scholarly journals Practical aspects of balance and vestibular rehabilitation after stroke

2018 ◽  
pp. 36-38
Author(s):  
M. V. Zamergrad ◽  
S. E. Khatkova
Keyword(s):  
Drug Therapy ◽  
Physical Rehabilitation ◽  
Cerebral Stroke ◽  
Physical Endurance ◽  
Functional Capabilities ◽  
Proprioceptive Sensitivity ◽  
Risk Of Falls ◽  
Detailed Assessment ◽  
Spastic Paresis ◽  
Cerebellar Disorders

Balance and vestibular disorders are often detected in patients who have suffered a stroke. Instability may be caused by various reasons. In some cases, impairment of gait is caused by spastic paresis, in others by proprioceptive sensitivity and cerebellar disorders. Management of patients with balance disorders in the post-stroke period is composed of a detailed assessment of functional capabilities, the risk of falls and the cause of instability, as well as the adjustment of physical rehabilitation and drug therapy. The effective methods of physical rehabilitation include general exercises to strengthen stability and physical endurance, and special simulators with biological feedback. The drug therapy includes basic pharmacotherapy for the secondary prevention of stroke and symptomatic agents that can manage various disorders due to pathogenetic mechanisms of cerebral stroke (botulinum therapy, Vasobral). 

Atypical Antipsychotics: Impact on Overall Health and Quality of Life

2002 ◽  
Vol 8 (4_suppl) ◽  
pp. S9-S17 ◽  
Author(s):  
Mary Ann Boyd
Keyword(s):  
Quality Of Life ◽  
Drug Therapy ◽  
Side Effects ◽  
Underlying Disease ◽  
Psychiatric Nurses ◽  
Increased Risk ◽  
Detailed Assessment ◽  
Concomitant Medications ◽  
Gait Disturbances

The use of antipsychotic medications for the treatment of schizophrenia requires a detailed assessment of patient history, including comorbidities and concomitant medications. Because all antipsychotics may produce a complex array of adverse effects, the patient’s drug therapy may lead to exacerbation of pre-existent health problems and impaired quality of life. The occurrence of drug-related side effects such as cardiac disturbances, diabetes, and obesity is important to document for these patients, especially if they are already at increased risk because of underlying disease, substance abuse, or smoking. Antipsychotics may also cause anticholinergic effects, gait disturbances, and excessive sedation, which are particularly important reactions to monitor in elderly patients. Psychiatric nurses need to be aware of the risk for these side effects in relation to patients’ new or ongoing medication so that potentially serious events can be recognized and corrected. Appropriate patient education about medication is also an important component in helping patients to recognize and manage side effects and to gain the most from their drug therapy.

scholarly journals Systematization of methods of physical rehabilitation of children with inherited nervo-muscle diseases

2020 ◽  
Keyword(s):  
Muscle Strength ◽  
Motor Activity ◽  
Rational Choice ◽  
Muscle Tone ◽  
Neuromuscular Diseases ◽  
Rehabilitation Program ◽  
Physical Rehabilitation ◽  
Fine Motor ◽  
Activity Increase ◽  
Functional Capabilities

