MISCELLANEOUS

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

Ivanova GE1,2,9, Melnikova EV1,5,8, Shmonin AA1,5,8, Verbitskaya EV5, Belkin AA1,3, Bodrova RA1,4,7, Lebedev PV1, Maltseva MN1,5, Prokopenko SV1,6, Prosvirnina MS1,8, Sarana АM1, Stakhovskaya LV1,2, Suvorov AYu1,2,9, Khasanova DR1,4,7, Shamalov NA1,2,9
About authors

1 All-Russian Union Rehabilitators, Moscow, Russia

2 Pirogov Russian National Research Medical University, Moscow, Russia

3 Ural State Medical University of the Ministry of health, Yekaterinburg, Russia

4 Kazan State Medical Academy, Kazan, Russia

5 The First Saint-Petersburg State Medical University named after Academician I. P. Pavlov, Saint-Petersburg, Russia

6 Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia

7 Kazan State Medical University, Kazan, Russia

8 City Hospital № 26, Saint Petersburg, Russia

9 Research Center of Cerebrovascular Pathology and Stroke, Ministry of Health of the Russian Federation, Moscow, Russia

Correspondence should be addressed: Andrey Yu. Suvorov
Ostrovityanova, 1–10, Moscow, 117342; ur.liam@vorovus_rd

About paper

Funding: Territorial Federal Compulsory Medical Insurance Fund, Ministry of Health of the Russian Federation and the Ministry of Education and Science of the Russian Federation universities budget funds, All-Russian Union Rehabilitators funds.

Acknowledgements: Yulia Buryak, neurologist of Pavlov First Saint Petersburg State Medical University. Victoria Kasatkina, neurologist of City Alexandovskaya Hospital. Ekaterina Lobachyova, 6th year student of Pavlov First Saint Petersburg State Medical University

Received: 2019-11-26 Accepted: 2019-12-13 Published online: 2019-12-27
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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.

Keywords: neurorehabilitation, medical rehabilitation, rehabilitation medicine, multidisciplinary team, acute stroke

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