ABSTRACT
INTRODUCTION: Individuals who have experienced stroke are often described as apathetic, having lost of interest, and unmotivated. This might be a problem in achieving treatment results. It is still unclear what impact age and gender have on the motivation. THE AIM OF RESEARCH: To evaluate motivation influence on the effectiveness of occupational therapy in patients with stroke. METHODS: Study included 30 patients who experienced acute stroke. Multidimensional Health Locus of Control (MHLC) scale has been used for motivation assessment. Internal persons' motivation was evaluated to determine how much a person believes that his recovery depends on his own behaviour and external persons' motivation-how a person relates his state of health to the impact of the surrounding people. Performance of daily activities was assessed using Functional Independency Measure (FIM). RESULTS: At the beginning of rehabilitation of the patients with stroke, external motivation was greater than the internal one. At the end of rehabilitation internal motivation has increased by 1.8±0.4 points, while the external motivation decreased by 2.4±0.6 points (p<0.05). At the beginning of rehabilitation patients independence in activities of daily living assessed with FIM was 70.0±2.9 points. At the end of rehabilitation their ability to perform daily activities improved by 26.9±1.9 points and reached 96.9±2.7 points (p<0.05). We found statistically significant (p<0.05) moderate correlation (r=0.72) between patients internal motivation at the beginning of the rehabilitation and increase of independence after rehabilitation. CONCLUSION: Older patients had lower internal motivation than younger ones, and independence in daily activities improvement was influenced by younger age and by brain damage depth.
ABSTRACT
Stroke patients often experience cognitive dysfunctions. One of the parameters assessing cognitive function is the reaction time as it reflects the speed of information processing. The aim of the study was to assess cognitive and psychomotor dysfunctions and the effectiveness of rehabilitation in stroke patients. The subjects of the study were 30 stroke patients who underwent rehabilitation at the Department of Neurorehabilitation. The mean age of patients was 65.33+/-13.2 years. During the study, the patients' cognitive functions, the handgrip strength, reaction time, and frequency of movements were assessed. There was a substantial improvement in patients' cognitive function after rehabilitation. Assessing the results obtained by Mini Mental State Examination, the change was 6.4+/-2.3 points, and assessing by Neurobehavioral Cognitive Status Examination (Cognistat), the change was 13.3+/-10 points (P<0.05). Before the early stage of rehabilitation, Cognistat results showed that the majority of the patients experienced memory loss, diminished constructive abilities, and disorientation. After occupational therapy, there was a statistically significant improvement in all cognitive function domains. At the end of the inpatient rehabilitation period, there was a significant change in patients' reaction time and movement frequency. At the end of early rehabilitation stage, the estimated reaction time in patients with stroke was compared with reaction time in healthy elderly people of the same age. There was no significant difference between these groups; consequently, we concluded that after rehabilitation, improvement of function was achieved. The results of this study showed that at the beginning of early rehabilitation period and after rehabilitation applied, there was a significant moderate correlation between mental state and reaction time in stroke patients.
