The Use of the ICF Classification Sheet to Assess Cognitive-Behavioral Disorders and Verbal Communication in Patients after Ischemic and Hemorrhagic Stroke during Rehabilitation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Group/Inclusion and Exclusion Criteria
- Restoring executive functions (e.g., day planning training, the chronology of proceedings, supervision over the implementation of daily duties).
- Training of memory processes (e.g., short-term memory in the verbal and visual modality and long-term memory in information encoding and decoding).
- Attention processes training (focusing attention on one indicated stimulus and shifting and dividing attention between several stimuli).
2.2. Cognitive-Behavioral Disorders
2.3. Verbal Communication Disorders
2.4. ICF Profile
2.4.1. ICF Categories of Cognitive Behavioral Disorders
2.4.2. ICF Categories of Verbal Communication Disorders
2.5. Statistical Analysis
3. Results
3.1. Study Groups
3.2. Cognitive Behavioral Disorders
3.3. Verbal Communication Disorders
3.4. Profile of Cognitive and Speech Therapy Disorders According to the ICF Classification Categories
3.4.1. ICH
3.4.2. IS
3.4.3. ICH vs. IS
4. Discussion
5. Conclusions
- (1).
- The type of stroke suffered determines the frequency and type of cognitive-behavioral and verbal communication disorders.
- (2).
- The ICF classification can be used to assess the occurrence of psychological and speech therapy disorders depending on the clinical type of stroke.
- (3).
- Using one tool during rehabilitation containing a description of cognitive-behavioral disorders as well as verbal communication in the form of an ICF sheet may improve communication between a speech therapist and a psychologist, which in turn may lead to an increase in the effectiveness of the therapy.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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ICH | IS | p | ||
---|---|---|---|---|
Sex n (%) | Females | 20 (42.6%) | 30 (63.8%) | 0.039 a |
Males | 27 (57.4%) | 17 (36.2%) | ||
Age (years) | Mean ± SD | 67.3 ± 10.6 | 71.7 ± 9.81 | 0.038 b |
Median | 66 | 70 | ||
Min–Max | 49–92 | 51–92 | ||
Time from stroke to rehabilitation (days) | Mean ± SD | 33.5 ± 17.7 | 18.0 ± 8.6 | <0.001 b |
Median | 29 | 16 | ||
Duration of rehabilitation (days) | Mean ± SD | 69.1 ± 32.2 | 59.0 ± 34.9 | 0.118 b |
Median | 63 | 51 | ||
NIHSS before rehabilitation | Mean ± SD | 13 ± 5 | 12 ± 4 | 0.847 b |
Median | 12 | 12 | ||
Min–Max | 5–24 | 6–24 | ||
NIHSS after rehabilitation | Mean ± SD | 5 ± 5 | 9 ± 4 | <0.001 b |
Median | 5 | 8 | ||
Min–Max | 0–17 | 4–22 |
ICF Category | Qualifier Criteria | ICH | IS | ICH vs. IS | |||||
---|---|---|---|---|---|---|---|---|---|
Before | After | p | Before | After | p | Before | After | ||
b110 Consciousness functions | 0—full consciousness | 36 (76.6%) | 44 (93.6%) | 0.005 | 45 (95.7%) | 47 (100.0%) | 1.0 | 0.007 | 0.784 |
1—sleepy | 7 (14.9%) | 3 (6.4%) | 2 (4.3%) | 0 (0%) | |||||
2—not fully conscious | 4 (8.5%) | 0 (0%) | 0 (0%) | 0 (0%) | |||||
3—unconscious | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |||||