Summary. Children with hereditary neuromuscular diseases constitute one of the main groups of patients in public and private rehabilitation institutions. Therefore, there is a need to develop a rational choice of physical rehabilitation means, their systematization depending on the level of functional capabilities, which is relevant when developing an individual rehabilitation program in the centres. Purpose. Formation of an integrated approach in the rational choice of methods of physical rehabilitation and orthopedic supply for patients with hereditary neuromuscular diseases. Tasks. Development of stages for the provision of rehabilitation services, determination of the composition of an individual rehabilitation program, development of an algorithm for choosing methods of physical rehabilitation and technical means, depending on the degree of limitation of the child's motor functions. Results. The study involved 46 children aged 2 to 15 years. Assessment of the functional status of children, in accordance with the recommendations of the International Committee for the Standards of Treatment of patients with SMA, was performed on the Hammersmith scale, the assessment of muscle strength - on the Lovett test. The rehabilitation course according to the developed algorithm consisted of 4 stages: the stage of diagnosis, the stage of drawing up an individual rehabilitation program in accordance with the patient's functional capabilities, the stage of the course of physical rehabilitation and the stage of assessing its effectiveness. The main principles of rehabilitation were: stretching of contracted tissues, positioning of segments of the limbs and spine, physical activity in a submaximal mode, verticalization with the use of aids, compensation of lost functions and orthopedic correction using orthoses of various designs. The course carried out helped to stabilize muscle strength and motor activity, increase the volume of passive movements in large joints, and fine motor dexterity. Technical means of rehabilitation made it possible to correct the deformity of the segments of the limbs and the spine, to increase the dexterity of movements when performing tasks for fine motor skills. Conclusions. Adequate rehabilitation measures aimed at maintaining the motor activity of patients, maintaining muscle tone (including the respiratory muscles), timely correction of pathological attitudes of the limbs and spine in children with progressive neuromuscular diseases, inhibit the development of deformities, prolong motor activity.

scholarly journals Training of Respiratory Muscles in Motion in the Physical Rehabilitation of Patients with Chronic Cerebral Ischem

2020 ◽  
Vol 100 (6) ◽  
pp. 19-24
Author(s):  
V.V. Ezhov ◽  
V.I. Mizin ◽  
A.Yu. Tsarev ◽  
T.E. Platunova
Keyword(s):  
Cerebral Ischemia ◽  
Respiratory Muscles ◽  
Physical Rehabilitation ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Endurance ◽  
External Respiration ◽  
Chronic Cerebral Ischemia ◽  
State Reduction ◽  
Therapeutic Exercises

The aim of the study was to evaluate the effectiveness of respiratory muscles training in patients with chronic cerebral ischemia at thehealth resort stage of medical rehabilitation. Materials and methods. An open randomized controlled clinical trial was conducted in 60 patients with chronic cerebral ischemia,who underwent a course of sanatorium-resort rehabilitation treatment on the southern coast of Crimea (Yalta, Republic of Crimea). Men - 11.0%, women - 89.0%, age - 62.3 ± 2.3 years, disease duration - 4.5 ± 1.2 years. In control group 1 (n = 30), climatotherapy, physical training (morning exercises, remedial gymnastics, health path), massage, hardware physiotherapy and medications were carried out. In the main group 2 (n = 30), a similar basic complex was used, but therapeutic exercises were carried out with a breathing simulator and included walking, exercises for diaphragm training, general motor skills, coordination, dexterity, mobility, and joint flexibility. Number 10–12. Before and after the treatment, clinical, laboratory, biochemical, functional (spirography, electrocardiography, fitness test), psychological (Reeder and Back tests) studies were carried out; the indicators of the quality of life were studied; the state of 23 selected domains of the “International classification of functioning, disabilities and health”, included in the section “Body functions”, was assessed. Results. During the sanatorium-resort stage of medical rehabilitation, significant systemic effects were noted in the form of a decrease in clinical manifestations of the disease, an improvement in physical performance indicators and an increase in reserves for overcoming psychological stress. In patients, there was an improvement in static-coordination and psycho emotional state, reduction of dizziness and cephalgia, fatigue, increase in exercise tolerance, general physical endurance, normalization of carbohydrate metabolism indicators and blood lipids.Conclusion. A method of physical rehabilitation based on the principle of external respiration modification by using a breathing trainer with vibration function has been developed. The study allows us to recommend the inclusion in the complex of medical rehabilitation of patients with chronic cerebral ischemia, physical exercises with a breathing simulator, focused on increasing the functional body reserves.

scholarly journals Usage of the GMFM-88 Scale for the Evaluation of the Effectiveness of Short-term Intensive Rehabilitation of Children with Motor Disorders

