The Peculiarities of the Correction of Psychomotor Disorders of Patients with Ischemic Stroke: the Psychological Aspect

Abstract

The objectives of article are: to propose the author’s view on biomechanical laws which show the picture of disorders of psychomotor function; to make the research and to analyze obtained data on the initial state of motor function of patients with ischemic stroke of the subgroup «plesia + paresis»; to propose psychological principles of the development of general compensatory reactions of the patient in a case of physical rehabilitation of patients with ischemic stroke.

Methods of the research. We used the method of the analysis of literature sources; the method of pedagogical observation; psychological and pedagogical experiment; providing the research of psycho-emotional state (M. Lucher’s test is used).

The results of the research. We proved that regardless of the level of disorders, the picture of disorders of psychomotor function is subjected to certain biomechanical laws: 1. The rule of redistribution of functions of the affected limb. The functionality of the affected limb to maintain body weight is significantly reduced. This is especially noticeable in the period of single support: decreases both absolute and relative in time intervals of the function of single support, as well as the duration of the period of this support. But this kind of unloading of the sick side must be compensated, because the period of support of a healthy leg increases significantly. The change of periods of support has an obvious consequence – the increase of the sick side of the transfer time, also of the healthy side – we mean its reduction. 2. The rule of functional copying of another person’s movements. Pathological asymmetry is not beneficial to the body in terms of energy or mechanics. The need to maintain the relative symmetry of the function of the right and left sides of the body leads to the following conclusion: the healthy side of the body (or a limb) has a considerable functional reserve than a sick limb, so the reduction of functional asymmetry occurs by approximating the pattern of functioning of a healthy limb. 3. The rule of ensuring the optimum in psychomotor activity. The functioning of all elements of the normal cycle of psychomotor activity is the basis of physiological optimality of the individual. Any deviations from physiological optimality require the inclusion of additional adaptive reserves, which are slightly altered on the affected side. It is possible to provide the patient with optimal functioning due to the functional stress of a healthy side.

Conclusions. We proposed psychological principles of the development of general compensatory reactions of the patient in a case of physical rehabilitation of patients with ischemic stroke were proposed in this research. These principles are: 1) the principle of actualization of the defect; 2) the principle of progressive mobilization of compensatory mechanisms of psychomotor activity; 3) the principle of continuous reverse of concentration of compensatory mechanisms of the psyche of the person; 4) the principle of sanctioning compensatory mechanisms of the psyche of the person; 5) the principle of relative stability of the compensatory mechanisms of the psyche of the patient.

It was proved that in a case of ischemic strokes there is a certain dynamics of recovery of locus disorders. Firstly, reflex functions and tone are restored, then psychomotor actions (global and coordinating synkinesis) and auxiliary actions appear, and finally arbitrary movements are restored. In order to begin to restore tendon reflexes and muscle tone, it is necessary to normalize the functions of the spinal cord.

We emphasized that compensation of certain function that had disorders is based on the restructuring of the old stereotype and the development of a new dynamic stereotype. The most important point of compensation for structural and functional disorders in the case of psychomotor pathology is active participation in the rehabilitation process and the patient himself/herself, who should seek to activate the body’s systems, which are not affected at all or suffered insignificantly. It has been shown that due to new unaffected parts of the central nervous system, it is possible to rearrange the innervation between the antagonists.