İnmeli Hastalarda Kognitif Rehabilitasyonun Fonksiyonel Bağımsızlık, Yaşam Kalitesi ve Toplumsal Katılım Üzerine Etkisi

Abstract

This study was planned to assess the effects of cognitive rehabilitation on functional independence, quality of life and communal participation of stroke patients. 20 people who have been diagnosed with having had stroke, were randomly devided to two groups, each including 10. Patients in each group were treated with neurophysiological exercises and the subjects in Group 1 recieved cognitive rehabilitation additionally. The patients' muscle strengths were evaluated based on Motricity Index, balances based on Tinetti Balance Evaluation Scale, sensation and movement functions based on Fugl-Meyer motor evaluation scale, cognitive states based on Loweinstein Occupational Therapy Cognitive Assessment (LOTCA) and Montreal Cognitive Assessment (MoCA). Canadian Occupational Performance Measure and Craig Handicap Assessment and Reporting Tecnique- Short Form were used to evaluate the communal participation, Short Form – 36 (SF – 36) was used to evaluate the quality of life and Functional Independence Measure (FIM) was used to evaluate the functional independence. All patients recieved therapy 3 days a week for 8 weeks. The group that recieved cognitive rehabilitation (CRG) were treated with 1 hour of curative and functional adaptive approaches together with highly inclusive treatment approaches as well as a combination of all and they were treated with 1 hour of rehabilitation methods being neurophysiological exercise therapy based on Bobath Techniques. The control group (CG) received 1 hour of rehabilitation methods being neurophysiological exercise alone. CRG' s total points at MoCA and points in the areas of Executive Functions and Attention, the improvements they showed in the areas of orientation, visual reception and attention according to LOTCA were found statistically meaningful when compared to CG' s received points (p<0,05). The total points received by CRG at LOTCA and points received in the areas of visual motor organization were found to be highly meaningful when compared to the points received by the CG (p<0,001). Scores received by CRG in the area of physical independence at CRAIG-SF, and quality of life scores received in the areas of physical component and emotional role limitation at SF – 36 were found to be meaningfully higher when compared to CG' s scores (p<0,05). It was concluded that cognitive rehabilitation does have positive impact on communal participation and quality of life.