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The aim of this study was to determine the differences in reaction time, reaction complexity, and movement speed depending on age. Material and Methods. The study included 40 healthy subjects (20 young and 20 older women and men). The study was conducted at the Human Motorics Laboratory, Lithuanian Sports University. An analyzer DPA-1 of dynamic upper and lower limb movements was used for the research purposes. Results. The reaction time of the right arm of the young subjects was 0.26 s (SD, 0.01) and that of the left arm was 0.25 s (SD, 0.02), when an accuracy task was performed. The reaction time of the older subjects was 0.29 s (SD, 0.03) and 0.28 s (SD, 0.03) for the right and left arms, respectively. The reaction time of the right leg of the young subjects was 0.26 s (SD, 0.02) and that of the left leg was 0.27 s (SD, 0.03). The reaction time of the right and left legs of the older subjects was 0.33 s (SD, 0.02) and 0.35 s (SD, 0.04), respectively. The reaction of the young subjects was almost two times faster compared with the older persons after the accuracy task with each limb was accomplished. Conclusions. In case of movements with arms and legs, reaction time and movement speed directly depend on the complexity of a task. Reaction time and movement speed are slower for the older subjects in comparison with the young ones; the results worsen in proportion to the increasing complexity of a task.

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The aim of the present work was to assess the influences of age, gender, and the severity of brain trauma on recovery of motor function using kinetotherapy. The study included 131 patients (99 men and 32 women) investigated during the acute phase of trauma in the Department of Brain Trauma, Clinical Hospital, Kaunas Medical University. After stabilization, 80 patients were transferred to the neurorehabilitation clinic and 51 were transferred to other rehabilitation centers. Motor function in the patients was assessed using the Clinical Outcomes Variable Scale (COVS) at the beginning and end of the acute trauma period and during early rehabilitation, i.e., at the beginning, 25 days later, and on completion. During the acute trauma period, patients had impairments to the abilities to turn over, sit, maintain balance while sitting, to move horizontally and vertically, walk, and use mobility aids, along with reductions in walking duration and speed, and difficulty in wheelchair mobility and hand functions. Kinetotherapy yielded high or intermediate levels of efficacy in 90% of the patients. The efficacy of kinetotherapy was significantly greater in young patients than in elderly and old patients (p < 0.05). Gender and trauma severity had no statistically significant effects on the efficacy of kinetotherapy (p > 0.05).

The aim of this study was to evaluate the recovery of functional status and effectiveness of the second-stage rehabilitation depending on the degree of cognitive impairment in stroke patients. Material and Methods. The study sample comprised 226 stroke patients at the Viršužiglis Hospital of Rehabilitation, Hospital of Lithuanian University of Health Sciences. Functional status was evaluated with the Functional Independence Measure, cognitive function with the Mini-Mental Status Examination scale, and severity of neurologic condition with the National Institutes of Health Stroke Scale. The patients were divided into 4 study groups based on cognitive impairment: severe, moderate, mild, or no impairment. Results. More than half (53%) of all cases were found to have cognitive impairment, while patients with different degree of cognitive impairment were equally distributed: mild impairment (18%), moderate impairment (17%), and severe impairment (18%). Improvement of functional status was observed in all study groups (P<0.001). In the patients with moderate and severe cognitive impairment, cognitive recovery was significantly more expressed than in other study groups (P<0.001). Insufficient recovery of functional status was significantly associated with hemiplegia (OR, 11.15; P=0.015), urinary incontinence (OR, 14.91; P<0.001), joint diseases (OR, 5.52; P=0.022), heart diseases (OR, 4.10; P=0.041), and severe cognitive impairment (OR, 15.18; P<0.001), while moderate and mild cognitive impairment was not associated with the recovery of functional status. Conclusions. During the second-stage rehabilitation of stroke patients, functional status as well as cognitive and motor skills were improved both in patients with and without cognitive impairment; however, the patients who were diagnosed with severe or moderate cognitive impairment at the beginning of second-stage rehabilitation showed worse neurological and functional status during the whole second-stage rehabilitation than the patients with mild or no cognitive impairment.

Isometric eversion and inversion testing using the Biodex 4 Pro system is a reliable method. The authors suggest that the angle of 7° of inversion is the best for isometric eversion and inversion testing.

