Psychological Principles of the Formation of General Compensatory Reactions of the Patient with Ischemic Stroke in a Case of Physical Rehabilitation

Abstract

The objectives of our article are: 1) to study the characteristics of disorders of psychomotor function and psycho-emotional state of patients with ischemic stroke according to the initial examination; 2) to develop the method of physical rehabilitation of patients with ischemic stroke at the inpatient stage of rehabilitation, depending on the severity of psychomotor functions and features of the psycho-emotional state; 3) to propose psychological principles of the formation of general compensatory reactions of the patient with ischemic stroke in a case of physical rehabilitation.

Research methods. There were used psychological and pedagogical research methods: the analysis of literature sources, the method of psychological and pedagogical observation, psychological and pedagogical experiment, providing the research of psycho-emotional state (M. Lucher's test is used (Lucher,2012)), determination of motor activity on the "Scale of psychomotor activity" by L.S. Rohovyk (Роговик, 2013).

For our research we proposed "The author's methodology of measuring the amount of active movements in the joints of the patient's limbs" (Харченко & Михальчук, 2022a) and "Six-point scale for assessing muscle strength in the joints of the patient's limbs" (Харченко & Михальчук, 2022b).

The results of the research. Patients showed increased tone in the flexion of the ankle joint and extension of the hip and knee joints. In other muscle groups, the tone was not increased, and in the upper extremities there was a decrease in muscle tone. Muscle strength was statistically significant (p <0.01) decreased in all groups of muscles.

In a case of the research of the limbs of the unaffected side, the following data were obtained: the volume of active movements was 55.68% ± 4.3 of the appropriate volume of movements and the values are significantly higher (at the level of reliability p<0.01 according to Student's t-test). The rate of passive movements was higher than the affected party (at the level of reliability p<0.01 according to the Student's t-test) and amounted to 63.06% ± 3.9 of the appropriate volume of passive movements and corresponded to the average values for the age group of respondents. The mean value of muscle strength was 61.28% ± 7.3 values are statistically significant (at the level of reliability p<0.01 according to Student's t-test) of the affected side. Muscle tone on the unaffected side was higher than normal and was 27.9% ± 3.6 of the maximum value (at a confidence level of p<0.05 according to Student's t-test).

It was proved that the amount of passive movements in the experimental group as a whole is slightly lower than in the control group.

Conclusions. Adequate tonal response of the muscular system leads to the formation of a pathological static stereotype. We proposed psychological principles for the formation of general compensatory reactions of the patient in a case of physical rehabilitation of patients with ischemic stroke: 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 concentration of compensatory mechanisms of the personality psyche. 4. The principle of authorizing the compensatory mechanisms of the individual psyche. 5. The principle of relative stability of the compensatory mechanisms of the individual psyche.