THE IMPACT OF STRUCTURAL AND NEUROCOGNITIVE FACTORS ON THE REHABILITATION POTENTIAL OF PATIENTS WITH MENINGIOMAS FOLLOWING SURGICAL TREATMENT

Аннотация

To evaluate the dynamics of functional, cognitive, and autonomic recovery in patients after surgical removal of intracranial meningiomas and to assess the effectiveness of the structured rehabilitation program RP-Rehab. Materials and Methods: The study included 118 patients with histologically confirmed meningiomas (WHO Grade I-III) who underwent surgical resection. Functional independence was assessed using the Functional Independence Measure (FIM) and Barthel Index; cognitive status was evaluated using the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). Autonomic regulation was analyzed based on heart rate variability (HRV) indices (SDNN, RMSSD, Stress Index). The RP-Rehab program consisted of early mobilization, functional task-specific kinesitherapy, domain-based cognitive training, and respiratory-autonomic modulation (HRV-biofeedback). Results: At baseline (postoperative discharge), patients demonstrated moderate functional dependency (FIM 91 ± 14; Barthel 64 ± 15), cognitive impairment (MoCA 22.3 ± 3.1; FAB 11.1 ± 2.7), and increased sympathetic tone (Stress Index 248 ± 71). Three months after RP-Rehab, there was a statistically significant improvement in daily functional independence and cognition (FIM 112 ± 9; Barthel 89 ± 10; MoCA 25.7 ± 2.4; FAB 13.8 ± 2.1; p < 0.001), accompanied by restoration of autonomic balance (SDNN 41.5 ± 12.7; Stress Index 183 ± 53; p < 0.001). Conclusion: The RP-Rehab program effectively enhances functional independence, cognitive abilities, and autonomic regulatory capacity in patients following meningioma surgery. Individualized rehabilitation intensity, based on pre-existing neurological and systemic factors, is essential for optimizing recovery outcomes.