Physiotherapy methods in the complex of cognitive rehabilitation of patients in the late recovery period in patients after ischemic stroke

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Abstract

BACKGROUND: For the purpose of early and late medical rehabilitation in recent decades, non-drug methods of physiotherapy have been actively used to restore patients who have had an ischemic stroke.

AIMS: substantiation of the inclusion of multimodal physiotherapeutic effects from the Alpha LED Ohu Light_Spa apparatus and low-frequency electrostatic massage from the Khivamat apparatus for the correction of cognitive impairment in patients who have suffered an ischemic stroke, with motor disorders in the form of hemiparesis, increased muscle tone by the type of spasticity in the late recovery period.

MATERIALS AND METHODS: The study included 120 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the form of spasticity in the late recovery period. Patients of group 3 (40 people) were prescribed standard drug therapy and medical rehabilitation, patients of group 1 (40 people in addition to standard therapy and rehabilitation, multimodal physiotherapeutic effects were used from the Alpha LED Oxy Light-Spa™ device and patients of group 2 (40 people) a low-frequency electrostatic massage from the Khivamat apparatus was added to the standard complex.

RESULTS: At all control points — after the course of treatment, after 6 and 12 months, in addition to general clinical studies, we assessed indicators of cognitive functions (according to the Montreal Cognitive Assessment Scale) and psycho-emotional state according to the HADS scale. In dynamics, it was revealed that in groups 1 and 2, where the developed rehabilitation programs were carried out, there was a significant improvement in cognitive functions (attention, memory, fluency, generalization, etc.), to a greater extent in group 1, while in patients who, against the background of drug therapy, underwent standard medical rehabilitation, only a positive trend was noted.

CONCLUSION: The inclusion in the medical rehabilitation of patients who have suffered an ischemic stroke, to a greater extent, multimodal physiotherapeutic effects and to a somewhat lesser extent, low-frequency electrostatic massage contributes to a significant improvement in cognitive functions and a reduction in anxiety and depression.

About the authors

Anna A. Mikhailova

Petrovsky National Research Centre of Surgery; MEDSI Group of Companies

Author for correspondence.
Email: mikhaylova003@gmail.com
ORCID iD: 0000-0002-4260-1619
SPIN-code: 7673-3241

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Moscow; Moscow Region

Natalia B. Korchazhkina

Petrovsky National Research Centre of Surgery

Email: mikhaylova003@gmail.com
ORCID iD: 0000-0001-6913-8778
SPIN-code: 9733-7646

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Elizaveta S. Koneva

MEDSI Group of Companies; The First Sechenov Moscow State Medical University (Sechenov University)

Email: mikhaylova003@gmail.com
ORCID iD: 0000-0002-9859-194X
SPIN-code: 8200-2155

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow Region; Moscow

Konstantin V. Kotenko

Petrovsky National Research Centre of Surgery

Email: mikhaylova003@gmail.com
ORCID iD: 0000-0002-6147-5574
SPIN-code: 5993-3323

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

References

  1. Sidyakina IV. Medical rehabilitation programs in the acute period of stroke. Bulletin of the Medical Dental Institute. 2011;(3):30–34. (In Russ).
  2. Khatkova SE. Treatment of spasticity after stroke. Neurology, neuropsychiatry, psychosomatics. 2010;(3):76–80. (In Russ).
  3. Abuseva GR, Antipenko PV, Arkov VV, et al. Physical and rehabilitation medicine: a national guide. Moscow: GEOTAR-Media; 2020. 688 p. (In Russ).
  4. Korchazhkina NB, Mikhailova AA, Kolganova DI, et al. Substantiation of the inclusion of pulsed low-frequency electrostatic massage in complex therapeutic and rehabilitation programs. Russian journal of the physial therapy, balneotherapy and rehabilitation. 2019;18(3):191–194. (In Russ). doi: 10.17816/1681-3456-2019-18-3-191-194
  5. Korchazhkina NB, Mikhailova AA. Features of the use of a stabiloplatform with biofeedback in various socially significant diseases. Russian journal of the physial therapy, balneotherapy and rehabilitation. 2019;18(2):103–106. (In Russ). doi: 10.17816/1681-3456-2019-18-2-103-106
  6. Mikhailova AA, Kotenko KV, Korchazhkina NB, Koneva ES. Database of scientific research on medical rehabilitation of patients after acute cerebrovascular accident: No. 2021621759. Certificate of state registration. Moscow: Federal State Budgetary Scientific Institution “Russian Scientific Center of Surgery named after Academician B.V. Petrovsky”; 2021. (In Russ).
  7. Mikhailova AA, Korchazhkina NB, Koneva ES, Kotenko KV. The psychocorrective effect of using combined methods of medical rehabilitation in patients who have suffered an ischemic stroke. Russian journal of the physial therapy, balneotherapy and rehabilitation. 2020;19(6):380–383. (In Russ). doi: 10.17816/1681-3456-2020-19-6-5

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Dynamics of indicators of cognitive functions on the MoCa scale in patients who suffered an ischemic stroke with motor disorders in the form of hemiparesis with increased muscle tone by the type of spasticity, immediately after the start of treatment.

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3. Fig. 2. Dynamics of МоСа subscales in the compared groups before and after rehabilitation in patients who suffered an ischemic stroke with motor disorders in the form of hemiparesis with increased muscle tone by the type of spasticity, in the late recovery period.

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Copyright (c) 2022 Mikhailova A.A., Korchazhkina N.B., Koneva E.S., Kotenko K.V.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


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