2021 ◽  
Vol 20 (4) ◽  
pp. 90-98
Author(s):  
Anna Yu. Litus ◽  
Gennadiy P. Feskov
Keyword(s):  
Motor Impairment ◽  
Integrated Approach ◽  
Motor Disorders ◽  
Short Term ◽  
Significance Level ◽  
Functional Capabilities ◽  
Before And After ◽  
Rehabilitation Period ◽  
Detailed Assessment ◽  
Intensive Rehabilitation

Aim. To explore the possibility of using the GMFM-88 scale for the evaluation of the effectiveness of short-term (21 days) intensiverehabilitation of children with motor impairment. Material and methods. The study included a combination of statistical and analytical methods. 83 children with cerebral palsy underwentintensive physical rehabilitation at the Centre of Medical Technology and Rehabilitation (CMTR. The level of the children’sfunctioning was assessed in accordance with the Gross Motor Function Classification System (hereinafter GMFCS). The GMFM-88 scalehas been employed for the planning of the intervention and the assessment of rehabilitation effectiveness. Results. Statistical analysis of the average values on GMFM-88, before and after rehabilitation and according to the Student t-criterion,shows significant changes in functioning after rehabilitation (t = -6.493, significance level less than 0.0001). This suggests the possibility of using the scale as a tool for assessing short-term interventions. At the same time, the use of this scale justifies the assumptionabout the effectiveness of short-term intensive rehabilitation in the form of significant improvements in the functional capabilities ofchildren with motor disorders. Conclusion. The use of the standardized GMFM-88 scale in this study confirms our assumption regarding the need for periodic, intensiverehabilitation for children with movement disorders. An integrated approach to the detailed assessment of the current state ofthe child makes it possible more accurately identify current problems, determine the nearest development zones, and, consequently,identify the goals and objectives for the rehabilitation period.

scholarly journals Influence of complex physical rehabilitation on the dynamics of recovery of cognitive functions in patients who have been cerebral ischemic stroke

2021 ◽  
pp. 32-36
Author(s):  
Valeriia Mishchenko
Keyword(s):  
Ischemic Stroke ◽  
Drug Therapy ◽  
Cognitive Functions ◽  
Secondary Prophylaxis ◽  
Main Group ◽  
Physical Rehabilitation ◽  
Standard Drug ◽  
Rehabilitation Treatment ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

The article presents the results of a study of the effect of a complex physical rehabilitation on the dynamics of restoration of cognitive impairments in patients in the early recovery period of the cerebral ischemic stroke. The study included 83 patients. All patients under study were distributed to the main group and the comparison group. The average age of the patients was 66,0 ± 2,3 years. Patients of two groups received standard drug therapy aimed at secondary prophylaxis. The patients under study from the main group additionally undertook a course of physical rehabilitation treatment within 21 days. Assessment of the condition of cognitive functions was carried out with the help of psychodiagnostic scales before the onset and after completion of treatment. The study showed that the use of a complex rehabilitation treatment, which includes drug therapy within the framework of secondary prophylaxis and course of physical rehabilitation can significantly affect the improvement of the state of moderately impaired cognitive functions in patients with a hemispheric ischemic stroke.

scholarly journals Validation of the Actibelt® speed measurement in patients with dizziness and vertigo

2016 ◽  
Author(s):  
Valentin Rampmaier ◽  
Fabian Schenkel ◽  
Martin Daumer ◽  
Roman Schniepp
Keyword(s):  
Control Variable ◽  
Speed Estimation ◽  
Accelerometer Data ◽  
Laboratory Environment ◽  
Promising Tool ◽  
Speed Measurement ◽  
Risk Of Falls ◽  
Walking Velocity ◽  
Walking Speeds ◽  
Cerebellar Disorders

Walking velocity is an important control variable in gait disorders due to sensory or cerebellar disfunction. Non-preferred walking speeds are closely linked to a higher risk of falls. A compensation strategy of patients to avoid these speed sectors can be assumed. So far speed measurements are only possible in a laboratory environment. Actibelt® is a promising tool that allows speed estimation based on accelerometer data. The used algorithms have not been validated for patients with sensory or cerebellar disorders.

