Effectiveness of a Comprehensive Medical Rehabilitation Program in Restoring Impaired Functions in a Patient with Intracerebral Hemorrhage (a Case Report)

The relevance of this clinical case lies in the need to identify effective rehabilitation strategies for patients who have experienced hemorrhagic stroke. During the recovery period after stroke, patients commonly present with severe neurological deficits, including motor impairment, speech disorders, cognitive dysfunction, and dysphagia, which may lead to life-threatening complications and adversely affect functional outcomes. This clinical observation illustrates the rationale and effectiveness of a multidisciplinary approach to post-stroke medical rehabilitation. A 52-year-old male patient with right hemispheric intracerebral hemorrhage and cerebral edema without midline shift, in the setting of multiple comorbidities, underwent an 8-week rehabilitation course in the intensive care unit and the neurological neurorehabilitation department. Swallowing function was assessed using an integrative evaluation method developed by specialists of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, which enabled timely adjustment of therapeutic interventions. The rehabilitation program included neuropsychological sessions, speech-language therapy, rhythmic transcranial magnetic stimulation using a dysphagia protocol, individualized therapeutic exercise, and robotic mechanotherapy with biofeedback. Rehabilitation effectiveness was assessed using the Functional Independence Measure (FIM): the gain was 1.81 points per day at the first stage, 1.41 points per day at the second stage, and 1.64 points per day over the entire rehabilitation course. Thus, a comprehensive multidisciplinary approach to post-stroke rehabilitation, incorporating interventions with proven efficacy in accordance with current clinical guidelines, remarkably improves medical rehabilitation outcomes. Assessment using the FIM allows reliable monitoring of patients’ ability to perform activities of daily living and their level of dependence throughout rehabilitation. The rate of FIM score improvement may serve as an additional indicator of rehabilitation effectiveness.