[Restoration of the complicated locomotor functions of the upper extremities in the patients surviving ischemic stroke]

[Methods to restore fine motor skills in stroke patients]

The review article considers the problem of nonmedical post-stroke rehabilitation, in particular the restoration of fine motor skills in patients in the early period of the disease. A review and analysis of various randomized controlled trials concerning the use of various rehabilitation methods both in monotherapy and in their combined application is carried out, and modern technical devices, with the use of computer technology and biofeedback, are reviewed. Proceeding from the presented literature data and their analysis, there are certain grounds for introducing modern apparatus complexes and robotized devices for fine motor skills restoration in post-stroke patients, especially in the early period, into the multimodal rehabilitation system. However, further research in this direction is needed to achieve a sustained positive result.

[The specific features of the clinical, functional and psychological status of the patients during the early and late restorative periods of ischemic stroke]

BACKGROUND

When choosing the algorithm of rehabilitative measures, the localization of the stroke, brain reserve, and neuroplasticity as well as clinical characteristics (motor, postural, speech, cognitive impairments), etc. are taken into consideration. Monitoring the health status of the patients is an integral component of and an important condition for the successful post-stroke rehabilitation.

AIM

The objective of the present study was to evaluate the clinical, functional and psychological status of the patients with stroke during the early and late restorative periods.

MATERIAL AND METHODS

The neurological disorders were characterized based on the National Institutes of Health Stroke Scale (NIHSS), the results of hand-grip dynamometry, the Frenchay arm test, and the modified Ashworth scale of muscle spasticity in the combination with the data on the activity of everyday life and the psychological status of the patients. Sstabilograpy, encephalography, and diagnostic transcranial magnetic stimulation (TMS) were carried out. The level of health of the patients was evaluated as the integral measure representing the sum of scores of ranked characters.

RESULTS

A total of 106 patients who had undergone ischemic stroke were available for the examination. During the early post-stroke period the gross disturbances of attention and vertical stabilization were documented. In addition, the dependence of equilibrium on the function of visual analyzer was revealed together with the large number of correlations between the clinical-psychological indicators and the functional parameters associated with neurological deficiency and disability. In the late rehabilitation period, the improvement of attention, the enhanced capability for maintaining equilibrium, and the positive influence of visual memory on the degree of dependence on the assistance of other persons were apparent in the majority of the patients even though some of them exhibited the signs of severe depression.

CONCLUSION

Taking account of the aforementioned clinical, functional and psychological characteristics of the patients surviving ischemic provides a basis for the differential approach to the correction of the complex of rehabilitative measures.