scholarly journals BACKWARD WALKING AS A NEW TECHNIQUE FOR PHYSICAL REHABILITATION

2018 ◽  
Vol 17 (1) ◽  
pp. 4-8
Author(s):  
Aleksey Viktorovich Klemenov
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Athletic Training ◽  
Anaerobic Capacity ◽  
Physical Rehabilitation ◽  
Lower Limbs ◽  
Physical Endurance ◽  
Backward Walking ◽  
A New Technique

Backward locomotion (backward walking and running) is increasingly used in sports and medicine. Kinetic and kinematic analysis of backward walking showed its advantages over the usual method of movement that can be successfully used in the athletic training and for treatment and rehabilitation after various diseases. During sports training backward walking/running can be used as one of the methods of fitness to improve physical endurance. Backward walking leads to a more cardiovascular and respiratory load and a more significant aerobic and anaerobic capacity of the organism compared with forward walking at similar parameters of physical activity. Backward walking is associated with less overload on knee joints, it is also one of the few natural ways of strengthening the quadriceps. Backward walking is used to elaborate the correct pattern of gait in children with cerebral palsy, in persons with hemiplegia after stroke, in patients suffering from Parkinson’s disease and multiple sclerosis, in spinal cord injured patients. Regular backward walking trainings improve spatial-temporal parameters of walking and balance, increase muscle strength of the lower limbs in these diseases. There is an information about the application of backward walking exercises in diabetic foot syndrome in order to reduce a plantar pressure and in physical rehabilitation of postoperative patients. Tests with backward walking are used for diagnostic purposes - to assess the severity of impaired coordination and motor skills in post-stroke patients and in Parkinson’s disease, to identify the minimal walking impairment in persons with multiple sclerosis and for probability of falling prediction in elderly individuals and patients with dizziness.

scholarly journals The motor activity in acute cerebral stroke based on the Performance Oriented Mobility Assessment test modified by M. T inetti (1986), functional stress tests and screening assessment of visual-spatial disorders

2019 ◽  
Vol 25 (2) ◽  
pp. 169-175
Author(s):  
A. N. Alekhin ◽  
I. V. Sakovsky ◽  
V. V. Kemstach ◽  
V. G. Pomnikov ◽  
V. M. Tarantseva ◽  
...  
Keyword(s):  
Motor Activity ◽  
Spatial Neglect ◽  
Cerebral Stroke ◽  
Stress Tests ◽  
Motor Rehabilitation ◽  
Visual Spatial ◽  
Mobility Assessment ◽  
Risk Of Falls ◽  
Design And Methods ◽  
Functional Stress

Objective. The article presents the survey data of 80 patients in the acute period of cerebral stroke who were treated in the department of the primary vascular center. Design and methods. Upon recommendations of the motor activity, the patients with acute stroke were screened for the presence of neglect. The choice of motor activity was based on the Performance Oriented Mobility Assessment test in the modification of M. Tinetti (1986) and the results of functional stress tests. Results. There were no complications or falls at the hospital when adequate vegetative support and a high score at Performance Oriented Mobility Assessment in the modification of M. Tinetti (1986) were present, as well as in the absence of visual-spatial inability. The patients with the significant visual-spatial neglect showed higher risk of falls, even with adequate vegetative support and postural stability. Results. We demonstrated the possibility, as well as the prognostic value of the Performance Oriented Mobility Assessment in the modification of M. Tinetti (1986) and functional stress tests along with the assessment of visual-spatial neglect in planning the early motor rehabilitation of patients with cerebral stroke. In addition, we developed an algorithm for the motor rehabilitation planning.

scholarly journals Validation of the Actibelt® speed measurement in patients with dizziness and vertigo

2016 ◽  
Author(s):  
Valentin Rampmaier ◽  
Fabian Schenkel ◽  
Martin Daumer ◽  
Roman Schniepp
Keyword(s):  
Control Variable ◽  
Speed Estimation ◽  
Accelerometer Data ◽  
Laboratory Environment ◽  
Promising Tool ◽  
Speed Measurement ◽  
Risk Of Falls ◽  
Walking Velocity ◽  
Walking Speeds ◽  
Cerebellar Disorders

