The influence of patient motivation on the motor function restoration during stroke recovery. Preliminary results of a clinical study

Abstract

Background: Acute cerebrovascular accidents lead to disability. The most important task is the rehabilitation and adaptation of these patients to society. Impaired motivation reduces the effectiveness of rehabilitation measures. Aims: to assess the motivation of patients during the recovery period of stroke; to identify relationships between the level of motivation, duration and type of stroke, cognitive and demographic indicators. To determine the influence of the patient's initial level of motivation on the effectiveness of the rehabilitation measures taken to restore motor function, balance and overall functional independence. Materials and methods: a prospective study of 36 patients with hemiparesis in the early and late recovery period of stroke. All patients were assessed according to the International Classification of Functioning, Disability and Health (ICF), the Functional Independence Scale (FIM), the Rivermead Mobility Index, the degree of paresis according to the Medical Research Committee (MRC) scale, the level of spasticity according to the Ashford scale, and the risk of falls assessment according to Morse scale, assessment of function of the upper and lower extremities using the Fugl-Meyer (FM) test, balance assessment using the Berg scale. Results: a significant positive correlation was found between the patient’s motivation and his cognitive indicators: the integral level of the BTLD (r = 0.653, p = 0) and the integral indicator of the Mini-Mental State Examination (MMSE) (r = 0.536, p = 0.001). There was no convincing evidence of a connection between the level of motivation and such indicators as gender, age of the patient, BMI, time since stroke, type and location of stroke, level of pain, level of functional independence and motor impairment. Although there was a trend toward greater positive changes in functional recovery of the arm, leg, balance, and overall independence, there was no significant difference between groups. Conclusion: a significant relationship was identified between motivation and cognitive functions, which can act as predictors of the level of motivation in patients when planning rehabilitation activities. There is a trend toward positive changes in functional recovery of the arm, leg, balance, and overall independence in patients with high level of motivation.