Alteration of Functional Independence Indicators in the Process of Rehabilitation of patients with Post-stroke Motor Dysorders

Acute cerebral stroke is the leading cause of adult disability worldwide. Motor dysfunction is particularly common and causes severe disability in many cases. Complete recovery of physical function is likely in only 14 % of stroke survivors, 25 to 50% require assistance for fulfillment of Activities of Daily Living (ADL), others develop serious long-term problems. Several instruments or scales that assess ADL are currently available in rehabilitation, Barthel Index (BI) and Functional Independence Measure (FIM) being most widely accepted, best validated and reliable. We studied 60 acute stroke patients with various degrees of motor deficiency. 26 patients were treated by standard rehabilitation protocol; 34 patients underwent neuro-muscular electric stimulation (NMES) in addition to standard rehabilitation regimen. Functional independence was measured by BI and FIM instruments, prior to rehabilitation course and at the end of acute stage. BI increased in both groups, but the increase was more prominent in NMES group and this difference was statistically significant (p<0.01). FIM increased in both groups as well and improvement was more apparent in NMES group (15.0 vs 9.7), although in this case this difference was not quite significant statistically (p=0.12). We conclude that neuro-muscular electric stimulation exerts a positive effect on ADL performance in the patients with post-stroke motor disorders. Lesser sensitivity of FIM instrument in given situation can be explained by its extensive cognitive-behavioral component. Barthel Index focuses primarily on motor functions and is more applicable for assessment of the patients with post-stroke motor deficiency