The impact of early kinesitherapy on the recovery of motor, cognitive functions and on quality of life in patients following ischemic stroke

Introduction. Ischemic stroke, characterized by combined motor and cognitive impairments and accompanied by an increase in the global burden and needs for rehabilitation, requires early, structured and dosed kinesiotherapy at the inpatient stage, with an assessment of its effectiveness using validated functional, cognitive and patient-oriented scales.

Aim. To assess the dynamics of functional independence, cognitive status, and stroke-specific quality of life in patients of both sexes undergoing early kinesiotherapy in an inpatient setting.

Materials and methods. A total of 60 patients (29 women, 31 men) were examined at the Kyrgyz Research Institute of Balneology and Rehabilitation Treatment, average age 65.68 ± 10.34 years. Rehabilitation was initiated at an early stage and included verticalization, passive and active exercises, as well as therapy based on the Bobath concept. The Barthel Index, the Mini-Mental State Examination (MMSE), and the Stroke-Specific Quality of Life (SS-QOL) questionnaire were assessed at admission and at discharge after 20 days.

Results. During the inpatient rehabilitation stage, patients with ischemic stroke demonstrated statistically significant improvements in functional and cognitive status, as well as in several quality-of-life indicators. According to the Barthel Index, the level of functional independence increased significantly from 54.83 ± 22.62 to 99.25 ± 20.95 points (p < 0.05); similar dynamics were observed in women (from 53.45 ± 23.05 to 98.27 ± 22.64) and men (from 56.12 ± 22.13 to 100.16 ± 19.19; p < 0.05). Cognitive status assessed by the MMSE also improved significantly: the mean score increased from 26.55 ± 3.47 to 29.38 ± 1.42 points (p < 0.05), with comparable changes in women (26.93 ± 3.14 to 29.38 ± 1.45) and men (26.19 ± 3.72 to 29.39 ± 1.38; p < 0.05). According to the SS-QOL questionnaire, statistically significant improvements were observed in the domains of “family role,” “mobility,” “mood,” “self-care,” “social role,” and “upper limb function” (p < 0.05). Several domains (energy, speech, thinking, vision, personality traits, and productivity) demonstrated positive trends without reaching statistical significance (p > 0.05). Overall, the findings indicate substantial recovery of functional independence, cognitive function, and key components of quality of life during the early rehabilitation period, with no clinically significant gender differences.

Conclusion. Early kinesiotherapy initiated in the acute phase of ischemic stroke and implemented through a stepwise program of mobilization and function-oriented exercises is associated with clinically significant improvements in functional independence and cognitive status. It also provides a statistically significant increase in stroke-specific quality of life, predominantly in domains related to mobility, self-care, upper limb function, emotional well-being, and social participation.

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