[Recovery of walk in persons with stroke and heart disease].

The goal of this research is to analyze the differences in recovery of walk of two groups of patients who have suffered the stroke--those who have and have not suffered from heart disease prior to the stroke. Test group consisted of patients who have suffered the stroke, and have been rehabilitated in the Clinic for physical medicine and rehabilitation in Tuzla, in 2003. Patients who have had a heart disease before suffering the stroke and have been treated by a cardiologist comprised the first test group (Group I, N=48), while patients without previous heart disease comprised the second test group (Group II, N=69). In relation to their ability to walk, patients have been divided into three groups: those who are able to walk without help, those who are not able to walk and those who are able to walk with a walking aid. Therapies used include kinesiotherapy, paraffin, criotherapy, and electro procedures. Total number of those rehabilitated in the hospital after the stroke is 117, out of which 45 (38.5 %) were women and 72 (61.5 %) men, with average of 68 +/- 9,2 years of age. According to the kind of stroke suffered, 105 patients have had ischemia (89.7 %) and 12 have had hemorrhagia (10.3 %). The highest number of patients have had paralysis of the left side of the body--48 (41.0 %), then paralysis of the right side--43 (36.8 %) and both sides--15 (12.8 %). In relation to the localization of the changes in the brain detected in the CT, the highest number of patients have had multiply lacunar changes--41 (35,0 %), then changes in parietal area--33 (28.2 %) and temporoparietal area--22 (18.8 %), and a bit less had changes in capsula interna--15 (12.8 %), occipital--3 (2.6 %) and cerebellum--3 (2.6 %). In relation to the heart diseases, most of the patients have had compensated weakness of the heart--20 (41.7 %), suffered infarctus myocardii--8 (16.7 %) and atrial fibrillation--8 (16.7 %), with angina pectoris 6 (12,5 %), with arrhitmia--3 (6.3 %) and heart surgery--3 (6.3 %). In relation to their ability to walk at the moment of their admission to the Clinic, 62 (53.0 %) of them were immobile, while at their discharge from the hospital this number decreased to 15 (12.9 %). 14 patients (12.0 %) were able to walk at the moment of the admission, while at the discharge, this number increased to 47 (40.1 %). Differences are statistically significant at the level of p<0,01 for the patients with heart diseases, and p<0.05 for those without a heart disease. Recovery of ability to walk is significantly better with patients that have had multiple lacunar changes, p<0.001, changes in parietal area, p<0.001 and capsula interna, p<0.01. Average hospitalization for the whole test group was 22 +/- 13,6 days--for the Group I it lasted 24 and for the Group II 21 days. Recovery of ability to walk of patients who suffered the stroke is better (p<0.01) if patients have had heart diseases before the stroke, then if patients did not have a previous heart condition (p<0.05), but the average rehabilitation is longer for 3 days.