Integrated training sessions by a neuropsychologist and a speech therapist in the rehabilitation of persons in chronic critical condition by the example of FRCC ICMR

Abstract

BACKGROUND: The study relevance is associated with the significant complexity of the treatment of patients with chronic impairment of consciousness. A successful treatment of chronic impairment of consciousness is formed from a comprehensive medical and multidisciplinary rehabilitation efforts aimed at restoring the consciousness, including a combination of various pharmacological and non-pharmacological methods. Modern rehabilitation techniques, with a competent approach to their development and application, not only are characterized by a significant potential in the context of improving the quality of life, but are also capable of providing a significant progress in alleviating the severity of the disease. At the same time, there are still no reliable methods in this area, which is a significant medical and social problem. AIM: Approbation and evaluation of the effectiveness of integrative sessions by a neuropsychologist and a speech therapist in the rehabilitation of persons in chronic critical condition, by the example of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology (FRCC ICMR). MATERIALS AND METHODS: 40 patients with diagnosed chronic impairment of consciousness were examined 20 patients in the main group and 20 patients in the control group. The rehabilitation work was carried out with the main group patients for 12 months, based on a developed system of integrated sessions of a neuropsychologist and a speech therapist. The evaluation of the rehabilitation work effectiveness was carried out at the time points of 6 and 12 months by monitoring the dynamics of improvement at the level of consciousness according to the CRS-R scale. RESULTS: We describe in detail the methodology and practical experience of integrated sessions of a neuropsychologist and a speech therapist in the rehabilitation of persons in chronic critical condition provided at the FRCC ICMR. A stable improvement in the level of consciousness, according to the CRS-R scale, was shown in patients with chronic impairment of consciousness, who underwent the integrated sessions of a neuropsychologist and a speech therapist. CONCLUSIONS: We have proven the effectiveness of an integrative approach to the rehabilitation of patients with chronically impaired consciousness, based on combined sessions of a neuropsychologist and a speech therapist. It has been confirmed that the simultaneous use of complex neuropsychological and speech therapy effects (exercises given by a neuropsychologist with a focus on the tactile gnosis in combination with the methods of active speech therapy mechanical action, known as an activating speech therapy massage) can ensure the progress in the rehabilitation of patients with chronic impairment of consciousness in comparison with the same techniques applied in a sequential manner.