THE IMPACT OF PHYSIOTHERAPY INTERVENTION ON OUTCOME IN PATIENTS WITH ISHEMIC STROKE

Uvod. Moždani udar nastaje kao posljedica poremećaja moždane cirkulacije čime dolazi do prekida moždanih funkcija. Drugi je uzrok smrtnosti kako u svijetu, tako i u Hrvatskoj. Prema mehanizmu nastanka moždani udar dijelimo na: ishemijski, hemoragijski i subarahnoidalno krvarenje. Ishemijski moždani udar nastaje zbog hipoperfuzije i slabe opskrbe krvne žile kisikom kao posljedica okluzije arterije. Cilj. Cilj istraživanja bila je procjena stanja bolesnika s ishemijskim moždanim udarom pomoću NIHSS skale, FIM testa i Barthelovog indeksa prilikom prijama u bolnicu i prilikom otpusta iz bolnice. Osim toga, cilj je bio pokazati utječe li fizioterapijska intervencija na ishod liječenja bolesnika s ishemijskim moždanim udarom i na koji način. Ispitanici i metode. U istraživanju je sudjelovalo 34 pacijenta zaprimljena na Klinici za neurologiju KBC-a Rijeka. Procjena je izvršena pomoću NIHSS skale, FIM testa i Barthelovog indeksa prilikom prijama i kod otpusta iz bolnice, a tijekom boravka u bolnici svakodnevno se provodila fizioterapija. Program fizioterapijske intervencije sastojao se od vježbi opsega pokreta, snaženja i istezanja u krevetu, vertikalizacije, vježbi u sjedećem i stojećem položaju, trening hoda te vježbi balansa i koordinacije. Rezultati. Analizom 34 ispitanika dokazana je statistički značajna razlika u ocjeni stupnja deficita bolesnika s ishemijskim moždanim udarom na početku i na kraju fizioterapijske intervencije. Vrijednost FIM testa i Barthelovog indeksa veća je kod otpusta iz bolnice nego prilikom prijama u bolnicu, što označava poboljšanje funkcionalne neovisnosti jer veća vrijednost FIM testa i Barthelovog indeksa označava bolju funkcionalnost i manju ovisnost. Zaključak. Iz provedenog istraživanja može se zaključiti da fizioterapijska intervencija tijekom hospitalizacije utječe na smanjenje deficita, poboljšanje funkcionalnosti i motorike nakon moždanog udara.Introduction. A stroke occurs as a result of cerebral circulation disorder which leads to an interruption of brain functions. It is the second cause of deaths both in the world and in Croatia. Based on the mechanism of occurrence, stroke is classified into: ischemic, hemorrhagic, and subarachnoid haemorrhage. An ischemic stroke occurs due to the hypoperfusion and the poor delivery of oxygen to the blood vessel as a result of arterial occlusion. Objective. The objective of this research was the evaluation of the conditions of patients with ischemic stroke using the NIHSS scale, the FIM test, and the Barthel Index at the time of admittance to a hospital and at the time of discharge. Apart from that, the objective was to determine whether or not a physiotherapy intervention affects the outcome of treatment of patients with ischemic stroke and in what manner. Test subjects and methods. 34 patients who were admitted to the Clinic for Neurology of the Rijeka Clinical Hospital Center participated in the research. The evaluation was conducted using the NIHSS scale, the FIM test, and the Barhel Index during the admittance and discharge from the hospital, while during the stay at the hospital, an everyday physiotherapy treatment was being carried out. The physiotherapy intervention programme consisted of movement range exercises, strenghtening and stretching in bed, verticalization, exercises in sitting and standing position, walking training, and the exercises of balance and coordination. Results. Through the analysis of 34 test subjects, a statistically significant difference in the evaluation of the deficit degree of patients with ischemic stroke at the beginning and the conclusion of physiotherapy intervention was proven. The value of the FIM test and the Barthel Index was higher during the admittance to the hospital than during the discharge from the hospital, which signifies an improvement of the functional independence, since a higher value of the FIM test and the Barhel Index means better functionality and lesser dependence. Conclusion. From the conducted research it can be concluded that a physiotherapy intervention during the hospitalization affects the decrease of deficit, the improvement of functionality, and the motorics following a stroke