b114 Orientation functions | 0—full orientation as to time and place preserved | 34 (72.3%) | 43 (91.5%) | 0.002 | 39 (83.0%) | 40 (85.1%) | 0.180 | 0.201 | 0.343 |
1—orientation to place and time preserved | 5 (10.6%) | 2(4.3%) | 5 (10.6%) | 4 (8.5%) | |||||
2—lack of full orientation as to the place or time | 7 (14.9%) | 2 (4.3%) | 1 (2.1%) | 2 (4.3%) | |||||
3—complete disorientation as to place and time | 1 (2.1%) | - | 2 (4.3%) | 1 (2.1%) | |||||
b130 Energy and drive functions | 0—no mood disorders | 17 (36.2%) | 39 (83.0%) | <0.001 | 18 (38.3%) | 28 (59.6%) | 0.009 | 0.831 | 0.007 |
1—depressed mood | 30 (63.8%) | 8 (17.0%) | 29 (61.7%) | 19 (40.4%) | |||||
b140 Attention functions | 0—no disturbances in attention systems | 11 (23.4%) | 30 (63.8%) | <0.001 | 15(31.9%) | 21 (44.7%) | 0.002 | 0.71 | 0.071 |
1—slight attention disorders | 18 (38.3%) | 10 (21.3%) | 12 (25.5%) | 16 (34.0%) | |||||
2—moderate attention disorders | 10 (21.3%) | 5 (10.6%) | 14 (29.8%) | 4 (8.5%) | |||||
3-severe attention disorders | 8 (17.0%) | 2 (4.3%) | 6 (12.8%) | 6 (12.8%) | |||||
b144 Memory functions | 0—no memory impairment | 13 (27.7%) | 28 (59.6%) | <0.001 | 17 (36.2%) | 26 (55.3%) | 0.005 | 0.177 | 0.656 |
1—mild memory impairment | 13 (27.7%) | 11 (23.4%) | 14 (29.8%) | 11 (23.4%) | |||||
2—moderate memory impairment | 10 (21.3%) | 3 (6.4%) | 11 (23.4%) | 5 (10.6%) | |||||
3—severe memory impairment | 11 (23.4%) | 5 (10.6%) | 5 (10.6%) | 5 (10.6%) | |||||
b147 Psychomotor functions | 0—no psychomotor slowing down | 15 (31.9%) | 35 (74.5%) | <0.001 | 23 (48.9%) | 29 (61.7%) | 0.074 | 0.06 | 0.184 |
1—psychomotor slowing down | 32 (68.1) | 12 (25.5%) | 24(51.06%) | 18 (38.30%) | |||||
b152 Emotional functions | 0—no emotional disturbances | 12 (25.5%) | 27 (57.4%) | 0.003 | 8 (17%) | 24 (51.1%) | <0.001 | 0.464 | 0.725 |
1—slight emotional disturbances | 18 (38.3%) | 11 (23.4%) | 20 (42.6%) | 16 (34.0%) | |||||
2—moderate emotional disturbances | 14 (29.8%) | 8 (17%) | 16 (34.0%) | 5 (10.6%) | |||||
3—severe emotional disturbances | 3 (6.4%) | 1 (2.1%) | 3 (6.4%) | 2 (4.3%) | |||||
b156 Perceptual functions | 0—no agnosia | 45 (95.7%) | 46 (97.9%) | 0.18 | 42 (89.4%) | 44 (93.6%) | 0.18 | 0.281 | 0.331 |
1—light agnosia | 0 (0%) | 0 (0%) | 5 (10.6%) | 3 (6.4%) | |||||
2—moderate agnosia | 1 (2.1%) | 1 (2.1%) | 0 (0%) | 0 (0%) | |||||
3—severe agnosia | 1 (2.1%) | 0 (0%) | 0 (0%) | 0 (0%) | |||||
b164 Higher-level cognitive functions | 0—no disorders of the executive systems | 31 (66.0%) | 38 (80.9%) | 0.013 | 29 (61.7%) | 32 (68.1%) | 0.066 | 0.669 | 0.198 |
1—slight disorders of the executive systems | 7 (14.9%) | 2 (4.3%) | 7 (14.9%) | 8 (17.0%) | |||||
2—moderate disorders of the executive systems | 4 (8.5%) | 7 (14.9%) | 6 (12.8%) | 4 (8.5%) | |||||
3—moderate disorders of the executive systems | 5 (10.6%) | 0 (0%) | 5 (10.6%) | 3 (6.4%) | |||||
b176 Mental function of sequencing complex movements | 0—no apraxia | 46 (97.9%) | 46 (97.9%) | 1 | 42 (89.4%) | 44 (93.6%) | 0.583 | 0.101 | 0.309 |
1—slight apraxia | 0 (0%) | 1 (2.1%) | 4 (8.5%) | 2 (4.3%) | |||||
2—moderate apraxia | 1 (2.1%) | 0 (0%) | 0 (0%) | 0 (0%) | |||||
