The aim of present work was to investigate the psychosocial factors of quality of life associated with health in patients with impaired motor functions. Representative sample consisted of 126 patients with impaired motor functions of various etiologies receiving medical rehabilitation. The contribution of socio-demographic and anamnesis characteristics (gender, age, education, marital status, social status, number of previous hospitalizations) in the formation of the quality of life has studied. The patients age, social status (retirement) are designated as significant factors. At the same time gender, marital status, education level, number of hospitalizations for rehabilitation treatment is not associated with the subjective assessment of the quality of life in the examined group of patients.
Purpose of the study: to examine sensibility of baroreceptors and the autonomic nervous in the passive orthostatic test in patients with chronic impairment of consciousness due to severe brain damage and determine their role in the rehabilitation process.Materials and methods. The study included 30 patients with long-term impairment of consciousness due to severe brain damage (group 1), 10 of them being in the vegetative state (VS) and 20 being in the minimally conscious state (MCS). Craniocerebral trauma was the main cause of severe damage in that group (53% of patients). The comparison group included 24 patients with focal neurological symptoms caused predominantly — 79.2% of cases — by cerebrovascular disorders (group 2). The control group (group 3) consisted of 22 healthy volunteers of a comparable age. All measurements were done with the help of a Task Force Monitor 1030i (CNSystem, Austria) in the course of passive orthostatic test at 0°–30°–60°–0°. Changes in the power of low-frequency (LFS) and highfrequency spectrum (HFS) of heart rate variability and baroreceptors sensibility (BRS) were analyzed. Statistical analysis was carried out using Statistica-10 software. Significance of inter-group differences on unrelated samples was determined by the Mann–Whitney U-test. Differences between groups were considered significant at P 0.05.Results. Maximal background values of BRS were found in the control group. In group 1 and 2 patients, considerable decrease of that index was noted, which was proportional to the brain damage severity. Similar dynamics was observed for the indices of autonomic nervous system sensibility (LFS and HFS). The main trend of orthostatic changes of BRS, LFS, and HFS was characterized by progressive decrease of the indices with increase of the patients’ angle of tilting and their return to the baseline level after the patients were put back into the horizontal position. 4 patients of group 1 (14%) displayed signs of orthostatic disorders upon tilting to 30°: in 3 cases, orthostatic hypotension was observed, and in one case the postural orthostatic tachycardia syndrome (POTS) was diagnosed. Those patients differed by lower BRS and higher sympathetic system activity (LFS) vs. the same indices of other patients in that group.Conclusion. Patients with chronic impairment of consciousness during the post-comatose period after a severe brain damage display a significant decrease of baroreceptors sensibility and autonomic nervous system disorders manifesting in significantly lower activity of the sympathetic and parasympathetic systems. The prominence of such disorders is associated with brain damage severity. Their risk of developing orthostatic hypotension during tilting towards a vertical position is higher in patients who have lower baroreceptors sensibility, and this should be taken into account beginning the process of their verticalization.
The purpose of present work is to study the dynamic characteristics of the personality (current psycho-emotional state, adherence to treatment) of patients with movement disorders in order to identify the main targets of psycho-correctional work. 363 patients were examined: 195 after stroke and 168 with degenerative-dystrophic diseases of large joints and spine. The following tools were used: SCL-90-R, Tampa Scale, Compliance Level Questionnaire, expert assessment of compliance by the attending physician and physical therapy instructor on a five-point scale. High level of somatization of anxiety and depressive feelings and psychological component of kinesiophobia (fear of movement), manifested in convincing patients that their illness is an insoluble medical problem were marked as targets of psycho-correctional works during the study. The contribution of personal compliance, understood as the implicit willingness of the patient to be committed to treatment and to the achievement of satisfactory compliance, registered in the rehabilitation process, is studied. The expediency of drawing up individual programs of psychological rehabilitation on the basis of preventive diagnostics of compliance is shown, while the average level of the mentioned indicator is determined as optimal for the effectiveness of rehabilitation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.