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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 January-February;174(1-2):49-56
Copyright © 2015 EDIZIONI MINERVA MEDICA
language: English
The rehabilitation of chronic neurological patients: an alternative answer to a growing demand
Betti E. 1, Lazzarino M. 1, Summa S. 2, Podda I. 3
1 Azienda Sanitaria Locale n° 3, Genoa, Italy; 2 University of Genoa Department Informatics, Systems, Telematics (DIST), Genoa, Italy; 3 University of Genoa, Faculty of Medicine, Genoa, Italy
AIM: The aim of this study was to demonstrate that it is possible to obtain an improvement in functional performance in chronic neurological patients, even in the absence of a take charge individual rehabilitation, on the basis of the scientific evidence reported by the Task Oriented Circuit Training.
METHODS: The patients recruited for the study in two consecutive years are 111. A group had suffered a stroke more than six months, and had been subjected to neuro-rehabilitation treatment as inpatient or outpatient. Another group of patients was composed of patients suffering from Parkinson’s disease and neuro-degenerative diseases whose symptoms were prevalent extrapyramidal (Parkinsonism). The groups are formed on the basis of pathology according to the order of the waiting list. The exclusion criteria are the presence of serious psychiatric symptoms, severe receptive aphasia and the inability to complete the Timed Up and Go test (TUG) while using an assistive device.
RESULTS: Was found a statistically significant improvement in both groups on the Barthel Index (BI) (stroke, P<0.001; Parkinson, P=0.004), the item “walking” of the BI (stroke, <0.001; Parkinson, P=0.001), the Trunk Control Test (stroke, P=0.005; Parkinson, P<0.001), the Test of 3 minutes (stroke, P=0.028; Parkinson, P=0.030), the Test of 6 minutes (stroke, P<0.001, Parkinson, P<0.001), the Berg Balance Scale (stroke, P<0.001; Parkinson, P<0.001), Mini-Mental State Examination (stroke, P=0.016; Parkinson, P=0.041). It was revealed a statistically significant only for the group to stroke Motricity Index (MI) (P=0.012) and the TUG (stroke, P=0.013), and only for the Parkinson’s group in the Trail Making Test B (P=0.019) and the Clock Drawing (P=0.016).
CONCLUSION: The data obtained in two years of observation, revealed a functional improvement, both for the motor and cognitive performance, in the face of a reduced number of hours of physiotherapy and a reduced ratio therapist/patient.