3—severe apraxia | 0 (0%) | 0 (0%) | 1 (2.1%) | 1 (2.1%) |
ICF Category | Qualifier Criteria | ICH | IS | ICH vs. IS | |||||
---|---|---|---|---|---|---|---|---|---|
Before | After | p | Before | After | p | Before | After | ||
b167 Mental functions of language | 0—linguistic functions preserved | 38 (80.9%) | 40 (85.1%) | 0.018 | 41 (87.2%) | 42 (89.4%) | 0.068 | 0.432 | 0.579 |
1—partially impaired language functions | 3 (6.4%) | 6 (12.8%) | 1 (2.1%) | 3 (6.4%) | |||||
2—completely impaired linguistic functions | 6 (12.8%) | 1 (2.1%) | 5 (10.6%) | 2 (4.3%) | |||||
b1671 Expression of language | 0—no speech disorders | 15 (31.9%) | 33 (70.2%) | <0.001 | 22 (46.8%) | 27 (57.4%) | 0.028 | 0.075 | 0.193 |
1—blurred speech | 5 (10.6%) | 4 (8.5%) | 7 (14.9%) | 5 (10.6%) | |||||
2—dysarthric speech | 27 (57.4%) | 10 (21.3%) | 18 (38.3%) | 15 (31.9%) | |||||
b1672 Integrative language functions | 0—no aphasia | 40 (85.1%) | 45 (95.7%) | 0.003 | 41 (87.2%) | 41 (87.2%) | 0.012 | 0.845 | 0.133 |
1—sensory or motor aphasia | 5 (10.6%) | 2 (4.3%) | 2 (4.3%) | 4 (8.5%) | |||||
2—sensory and motor aphasia | 2 (4.3%) | 0 (0%) | 4 (8.5%) | 2 (4.3%) | |||||
b5108 Ingestion functions. other specified | 0—no dysphagia | 46 (97.9%) | 46 (97.9%) | 1 | 47(100.0%) | 47(100.0%) | 1 | 0.859 | 0.860 |
1—dysphagia | 1 (2.1%) | 1 (2.1%) | 0 (0%) | 0 (0%) | |||||
d330 Speaking | 0—no word choice disorders | 28 (59.6%) | 40 (85.1%) | 0.001 | 28 (59.6%) | 32 (68.1%) | 0.001 | 0.347 | 0.033 |
1—inadequate. limited word choice | 17 (36.2%) | 7 (14.9%) | 5 (10.6%) | 9 (19.1%) | |||||
2—no sentence formulation | 1 (2.1%) | 0 (0%) | 11 (23.4%) | 6 (12.8%) | |||||
3—no speech. making sounds | 1 (2.1%) | 0 (0)%) | 3 (6.4%) | 0 (0%) | |||||
d710 Basic interpersonal interactions | 0—preserved | 45 (95.7%) | 47 (100%) | 0.180 | 43 (91.5%) | 44 (93.6%) | 0.5 | 0.427 | 0.082 |
1—moderately disturbed | 0 (0%) | 0 (0%) | 2 (4.3%) | 2 (4.3%) | |||||
2—completely disturbed | 2 (4.3%) | 0 (0%) | 2 (4.3%) | 1 (2.1%) |
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Lucka, E.; Lucki, M.; Cybulski, M.; Daroszewski, P.; Lisiński, P. The Use of the ICF Classification Sheet to Assess Cognitive-Behavioral Disorders and Verbal Communication in Patients after Ischemic and Hemorrhagic Stroke during Rehabilitation. Int. J. Environ. Res. Public Health 2022, 19, 12127. https://doi.org/10.3390/ijerph191912127
Lucka E, Lucki M, Cybulski M, Daroszewski P, Lisiński P. The Use of the ICF Classification Sheet to Assess Cognitive-Behavioral Disorders and Verbal Communication in Patients after Ischemic and Hemorrhagic Stroke during Rehabilitation. International Journal of Environmental Research and Public Health. 2022; 19(19):12127. https://doi.org/10.3390/ijerph191912127
Chicago/Turabian StyleLucka, Ewa, Mateusz Lucki, Marcin Cybulski, Przemysław Daroszewski, and Przemysław Lisiński. 2022. "The Use of the ICF Classification Sheet to Assess Cognitive-Behavioral Disorders and Verbal Communication in Patients after Ischemic and Hemorrhagic Stroke during Rehabilitation" International Journal of Environmental Research and Public Health 19, no. 19: 12127. https://doi.org/10.3390/ijerph191912127