POST-STROKE RECOVERY: AN INNOVATIVE PHYSICAL THERAPY PROGRAM USING FUNCTIONAL TRAINING

Abstract

Intracerebral stroke is one of the leading causes of disability, leading to complex physical, sensory, cognitive, and psycho-emotional disorders that significantly limit daily activities and the quality of life of patients. Existing standard rehabilitation programs often fail to consider this multidimensionality, focusing on the isolated restoration of functions. In response to these challenges, an innovative comprehensive rehabilitation and physical therapy (RPT) program has been developed for post-stroke patients in the early recovery period, with functional training as its central element. The purpose of this work is to develop, implement, and evaluate the effectiveness of this program, aimed at the full return of patients to daily life with the highest possible level of functioning, activity, and participation, or effective compensation for lost functions. The RPT program is based on a person-centered approach and the methodological principles of the International Classification of Functioning (ICF), which allows for the formation of individual SMART goals, taking into account the real needs of the patient and their family, as well as integrating the correction of sensory and psycho-emotional disorders. The total duration of the program is 26 weeks, divided into three 4-week intensive periods with intermediate intervals. Sessions are held 5 times a week, twice a day, with an emphasis on high intensity and density of training. The first period focuses on the restoration of functions and structures, the second on the level of activity and participation (selfcare, household tasks), and the third on achieving full independence (social, professional activity, hobbies). Functional training is the core of the program, aimed at improving motor skills critical for daily tasks and developing strength, endurance, coordination, and balance. The methodology includes the use of everyday objects, various training modes (facilitation, splinting-training, resistance), and the integration of breathing/articulation exercises. Special attention is paid to the restoration of gait through biomechanical analysis, targeted strength and coordination exercises, training on unstable surfaces, and combating contractures and spasticity. The restoration of upper limb functions takes into account the role of the hand as a sensory organ and the postural control of the trunk and shoulder girdle. The cognitive component and motivation are integrated into functional tasks, which helps to improve attention, memory, thinking, and increase patient adaptability. The RPT program provides a comprehensive and integrated approach that considers the interrelation of all residual stroke effects, leading to more lasting and meaningful results for the patient. It emphasizes the importance of postural control, balanced limb work, neuroplasticity, and functionally oriented tasks, as well as the role of cognitive recovery and motivation for long-term positive outcomes.