УЛОГА НА КИНЕЗИТЕРАПИЈАТА ВО ТРЕТМАНОТ НА ПАЦИЕНТИ СО ИСХЕМИЧЕН МОЗОЧЕН МОЗОЧЕН ИНСУЛТ
ROLE OF KINESITHERAPY IN THE TREATMENT OF PATIENTS WITH ISCHEMIC STROKE

Summary/Abstract: Cerebrovascular diseases: Cerebrovascular diseases include a group of diseases that occur as a result of disruption of the arterial or venous cerebral circulation. They can manifest as acute and subacute incidents (ischemic, hemorrhagic, venous thrombosis) and through chronic complaints (from compression of structures, vascular headache, encephalopathy, etc.). Acute ischemic disorders can be divided into three groups according to the presence and duration of symptoms: Asymptomatic, Transient ischemic attacks, and Ischemic strokes. The most important risk factors for ischemic stroke are arterial hypertension, heart disease, atrial fibrillation, diabetes mellitus, smoking, hyperlipidemia. Atherosclerosis is among the main causes of acute ischemic events. The carotid arteries are most commonly affected, with plaque formation, most commonly localized in the bifurcation and carotid sinus. (sinus caroticus). Differential diagnosis: In the case of acute onset, a distinction is made between cerebral hemorrhage and usually embolic stroke - imaging studies are of primary importance for establishing an accurate diagnosis. In acute onset, a distinction is made between ischemic stroke and trauma, with computed tomography and skull X-ray being important. Magnetic resonance imaging (MRI) detects cerebral infarction within the first 24 hours and is significantly more sensitive than (CT) for posterior fossa strokes. Diagnosing ischemic stroke: The diagnosis of ischemic stroke is made on the basis of anamnestic data, neurological status and examinations. Modern clinical examination includes classic neurological status and the National Institute of Health Stroke Scale, in patients in a comatose state and the Glasgow-Liege scale. (National Institute of Health Stroke Scale). Research methods:The research will be conducted in the PHI "Clinical Hospital - Shtip, in the Department of Neurology, and Banja Kežovica, in the departments of Physical Medicine and Kinesitherapy. The research will include 13 patients diagnosed with ischemic stroke (7 male patients and 6 female patients). The aim of the research is: To determine the effects of kinesitherapy treatment in the rehabilitation of patients with ischemic stroke. Physical rehabilitation should be as intensive as possible, and it is best to conduct it in specialized rehabilitation centers – with the restoration and preservation of the patient's mobility being particularly important. Patients will receive Neurorehabilitation and Kinesitherapy Treatment, which includes: treatment with posture, passive exercises, actively assisted exercises, flexibility and stretching exercises, relaxation exercises, breathing exercises; Balneotherapy with thermal waters with temperature of (32-34 C).Results: Early intervention and rehabilitation play a key role in determining the prognosis of stroke, emphasizing the importance of timely medical attention and individualized care. Discussion: Effective management of ischemic stroke requires a cohesive, interprofessional healthcare team dedicated to providing patient-centered care, improving outcomes, and maximizing patient safety. Conclusion: The goal of therapy in acute ischemic stroke is to preserve tissue in areas where perfusion is reduced, but still sufficient to prevent infarction. An organized protocol for patients with acute ischemic stroke allows for accelerated patient evaluation and treatment.

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