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 stroke recovery; identify relationships between the level of motivation, duration and type of stroke, and cognitive and demographic indicators; and determine the influence of the patient’s initial level of motivation on the effectiveness of the rehabilitation. MATERIALS AND METHODS: This prospective study analyzed 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; functional independence scale; Rivermead mobility index; degree of paresis according to the Medical Research Committee scale; level of spasticity according to the Ashford scale; risk of falls assessment according to the Morse scale; assessment of function of the upper and lower extremities using the Fugl–Meyer test; and balance assessment using the Berg scale. RESULTS: A significant positive correlation was found between the patient’s motivation and cognitive indicators: the integral level of the BTLD (r=0.653; p=0) and the integral indicator of the Mini-Mental State Examination (r=0.536; p=0.001). No convincing evidence supports the connection between the motivation level and indicators as such sex, age, body mass index, time since stroke, stroke type and location, pain level, functional independence level, and motor impairment. Although a trend toward greater positive changes in functional recovery of the arm, leg, balance, and overall independence was observed, no significant difference was found between groups. CONCLUSION: A significant relationship was found between motivation and cognitive functions, which can serve as predictors of the motivation level of patients when planning rehabilitation activities. A trend toward positive changes in functional recovery of the arm, leg, balance, and overall independence was found in patients with high motivation levels.