PSYCHOLOGICAL PECULIARITIES OF CORRECTION OF PSYCHOMOTRIC DISORDERS OF PATIENTS WITH ISCHEMIC STROKE

Abstract

The article deals with somatic disorders that occur in a case of ischemic stroke; programming disorders of psychomotor activity of patients were described; disorders of coordination of presenting of psychomotor activity by patients were described; the psychological peculiarities of correction of psychomotor disorders of patients with ischemic stroke were singled out. The most frequent and severe consequence of cerebral ischemic stroke is the disorder of the motor functions of the person. Characteristic feather is the polymorphism of motor disorders of patients with cerebral ischemic stroke. In this case, general for patients is only the loss or violation of arbitrary actions (in the cases of hemiparesis or hemiplezia). Other clinical symptoms are largely variable and depend on a certain extent of the size of affected area, also its localization. According to various authors, persistent disturbances of motor function are also observed in the first days after the disease (in 70-80% of cases of patients who had the ischemic stroke).

Motor disorders can be distinguished (by the type of their genesis) on primary-organic and psychogenic motor disorders. In the case of primary-organic motor disorders pathological changes are observed in the muscular, skeletal or nervous systems, however, in the conditions of psychogenic motor disorders the presence of such changes proved to be objectively impossible. To describe motor disorders of a patient, first of all, it is necessary to know: a) what functions must be distinguished in the cases of the process of motor regulation of a person; b) in what forms the disorders of these functions are revealed. The main differences observed between disorders are: a) initiation of actions; b) frustration in their presentation. In the cases of doing the actions there are disorders of the programmed control, regulation and coordination. Disorders that occur in the case of actions in a case of ischemic stroke can be compared with so called «initiated actions». From the functional point of view any action does not start at the moment when any muscles are reduced or relaxed. With the help of physiological and psychological methods it can be proved first of all, that there are processes of preparation for actions, which are often called «programming ones»: the previously formed motion program must be ready and its parameters should be adapted to required action. Such kind of disorder appears sometimes only in a case of performance of certain action and then they can be described as disturbances of purposeful management of the program of a patient. But, according to this, there are disorders that relate to a fundamentally different motor programs which have not be programmed by the person.

Psychological principles of the development of general compensatory reactions of the patient in a case of physical rehabilitation of patients with ischemic stroke were proposed in this research. These principles are: 1) the principle of actualization of the defect; 2) the principle of progressive mobilization of compensatory mechanisms of psychomotor activity; 3) the principle of continuous reverse of concentration of compensatory mechanisms of the psyche of the person; 4) the principle of sanctioning compensatory mechanisms of the psyche of the person; 5) the principle of relative stability of the compensatory mechanisms of the psyche of the patient.