Сomplex rehabilitation of walking function in central paresis of the lower limb using neuroprosthetic technology

Disability after a stroke is most often associated with decreased patient activity due to walking disorder. In case of severe paresis, the function of the limb in the early stages of recovery is advisable to support with the help of partial prosthetics, using methods that provide functional stimulation. The complex treatment of central paresis includes botulinum therapy, which is due to the high incidence of spasticity. Aim: of the study: evaluation of the efficacy of functional electrical stimulation in a complex of multimodal effects in restoring movement in stroke patients with lower limb paresis. Materials and methods: Stimulation and neuroprosthetic methods (Bioness L300) were used as the main therapeutic program of rehabilitation treatment for patients with motor disorders of the lower limb after an ischemic stroke (n = 70). The median period of stroke was 21 [11; 47] days, median age 54 [42; 65] years. Scales and questionnaires were used to assess the loss of strength and volume of movement disorders, spasticity, walking speed and self-care (Medical Research Council Weakness Scale (1981, MRC), Barthel Index (1965), Modified Ashworth Scale (MAS), 10-meter test). Results: The effectiveness of personalized therapy with the use of a neuroprothesis (Bioness L300) in patients in the acute and early recovery period of ischemic stroke was shown. The additional use of botulinum toxin made it possible to eliminate the inhibitory effect of spasticity, which expanded the possibility of using intensive methods of physical rehabilitation. There was an increase in daily activity, walking speed, and the level of self-care of patients in 90 % of cases. Conclusion: The use of a complex of stimulating personalized techniques in the acute period of a stroke is justified and safe. The functional electrical stimulation helps to overcome power paresis, increases the overall level of physical activity of patients after a stroke, motivation for recovery and improves the quality of life. (1 figure, 2 tables, bibliography: 9 refs)

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Neurorehabilitation in the Early Recovery Period of Ischemic Stroke. Pharmacology Support

Acta Balneologica ◽

10.36740/abal202101103 ◽

2021 ◽

Vol 63 (1) ◽

pp. 22-25

Author(s):

Denys N. Khramtsov ◽

Olexandr N. Stoyanov ◽

Tetiana N. Muratova ◽

Olexandr R. Pulyk

Keyword(s):

Ischemic Stroke ◽

Acute Stroke ◽

Recovery Period ◽

Rehabilitation Medicine ◽

Neuroprotective Agents ◽

Early Recovery ◽

National Medical ◽

Cholinergic Agents ◽

Early Recovery Period ◽

Medical University

Aim: The aim of the study was to evaluate the clinical outcome in the use of neuroprotective agents in the acute period of ischemic stroke. Material and Methods: The study was performed on the basis of the stroke of the Center for Reconstructive and Rehabilitation Medicine (University Clinic) of the Odessa National Medical University. A retrospective analysis of clinical outcomes of 115 patients with acute stroke was conducted. Results: An average NIHSS score at discharge was 4.1±0.1 points when treated with no refinery, then it reached 3.6±0.1 points when using peptidergic drugs, and 3.4±0.1 when using D-fdf. 3.1±0.1 points. When using D-FDF, the MMSE score was 3.5±0.1 points, whereas when using cholinergic agents, this index did not exceed 26.9±1.5 points, and when using peptidergic agents - 26.8±1.4 points. Conclusion: The use of neuroprotective agents positively affects the effectiveness of neuro-rehabilitation in patients with acute stroke. The best results in three months after the hospitalization were obtained for peptidergic agents and D-fructose-1,6-diphosphate.

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Relationship between Movement Stereotype and Focus Location in the Early Recovery Period after Mild Ischemic Stroke

Neuroscience and Behavioral Physiology ◽

10.1007/s11055-019-00881-2 ◽

2019 ◽

Vol 50 (2) ◽

pp. 149-155

Author(s):

I. A. Belayeva ◽

M. Yu. Martynov ◽

Ya. G. Pehova ◽

A. A. Vershinin ◽

A. P. Rachin ◽

...

Keyword(s):

Ischemic Stroke ◽

Recovery Period ◽

Early Recovery ◽

Early Recovery Period

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Dynamics of recovery of cognitive deficit in patients in the early recovery period of ischemic stroke

Zhurnal nevrologii i psikhiatrii im S S Korsakova ◽

10.17116/jnevro202112111126 ◽

2021 ◽

Vol 121 (11) ◽

pp. 26

Author(s):

S.V. Kotov ◽

V.A. Borisova ◽

E.V. Slyunkova ◽

E.V. Isakova ◽

A.V. Kiselev ◽

...

