to women only in the control group. The physical health of Livonian patients was better (p<0.008) than that of patients of other ethnic groups. People living alone scored their physical health lower as in the control (p<0.01) as well in main (p<0.008) groups. The physical health of working people was better (p<0.005) in both groups. In both groups, subjects with higher education and those not living alone reported themselves in better health regardless of sex compared to people with lower education and/or those living alone and/or unemployed.

An aim of the present study is to evaluate the risk factors for death after a first-ever stroke within one year after stroke onset in the Kaunas population. The patient's group consisted of 331 men and women with a first-ever stroke who were treated in two Kaunas hospitals during 1997-1998. The data were collected using a "hot pursuit" approach. The methods used were those applied for the EC BIOMED-2 study. All stroke patients were followed up for one year. The end-point of the present study was death due to any cause. The relative risk estimates were based on the Cox model. Age at disease onset, impaired consciousness and incontinence were the only independent predictors of death during the first 12 months after a first-ever stroke. An increase of the patient's age by one year increased the risk of death by 4%. The impaired consciousness was associated with a 3-fold (relative risk (RR) =2,76; p=0,004) and incontinence with a 4-fold (RR=3,56; p < 0,0001) risk of death during the first year after initial stroke. In addition to the factors relating to the severity of stroke, only age was a predictor of a poor outcome after a first-ever stroke.

To evaluate outcome of stroke during first 12 months of the illness, 311 men and women from Kaunas who survived the first stroke in 1997 were studied. Patients were followed up for 12 months in accordance to the BIOMED-2 program protocol. The average age of patients was 69,8±0,64 years (68,1±0,99 years for men and 70,8±0,89 years for women). The percentage of survival for 12 months after stroke was 72,7 % for men (95% CI 63,9-80,40 and 71,4% for women (95% CI 64,8-77,4%). During the first 3 months of the illness, 11 patients were readmitted to a hospital: 7 patients (3women and 4 men) due to worsening of their health status, 4 - due to a recurrent stroke from which 1 of these 4 patients died. The functional status of patients who received rehabilitation in the hospital of during the first three months after the event of stroke was improved by 2,38±0,33 points on average (p=0,006). The functional status of patients without rehabilitation did not change (0,35±0,51 pints, p<0,05). An assessment of the patients' functional status 12 months after the first stroke revealed a negative tendency among those who received rehabilitation treatment. The functional status of the patients without rehabilitation treatment tended to improve. The results presented support the importance of early rehabilitation treatment which should be aspplied to every stroke patient.

An aim of the study was to evaluate volume of medical care for stroke patients in Kaunas, Lithuania. Patients with first-ever stroke admitted to 2 Kaunas municipal hospitals have been registered. Data have been collected according to the requirements of the EC BIOMED-2 Program "Towards cost-effective stroke care" using standardized questionnaires. In total 331 patients (121 men and 210 women, mean age 69,8 +/- 0,64 years) were studied, 52% being admitted to the hospital during the first 6 h of the illness and over two thirds during the first 24 h. Most of patients (85%) were hospitalized into general neurological wards. Computed tomography of the brain was performed in one third of the patients. More than two thirds did not undergo any of the possible neurodiagnostic procedures. During staying in the hospital, rehabilitation was launched for 53,2% of patients. Out of all patients survived (83,5%), 29,9% were discharged to the rehabilitation unit. The results revealed that the level of medical care for a stroke patient appeared to be rather moderate: delay time for hospital medical care was too long, proportion of diagnostic examinations was too low and the volume of rehabilitation and social services were not sufficient.