THE EFFECTIVENESS OF USING THE MODEL OF PATHOGENETICALLY SUBSTANTIATED REHABILITATION OF SENSORIMOTOR DISORDERS IN THE PATIENTS AFTER ISCHEMIC STROKE


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Abstract

The objective of the present study was to evaluate the effectiveness of pathogenetically substantiated rehabilitation of sensorimotor disorders in the patients who had experienced ischemic stroke. Material and methods. A total of 220 patients presenting with hemiparesis following ischemic stroke were available for the examination. The control group was comprised of 35 healthy subjects. All the patients underwent the rehabilitative treatment which included robotized mechanotherapy, stabilography, neuro-muscular stimulation, physical therapy, ergotherapy, massage, etc. Before and after the course of rehabilitation therapy, transcranial magnetic stimulation (MS) was applied and the characteristics of somatosensory evoked potentials (SSEP) were measured in all the patients. Results. Rehabilitation with the use of a personified, pathogenetically grounded approach contributed to a better replenishment of the neurological deficit. In those patients who received the personalized neurorehabilitative treatment significant changes of TMS parameters (central motor conduction time at rest and TMS facilitation test) but not SSEP were registered. Conclusions. The effectiveness of the model of pathogenetically substantiated rehabilitation of sensorimotor disorders in patients after ischemic stroke was confirmed. We have demonstrated a higher effectiveness of restorative therapy of sensorimotor deficit. The somatosensory functions less efficiently responded to the treatment which suggests the necessity of identification of the sensory deficit and taking it into consideration together with neurophysiological monitoring of the rehabilitation process with the use of TMS and SSEP for the enhancement of the effectiveness of ongoing rehabilitation in this category of the patients.

About the authors

Evgeniya Viktorovna Ekusheva

Federal state budgetary educational institution of additional professional education «Advanced Training Institute» of the Federal Medical Biological Agency

Email: ekushevaev@mail.ru
MD, PhD, associate professor, Department of nervous diseases and neurostomatology, Federal state budgetary educational institution of additional professional education «Advanced Training Institute», Federal Medical Biological Agency, 125371, Moscow, Russia. 125371, Moscow, Russia

E. S Kiparisova

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

I. S Denischuk

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

E. V Khozhenko

Clinical Military Hospital

125481, Moscow, Russia

I. V Pryanikov

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

M. N Puzin

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

S. M Makkaeva

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

Yu. V Lepaev

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

L. A Tarasova

Federal state budgetary institution «Federal Bureau of Medical and Social Expertise». Ministry of Labour of the Russian Federation

127486, Moscow, Russia

B. G Afanasiev

«Educational center» Non-Governmental Educational Facility «Medical stomatological institute»

127486, Moscow, Russia

References

  1. Гусев Е.И., Коновалов А.Н. Клинические рекомендации. Неврология и нейрохирургия. М.: ГЭОТАР-Медиа; 2015.
  2. Кадыков А.С., Черникова Л.А., Шахпаронова Н.В. Реабилитация неврологических больных. М.: МЕДпресс-информ; 2014.
  3. Нуднов Н.В., Кузьменко В.А., Кипарисова Е.С., Буров С.А. Современные рекомендации по диагностике и лечению нарушений мозгового кровообращения и черепно-мозговой травмы. Практическое руководство для неврологов, реаниматологов и нейрохирургов. Под общ. ред. В.В. Добржанского. М.: Издательский дом «Русский врач»; 2012.
  4. Lawrence E.S., Coshall C., Dundas R., Stewart J., Rudd A.G., Howard R., Wolfe C.D. Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001; 32(6): 1279-84.
  5. Leipert J. Pharmacotherapy in restorative neurology. Curr. Opin. Neurol. 2008; 21(6): 639-43.
  6. Miller E.T., Murray L., Richards L., Zorowitz R.D., Bakas T., Clark P. et al. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010; 41(10): 2402-48.
  7. Дамулин И.В., Екушева Е.В. Инсульт и нейропластичность. Журнал неврологии и психиатрии им С.С. Корсакова. 2014; 114(8): 136-42.
  8. Екушева Е.В. Сенсомоторная интеграция при поражении центральной нервной системы: клинические и патогенетические аспекты: автореф. дис.. д-ра мед. наук. М., 2016.
  9. Екушева Е.В., Устьянцева Н.В. Сенсомоторные нарушения после ишемического инсульта: межполушарные аспекты и патогенетические подходы к нейрореабилитации. Вестник клинической нейрофизиологии. 2016; 1(11): 63-70.

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