Effectiveness of multidisciplinary team as a new model of after stroke patients’ rehabilitation

Author:

Ivanova GE1,Melnikova EV2,Shmonin AA2ORCID,Verbitskaya EV3,Belkin AA4,Bodrova RA5,Lebedev PV3,Maltseva MN6,Prokopenko SV7,Prosvirnina MS8,Sarana AM3,Stakhovskaya LV9,Suvorov AYu1,Khasanova DR5ORCID,Shamalov NA1ORCID

Affiliation:

1. All-Russian Union Rehabilitators, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia; Research Center of Cerebrovascular Pathology and Stroke, Ministry of Health of the Russian Federation, Moscow, Russia

2. All-Russian Union Rehabilitators, Moscow, Russia; The First Saint-Petersburg State Medical University named after Academician I. P. Pavlov, Saint-Petersburg, Russia; City Hospital № 26, Saint Petersburg, Russia

3. All-Russian Union Rehabilitators, Moscow, Russia

4. All-Russian Union Rehabilitators, Moscow, Russia; Ural State Medical University of the Ministry of health, Yekaterinburg, Russia

5. All-Russian Union Rehabilitators, Moscow, Russia; Kazan State Medical Academy, Kazan, Russia; Kazan State Medical University, Kazan, Russia

6. All-Russian Union Rehabilitators, Moscow, Russia; The First Saint-Petersburg State Medical University named after Academician I. P. Pavlov, Saint-Petersburg, Russia

7. All-Russian Union Rehabilitators, Moscow, Russia; Krasnoyarsk State Medical University, Krasnoyarsk, Russia

8. All-Russian Union Rehabilitators, Moscow, Russia; City Hospital № 26, Saint Petersburg, Russia

9. All-Russian Union Rehabilitators, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia

Abstract

Modern papers on treatment and rehabilitation of stroke patients describe the advantages and effectiveness of certain medical rehabilitation types, but these data are not enough to evaluate the efficiency of the whole rehabilitation system. The study was aimed to investigate the potential of the patient-centered problem-oriented multidisciplinary three-stage system for medical rehabilitation of stroke patients. Thestudyincluded 1021 patientsover 18 affected with ischemic or hemorrhagic stroke in the acute phase. All patients had a disability of admission at the time (but no persisting disability in their history). Two models of rehabilitation measures were compared in two consecutive phases of the study. The linear model of rehabilitation assistance was mainly implemented in phase 1, and the multidisciplinary model was implemented in phase 2. The patients’ condition was evaluated using the Modified Rankin Scale (mRS) at the end of rehabilitation. Comparison of the 1st and 2nd phase results demonstrated that the number of patients with mRS score 0–1 in the 2nd phase was lower by 18%. The proportion of patients with positive dynamics was significantly higher in the 2nd phase than in the 1st phase, (16 and 30% respectively). In the 2nd phase there were significantly more patients who demonstrated improvement by 1–4 (mRS score). Thus, the use of a multidisciplinary model provides a significant benefit compared with a linear rehabilitation model.

Publisher

Pirogov Russian National Research Medical University

Subject

General Medicine

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