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

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.

From the medical to the bio-psychosocial approach of COPD patients through the lens of the International Classification of Functioning, Disability and Health

“…Spre deosebire de Clasificarea Internațională a Maladiilor (CIM-10) care evaluează consecințele maladiilor pe principiul său etiologic, CIF este o clasificare a componentelor sănătății și evaluează funcționarea și limitările funcționalității prin prisma abordării bio-psihosociale [7]. Utilizarea CIF, face posibilă explorarea cu precizie a naturii și severității restricțiilor de participare, precum și a limitărilor de funcționalitate, fapt care permite argumentarea științifică al volumului de acordare al asistenței medicale și a măsurilor de protecție sociale pentru pacienți [6].…”

“…Un volum semnificativ al acestei clasificări complică în mod substanțial aplicarea acestui instrument în practică. În această formă, CIF este pe larg utilizat în cercetări științifice, decât în activități clinice a medicilor practicieni [7,10,13].…”