Keyword(s):

Ischemic Stroke ◽

Cognitive Deficit ◽

Recovery Period ◽

Early Recovery ◽

Early Recovery Period

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Efficacy of Metabolic Correction in the Early Recovery Period in Patients with Ischemic Stroke

Neuroscience and Behavioral Physiology ◽

10.1007/s11055-020-01032-8 ◽

2020 ◽

Vol 51 (1) ◽

pp. 12-15

Author(s):

T. S. Poltavskaya ◽

V. A. Bazhenov ◽

A. V. Volojanin

Keyword(s):

Ischemic Stroke ◽

Recovery Period ◽

Early Recovery ◽

Early Recovery Period ◽

Metabolic Correction

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Mirror therapy in complex rehabilitation of the function of the upper extremity in the early recovery period of ischemic stroke

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.1700 ◽

2017 ◽

Vol 381 ◽

pp. 603

Author(s):

N. Kurenkova ◽

A. Shukaylova ◽

A. Bakeeva ◽

D. Popov ◽

O. Lvova ◽

...

Keyword(s):

Ischemic Stroke ◽

Upper Extremity ◽

Recovery Period ◽

Mirror Therapy ◽

Early Recovery ◽

Early Recovery Period

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Comparative Characterization of Candidate Molecular Markers in Ischemic and Hemorrhagic Stroke

General Reanimatology ◽

10.15360/1813-9779-2021-5-23-34 ◽

2021 ◽

Vol 17 (5) ◽

pp. 23-34

Author(s):

A. M. Golubev ◽

A. V. Grechko ◽

V. E. Zakharchenko ◽

M. M. Kanarsky ◽

M. V. Petrova ◽

...

Keyword(s):

Ischemic Stroke ◽

Molecular Markers ◽

Neurotrophic Factor ◽

Hemorrhagic Stroke ◽

Recovery Period ◽

Control Group ◽

Early Recovery ◽

Acute Period ◽

S 100 ◽

Early Recovery Period

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

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Features of prognostic function in patients with ischemic stroke of frontal localization in the early recovery period

Russian neurological Journal ◽

10.30629/2658-7947-2021-26-4-31-38 ◽

2021 ◽

Vol 26 (4) ◽

pp. 31-38

Author(s):

E. I. Nikishina ◽

A. E. Danilova ◽

V. B. Nikishina ◽

I. V. Zapesotskaya ◽

T. V. Nedurueva ◽

...

Keyword(s):

Ischemic Stroke ◽

Recovery Period ◽

Time Estimation ◽

Total Sample ◽

Practical Significance ◽

Research Subjects ◽

Early Recovery ◽

Preliminary Orientation ◽

Incomplete Images ◽

Early Recovery Period

The article presents the results of the research of the features of the anticipation and prognostic function in patients with ischemic stroke of frontal localization in the early recovery period.Material and methods. The total sample group was represented by 60 patients who had suffered an ischemic stroke of frontal or parietal localization. The average age of the research subjects was 53.00 ± 5.44 years. The study was conducted with the use of functional neuropsychological tests (by A.R. Luria, L.S. Tsvetkova), methods of predictive function research (time estimation test, spatial anticipation test, Maze test, London Tower test, “incomplete images” test), as well as statistical methods of quantitative and qualitative data processing.Results. In patients with prefrontal localization of ischemic stroke a specific impairment of prognostic function and a non-specific decrease in anticipation were revealed. It is due to disorders of mental activity purposefulness and preliminary orientation in the conditions of the task. When the lesion was localized in the premotor areas, a less significant decrease in the rate and accuracy of the prognostic function due to the inertia of the mental processes was revealed. In the localization of ischemic stroke in the associative parietal cortex, a specific decrease in the rate and accuracy of sensorimotor, perceptual, and temporal anticipation was revealed, as well as a non-specific decrease in the rate of planning, while maintaining its accuracy of implementation.Conclusion. In terms of practical significance, taking into account the features of prognostic function that have arisen in a particular form of brain damage can serve as a basis for restoring other gnostic or motor impaired functions, increasing the effectiveness of correctional and rehabilitation measures.

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