Development of a correctional program of rehabilitation training for patients after a stroke having regard to the postulates of K.D. Ushinsky
The consequences of a stroke are manifested not only in the motor sphere, but also in the cognitive sphere, which complicates the process of rehabilitation and adaptation of the patient. This makes it relevant to study impairments of higher mental functions and build a program for their correction. The study is focused on the features of memory loss in elderly patients after an ischemic stroke with a lesion in the left and right hemispheres. The authors identify correction targets and develop a program for psychological correction of memory. The study involved 22 patients aged 60-75 (13 men and 9 women) who were treated after an ischemic stroke in a clinic in Saint Petersburg: 11 patients had a lesion in the right hemisphere, and 11 patients, in the left hemisphere. Auditory-speech memory and visual memory were analyzed using the following methods: memorizing ten words; memorizing images of objects (S. Ya. Rubinshtein); Benton’s visual retention test (adapted by L. I. Vasserman, S. A. Dorofeeva, Ya. A. Meyerson). The study revealed that the delay in reproduction of words is greater in patients with a lesion in the left hemisphere. The patients with a lesion in the left hemisphere also reproduce visual-spatial stimuli with fewer errors. At the same time, they are more slow to cope with the process of visual memorization. We developed a psycho-correctional program which took into account the following postulates of K. D. Ushinsky: increasing difficulty of tasks (tasks range from simple to complex), understandability (tasks are understood by the patient after a stroke), feasibility (tasks are adequate to the patient’s condition), the role of labor (drawing therapy), and nationality (the knowledge of the Russian language). The program is aimed at strengthening short-term and long-term memory (auditory-speech and visual) by memorizing and then reproducing figures, and names and locations of streets.