Title OPORAVAK FUNKCIONALNIH SPOSOBNOSTI BOLESNIKA NAKON ISHEMIJSKOG I HEMORAGIJSKOG MOŽDANOG UDARA Title (english) RECOVERY OF FUNCTIONAL ABILITIES OF PATIENTS AFTER ASCHEMIC AND HEMORRHAGIC STROKE Author Jasna Imgrund Mentor Mira Bučuk (mentor)Committee member Toni Valković (predsjednik povjerenstva)Committee member Olivio Perković (član povjerenstva)Committee member Mira Bučuk (član povjerenstva)Granter University of Rijeka Defense date and country 2018-07-20, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Cilj ovog istraživanja je ustanoviti da li postoji razlika u oporavku funkcionalnih sposobnosti između bolesnika s preboljelim ishemijskim i hemoragijskim moždanim udarom koristeći koncept Proprioceptivne Neuromuskularne Facilitacije (PNF koncept).
Ispitanici i metode: Ovo retrospektivno istraživanje obuhvatilo je 50 bolesnika koji su liječeni na Klinici za neurologiju Kliničkog bolničkog centra u Rijeci pod dijagnozom moždanog udara u razdoblju od 01.01.2017. do 31.12.2017. Bolesnici su bili podijeljeni u dvije skupine: na bolesnike s ishemijskim moždanim udarom (25) i na bolesnike s hemoragijskim moždanim udarom (25). Prosječna dob ispitanika iznosila je 75±8 godina. Najmlađi ispitanik imao je 56 godina, a najstariji 92 godine. U radu su bili korišteni podaci iz medicinske dokumentacije KBC-a Rijeka: dob, spol, komorbiditeti, klasifikacija moždanog udara (ishemijski ili hemoragijski), FIM test proveden kod prijeme i kod otpusta bolesnika. Faktori uključenja bili su: bolesnici s preboljelim ishemijskim i hemoragijskim moždanim udarom u području prednje i srednje moždane arterije ( a.cerebri media, a. cerebri anterior), a faktori isključenja: ishemijski moždani udar u području vertebrobazilarnog sliva, hemoragijski moždani udar u području vertebrobazilarnog sliva, ishemijski moždani udar u području karotidnog sliva, druga oboljenja središnjeg živčanog sustava.
Rezultati: U vremenskom periodu od 01.01.2017. godine do 31.12.2017. godine u Klinici za neurologiju Kliničkog bolničkog centra u Rijeci liječeno je 889 bolesnika s dijagnozom moždanog udara. Za istraživanje odabrano je 25 ispitanika s hemoragijskim i 25 ispitanika sa ishemijskim moždanim udarom. Pokazalo se da nakon primjene PNF koncepta, znatno bolji funkcionalni oporavak prikazuju bolesnici oboljeli od ishemijskog moždanog udara. Također bolesnici kod kojih imamo prisutstvo komorbiditeta, imaju lošiji ukupni rezultat na FIM testu kod prijema, iako kod otpusta pokazuju jednake rezultate kao bolesnici bez komorbiditeta. Dob i spol nemaju utjecaj na konačni funkcionalni oporavak bolesnika.
Zaključak: Motorička i kognitivna oštećenja kod moždanog udara glavna su prepreka u povratku aktivnostima svakodnevnog života većine bolesnika. Nakon ishemijskog moždanog udara bolesnici ostvaruju bolje rezultate u funkcionalnim testovima, a komorbiditeti nisu od značaja u ostvarivanju dobrih rezultata. Potrebno je pridati pažnju dobroj prevenciji, a kada se moždani udar razvije potrebno je dobro zbrinuti i individualno pristupiti rehabilitacijskom postupku.
Abstract (english) The aim of this study is to determine whether there is a difference in the recovery of functional abilities between patients with underlying ischemic and hemorrhagic stroke using the concept of Proprioceptive Neuromuscular Facilitation (PNF concept).
SUBJECTS AND METHODS
This retrospective study included 50 patients treated at the Clinic for Neurology of the Clinical Hospital Center in Rijeka under a stroke diagnosis in the period from 01.01.2017. until 31.12.2017. Patients were divided into two groups: patients with ischemic stroke (25) and patients with hemorrhagic stroke (25). Average age of respondents was 75 ± 8 years. The youngest examinee was 56 years old and the oldest 92 years.
The data from medical documentation of KBC Rijeka were used in this stydy: age, sex, comorbidity, stroke classification (ischemic or hemorrhagic), FIM test at reception and on discharge of patients.
Inclusion factors were: patients with a history of ischemic and hemorrhagic stroke in the area of the front and middle cerebral arteries (a.cerebri media, and cerebral anterior), and exclusion factors: ischemic stroke in the vertebrobazile basin area, hemorrhagic stroke in the vertebrobasilar area basin, ischemic stroke in the area of the carotid line, other diseases of the central nervous system.
RESULTS
During the period from 01.01.2017. until 31.12.2017, 889 patients with stroke diagnosis were treated in the Clinic for Neurology of the Clinical Hospital Center in Rijeka.
25 subjects with hemorrhagic and 25 subjects with ischemic stroke were selected for this research. It has been shown that after the application of the PNF concept, patients with ischemic stroke show a significantly better functional recovery.
Furthermore, patients with comorbidities have a lower total score on the FIM test at reception, although at discharge they show the same results as non-comorbid patients. Age and gender do not affect the final functional recovery of the patients .
CONCLUSION
Motor and cognitive impairment in stroke is the main obstacle in returning to the activities of daily living of the most patients. After the ischemic stroke, the patients achieved better results in a functional tests, and the comorbidities are not of importance in achieving a good results. Attention should be paid to a good prevention, and when the stroke develops it is necessary to provide a good care and the individual access to the rehabilitation procedure.
Keywords
Functional Independence Measure (FIM)
hemoragijski moždani udar
ishemijski moždani udar
koncept Proprioceptivne Neuromuskularne Facilitacije (PNF koncept)
moždani udar
rehabilitacija
Keywords (english)
Functional Independence Measure (FIM)
hemorrhagic stroke
ischemic stroke
concept of Proprioceptive Neuromuscular Facilitation (PNF Concept)
Stroke
rehabilitation
Language croatian URN:NBN urn:nbn:hr:184:746504 Study programme Title: Graduate university study of Physiotherapy (Biomedicine and Healthcare; clinical medical sciences) Type of resource Text File origin Born digital Access conditions Access restricted to students and staff of home institution Terms of use Repository Repository of the University of Rijeka, Faculty of Health Studies Created on 2019-04-04 09:02:02