The aim of the study was to determine the functions influencing the recovery of the motor and cognitive functions and general functional state in cerebral stroke patients during the second rehabilitation stage, and their prognostic value. The contingent and methods. The studied contingent consisted of 226 cerebral stroke patients: 109 men and 117 women who had undergone the second stage rehabilitation in Viršužiglis Rehabilitation Hospital, a branch institution of Hospital of Kaunas University of Medicine. The mean age of the patients was 67.8±10.4 years. The greatest proportion of the patients (88.5%) was with cerebral infarction. The mean duration of rehabilitation was 38.8±8.9 days. The functional state of the patients was assessed by functional IndependenceMeasure; the cognitive function, by the short mental function study method; the severity of the stroke, in accordance with the National Institutes of Health Stroke Scale. The prognostic value of the factors was evaluated by the logistic regression method. A study analyzed the influence of patient’s gender, age, social factors, clinical symptoms and signs, risk factors for stroke, comorbities, the character and localization of the stroke, and psychoemotional state on the recovery of capacities related to motor and cognitive functions, and restoration of general functional state. Results. During the second stage of rehabilitation, the score of the functional state of the patients assessed by the Functional Independence Measures significantly improved from 65.9±20.3 to 93.5±20.9 (P<0.0001). At the end of rehabilitation, good efficacy of rehabilitation was determined in 64.2% of the rehabilitees; moderate, in 19.4%; insufficient, in 16.4%. In prognosing insufficient recovery of general functional state during the second stage of rehabilitation, the following factors had a significant influence: extremity hemiplegia, disturbed cognitive functions, urination impairment, joint and heart diseases. In cases of insufficient recovery of capacities linked with motor function in the second stage of rehabilitation, exerted extremity hemiplegia, neglect of the affected side of the body, urination impairments, joint and heart disorders had a significant influence, whereas localization of the stroke lesion in the left hemisphere of the brain, impairment of cognitive functions (disturbance of speech and perception), urination disturbances – on the insufficient recovery of capacities related to cognitive functions. Conclusion. Insufficient efficacy of rehabilitation of the rehabilitees with cerebral stroke in the second stage of rehabilitation was influenced by impairment of motor and cognitive functions, urination disturbancies, and comorbidities. In forming individualized inpatient rehabilitation programs and prognosing the further health care of patients with cerebral stroke, it is important to pay attention to factors, influencing insufficient efficacy of rehabilitation.

Raktažodžiai: galvos smegenų insultas, reabilitacija, veiksniai. Santrauka. Galvos smegenų insulto pasekmės daugumai ĮvadasGalvos smegenų insultas pripažintas viena pagrindinių sergamumo, mirtingumo ir ilgalaikės negalios priežasčių visame pasaulyje (1). Nustatyta, kad kas trečias pacientas po insulto miršta per pirmuosius metus, kas trečio paciento funkcinė būklė normalizuojasi, kas trečio paciento funkcinė būklė išlieka vidutinio sunkumo ir sunki (2).Moksliniais tyrimais įrodyta, kad stacionarinė reabilitacija gali pagerinti persirgusiųjų insultu funkcines baigtis ir gyvenimo kokybę (3). Beje, pacientų, kuriems nustatyta ta pati galvos smegenų insulto diagnozė, funkcinis atsigavimas gali būti labai skirtingas. Todėl ligos pradžioje tikslinga įvertinti, kurie pacientai pasiektų didžiausią funkcinį pagerėjimą, o kuriems būtų galima taikyti intensyvią ir efektyvią reabilitacijos programą (4, 5).Pastaraisiais metais atliekami moksliniai tyrimai, kurių tikslas -įvertinti pacientų galimybę pasiekti tam tikrą funkcinės būklės lygį, pavyzdžiui, savarankiškumą tam tikru laiko momentu (6) ir nustatyti veiksnius, kuriais remiantis galima būtų prognozuoti pacientų, persirgusių insultu, funkcinės būklės atsigavimą bei atrinkti pacientus, kurių ligos baigtis gera ir kurių bloga (7).Kuo anksčiau ir tiksliau bus prognozuota insulto baigtis ir įvertinti veiksniai, turintys įtakos ligos baigčiai, tuo reabilitacijos specialistams bus lengviau parengti reabilitacijos programą ir suteikti informaciją pacientui ir jo šeimos nariams apie funkcinės būklės atsigavimo galimybes, planuojant ligonio išrašymą iš ligoninės ir numatant namų aplinkos pritaikymo ir bendruomenės pagalbos poreikį pacientui grįžus į namus (5,7,8).Straipsnio tikslas -apžvelgti veiksnius, turinčius įtakos galvos smegenų insulto baigčiai. Dažniausiai mokslinėse studijose analizuojami pacientų, persirgusių insultu, funkcinės būklės atsigavimo prognoziniai veiksniai yra amžius, lytis, insulto sunkumas, šlapimo nelaikymas, sąmonės sutrikimas ligos pradžioje, pažintinių funkcijų sutrikimas, paralyžiaus sunkumas, sutrikęs gebėjimas išlaikyti pusiausvyrą sėdint, funkcinė būklė hospitalizuojant, pažeistos pusės neigimo sindromas, sunki sveikatos būklė dėl gretutinės patologijos, depresija, socialinės pagalbos apimtis.Lytis. Literatūroje pateikiami nevienareikšmiai tyrimų duomenys apie lyties įtaką ligos baigčiai. Yra įro-dymų, jog tarp išgyvenusių po insulto pacientų vyrų funkcinės būklės atsigavimas yra daug geresnis nei moterų. Kelių studijų duomenimis, moterims išlieka ryškesnių motorinių, pažintinių funkcijų pažeidimų ir daugiau jų kasdienėje veikloje reikalinga kitų žmonių pagalba (9-11).S. M. Lai ir kiti tyrė vyrų ir moterų, persirgusių insultu, gebėjimo atlikti pagrindinę kasdienę veiklą po insulto skirtumus. Tyrėjai padarė išvadą, kad ikiinsul-