Effectiveness of comprehensive rehabilitation of patients after a stroke in terms of changes in clinical and functional characteristics

Objective: To identify the main clinical syndromes in patients and the corresponding domains of individual profiles of the International Classification of Functioning (ICF); to assess the effectiveness of rehabilitation using assessment scales, clinical syndromes, and indicators of rehabilitation profiles of ICF.

Methods: During the rehabilitation course, 38 stroke patients were examined using clinical examination data, ICF instruments, and standard rehabilitation scales.

Results: The domains of function (muscle strength, muscle tone, short-term memory), activity and participation (hand use, walking, changes in body position), and context factors (items for everyday use, family, and immediate family) were identified as the most frequently represented in patient profiles. There were correlations between neurological syndromes (neglect, hemianopsia) and activity domains (doing housework, maintaining the daily routine). Activity domains were established that most reliably reflect the effectiveness of rehabilitation with a significant improvement in neurological status (hand use, walking, posture change, and overcoming stress).

Conclusions: The use of ICF individual rehabilitation profiles in assessing the clinical and functional status of patients after a stroke helps to identify the leading clinical syndromes and the corresponding limitations of activity and participation, demonstrates the prospects for using rehabilitation profiles both for constructing prognostic models for certain activity limitations and makes it possible to identify the most significant problems for patients, and set personalized rehabilitation goals.