Urgent modern trends in disability assessment after a stroke, life activity criteria according to the ICF and principles of neurorehabilitation (literature review and own research)

Background. The purpose of our work was to study the functional outcomes in stroke patients, the justification of a clinical diagnosis according to the International Classification of Functioning, Disability and Health (ICF), including criteria, principles of disability prevention and rehabilitation. Materials and methods. We conducted a prospective, case-control cohort study of 5,818 patients who suffered a cerebral stroke over the past 10 years, 4,520 (78 %) were survivors, with an average age of 73.0 ± 10.2 years. All participants underwent a standard neurological examination and ICF testing. Results. It is obvious that in every case after a stroke, there are functional disorders, and in most patients (from 76 to 85 %) this results in disability. Such trend is consistent worldwide and was also observed in our study. However, the overall 37% decrease in the disability rate over the specified period, in our opinion, can be attributed to population aging and the lack of workplace opportunities for the able-bodied population, which previously served as a form of social protection for patients. Therefore, the further optimization of preventive and rehabilitation measures, starting with addressing stroke risk factors and preventing recurrences, could significantly improve the quality of life of stroke patients without imposing a substantial burden on their families and society as a whole. Factors have been determined, criteria for limiting life activities in the main areas of life have been developed. The adaptation of the ICF makes it possible to use it in expert diagnosis, the formation of a correct clinical and functional diagnosis, and allows assessing the potential and effectiveness of rehabilitation measures in the post-stroke period. Conclusions. 1. The use of the ICF makes it possible to objectively assess the state of patients, the rehabilitation potential and the effectiveness of rehabilitation measures in people with the consequences of a stroke. 2. The use of the criteria for limiting life activities developed by the authors will improve the quality of medical and social examination of patients who have suffered a stroke, and further research will optimize new approaches to the rehabilitation of these patients and their adaptation in society. 3. Further optimization of preventive and rehabilitation measures, starting with addressing stroke risk factors and preventing recurrences, could significantly improve the quality of life of patients, their relatives and society as a whole.