Walking velocity is an important control variable in gait disorders due to sensory or cerebellar disfunction. Non-preferred walking speeds are closely linked to a higher risk of falls. A compensation strategy of patients to avoid these speed sectors can be assumed. So far speed measurements are only possible in a laboratory environment. Actibelt® is a promising tool that allows speed estimation based on accelerometer data. The used algorithms have not been validated for patients with sensory or cerebellar disorders.

scholarly journals Cardiovascular Diseases and Drug Treatment in Patients with the History of Cerebral Stroke: Data of the Outpatient Registry REGION

2019 ◽  
Vol 14 (6) ◽  
pp. 879-886 ◽  
Author(s):  
M. M. Loukianov ◽  
S. S. Yakushin ◽  
S. Yu. Martsevich ◽  
O. M. Drapkina ◽  
A. N. Vorobyev ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Cardiovascular Diseases ◽  
Drug Treatment ◽  
Outpatient Clinics ◽  
Cerebral Stroke ◽  
History Of ◽  
Drug Provision

Aim. To evaluate the structure of combined cardiovascular diseases, drug treatment and observation of patients with a history of stroke in the framework of prospective outpatient registries. Material and methods. The study was conducted based on 3 outpatient clinics of Ryazan city. Patients with a history of acute cerebrovascular accident (ACVA) of any remoteness (AR) were included into ACVA-AR outpatient registry (n=511). Patients who had visited the outpatient clinics for the first time (FT) after cerebral stroke (n=475) were included into the ACVA-FT outpatient registry. The structure of the cardiovascular diseases (CVD), compliance with the clinical recommendations of the prescribed and received drug therapy were evaluated. The proportion of patients with dispensary observation for CVD, using preferential drug provision was determined. Results. A combination of 2 or more CVDs was found in 84.4% and 82.5% of cases, and severe cardiovascular multimorbidity (3-4 CVDs) – in 69% and 64% of cases, respectively, in ACVA-AR and ACVA-FT registers. Compliance with the clinical guidelines prescribed and received drug therapy was insufficient at the outpatient stage. Necessary prescription of drugs with a proven beneficial effect on the prognosis were observed significantly more frequent in the ACVA-FT registry, compared to the ACVA-AR registry at the enrolling stage of the study (p<0.05): statins for stroke – 50.1% vs 25.2%; statins for coronary heart disease (CHD) – 47.2% vs 27.9%; antiplatelet agents for CHD without atrial fibrillation – 65.6% vs 54.3%; anticoagulants for atrial fibrillation – 17.7% vs 9.3%; beta-blockers for heart failure 43.5% vs 33.1%, respectively. After 2-3 years of the follow-up frequency of prognostically significant prescriptions in patients of the compared registries were not significantly different, except prescriptions for statin therapy (47.6% vs 21.3%, respectively). The prognostically significant prescriptions during the enrolling stage in ACVA-AR and ACVA-FT registries occurred in 44.4% and 54% of the total number of proper prescriptions, and in the long-term follow-up period – in 55% and 57%, respectively; and the dispensary observation coverage was only 35.0% and 31.8%, respectively. According to patient contact only 21-24% of patients used the system of preferential drug provision at the stage of inclusion into the registers, and after 2-3 years of follow-up – 1.5-2 times less (12-14%). Conclusion The results of the study REGION found the presence of cardiovascular multimorbidity in 83% of patients with a history of stroke, insufficient quality of prescribed drug therapy in the out-patient clinic, especially in the ACVA-AR registry. The quality of medical treatment of patients improved within 2-3-year follow-up after the reference visit to out-patient clinic, but not sufficiently. Increase in dispensary observation coverage and optimization of the system of preferential drug provision are also important reserves for improving the quality of treatment of patients with a history of stroke, as well as prevention of cardiovascular complications. 

Sign in / Sign up

Export Citation Format

Share Document