Team neurorehabilitation care after a cerebrovascular accident (CVA/ stroke) in acute and inpatient facilities is at a very high level. However, models suitable for subsequent rehabilitation in home environments are less known. A review of the literature published between 2013–2023 was conducted using the PRISMA methodology. The search for relevant articles used three electronic databases, i.e., Web of Science, Scopus, and PubMed. Twenty-three articles were initially selected for review. This study summarizes the physiotherapeutic methods and approaches available to stroke patients undergoing rehabilitation in the home environment. The study also characterizes home rehabilitation programs in terms of content, duration, frequency of visits, availability, and use of self-therapy materials, interactions with the therapist, exercise record keeping, tools used to assess the functional status of stroke patients, and whether or what kind of an interprofessional team was involved in home rehabilitation. The goal of successful community rehabilitation is to have an interprofessional neurorehabilitation program specific to each stroke patient, and a program focused on the patient’s current needs and goals relative to their rehabilitation environment.
Background: Stroke is the leading cause of disability, impacting both the affected person and informal caregivers. As the number of stroke patients rises, it is increasingly important to recognize that informal stroke caregivers have needs that require support and interventions. Objectives: The aim was to create an overview of studies where informal caregivers express their specific needs related to providing care for stroke patients in the home environment and summarize the described needs into particular categories. Methods: A review of the literature published between 2013-2023 was conducted using the PRISMA methodology. The search for relevant articles used electronic databases Web of Science, Scopus, and PubMed. 21 articles met the entry criteria. Results: Our analysis revealed 10 domains of needs of informal caregivers taking care of stroke patients in the home environment: the need to obtain information, the need to learn the life aspects of the patient after stroke, the need for a new family dynamic, the need to manage practical matters/non-care tasks, the need to communicate with the patient, the need for closeness, the need for physical health, the need for mental health, social needs, and the need for formal and informal support. Conclusion: The burden on informal caregivers has been confirmed by a wealth of research, including this study. As challenges faced by stroke patients and their caregivers evolve, their needs must be regularly reviewed to ensure appropriate interventions, treatments, and support to improve overall care after a stroke.
Úvod: Získané poškození mozku netraumatického původu je onemocnění, které je příčinou těžké disability, jež s sebou nese nejen medicínské, fyzioterapeutické, ale také sociální a ekonomické problémy. Z tohoto důvodu jsme vytvořili interdisciplinární rehabilitační tým složený z lékařů, fyzioterapeutů, ergoterapeutů a sociálních pracovníků působících v domácím prostředí - ve snaze minimalizovat důsledky dlouhodobého zdravotního postižení. Cíl: Hodnocení vývoje posturálních a lokomočních funkcí u 17 klientů se získaným poškozením mozku v časovém období 9 měsíců, u kterých byla prováděna individuální tříměsíční fyzioterapie v domácím prostředí. Metody: K objektivizaci funkčního stavu klientů byly použity standardní testy Berg Balance Scale (BBS) a Timed Up and Go test (TUG). Hodnocení bylo prováděno při vstupu do studie, dále po 3, 6 a 9 měsících - celkem 4 měření u každého klienta. Výsledky: Na základě vyhodnocení testů BBS a TUG došlo po tříměsíční intervenci u 15 klientů k výraznému zlepšení jejich balančních funkcí; 2 klienti nebyli schopni dokončit TUG test a 6 klientů zůstalo stále ohroženo pádem. Závěr: Z longitudinálního sledování vývoje posturálních a lokomočních funkcí u klientů s poškozením mozku je jednoznačný benefit tříměsíční fyzioterapeutické intervence v jejich domácím prostředí. S odstupem půl roku po ukončení terapie je ale téměř u třetiny klientů zřejmé mírné zhoršení v testu TUG, naopak v BBS se všech 15 klientů dále zlepšovalo, což může poukazovat na větší citlivost testu TUG pro hodnocení balančních funkcí. Proto by bylo vhodné fyzioterapeutickou intervenci prodloužit na delší časový úsek, hlavně u klientů, kteří mají FIM pod 6 stupňů.
Background: Acquired brain injury (ABI) is a disease that causes severe disability. For this reason, we established an interprofessional rehabilitation team consisting of physicians, physiotherapists, occupational therapists, and social workers operating in home settings - in an effort to minimize the consequences of long-term disability. Objectives: Evaluate the development of postural and balance functions (over a 9-month period) in 17 clients with ABI undergoing individualized 3-month physiotherapy in the home setting. Methods: Berg Balance Scale (BBS) and Timed Up and Go test (TUG) were used to quantify the functional status of the clients. A total of 4 assessments were completed at the initial, 3 months, 6 months, and final 9-months examinations. Results: According to BBS and TUG, 15 clients showed an improvement in their balance functions after the intervention; 2 clients were unable to complete the TUG, and 6 clients remained at risk of falling. Conclusions: Our results showed a clear benefit of the physiotherapeutic intervention. However, 6 months after completion, one-third of the clients had worse results on the TUG; although 15 clients continued to improve according to the BBS. This indicates the higher sensitivity of the TUG test for evaluating balance functions, and that physiotherapeutic interventions should be prolonged, particularly in clients with a Functional Independence Measure instrument (FIM) of less than 6 points.
- Klíčová slova
- získané poškození mozku,
- MeSH
- core stabilita MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- poranění mozku * rehabilitace MeSH
- posturální rovnováha MeSH
- techniky fyzikální terapie MeSH
- Check Tag
- lidé MeSH
