Modern Rehabilitation Technologies of Patients with Motor Disorders at an Early Rehabilitation of Stroke (Review).

Cerebral stroke is one of the leading disability causes among adult population worldwide. The number of post-stroke patients, who need rehabilitation including motor recovery, keeps growing annually. Standard motor rehabilitation techniques have a limited effect on recovering extremity motor defunctionalization. In this regard, in recent years, new technologies of post-stroke rehabilitation are being suggested. The present review summarizes the existing literature data on current techniques applied in patients with motor disorders at an early rehabilitation period of cerebral stroke. The current modern technologies are divided into the methods based on "interhemispheric inhibition" theory (repetitive transcranial magnetic stimulation, transcranial direct current stimulation), and on "mirror neurons" theory (virtual reality systems and brain-computer interfaces). The authors present the neurophysiological causes and feasible protocols of using the techniques in clinical practice, the clinical research findings due to the initial severity level of motor disorders and stroke age, as well as the factors contributing to the motor rehabilitation efficiency when using these methods.

Colon Microbiocenosis and Its Correction in Patients Receiving Programmed Hemodialysis.

The aim of the investigation was to study the species composition of colon microbiocenosis in patients with chronic kidney disease receiving programmed hemodialysis treatment and to evaluate the efficacy of its correction using a new immobilized synbiotic. MATERIALS AND METHODS: Samples of colon microbiota from 62 patients undergoing programmed hemodialysis were studied before and after a course of diet therapy that included probiotic components, in particular, the immobilized synbiotic LB-complex L. Isolation of microorganisms was carried out according to our original method; for bacteria identification, a MALDI-TOF Autoflex speed mass spectrometer (Bruker Daltonik, Germany) was used in the Biotyper program mode. The results were assessed using the criteria proposed by the authors and based on the OST 91500.11.0004-2003. The efficacy of the immobilized synbiotic was determined based on the clinical data, questionnaires, and bacteriological tests. RESULTS: In patients receiving programmed hemodialysis (before the start of the diet therapy), chronic moderate inflammation and azotemia were found. Dysbiotic changes in microbiocenosis were revealed in all the examined patients; in the absence or suppression of lacto- and bifidoflora, the number and diversity of Bacteroides spp., Clostridium spp., Collinsella spp., Eggerthella spp. and other bacteria increased, which was consistent with the theory of functional redundancy of gut microbiota. From the answers to the questionnaires, a decrease in the quality of life was found (up to 70 points out of 100) according to six of the eight scales used. After the combined therapy using the synbiotic LB-complex L in the study group, 56% of the examined patients showed their microbiocenosis restored to normal; no grade III dysbiosis was detected in any patient. There was a significant decrease in CRP and ESR in these patients and an improvement in the quality of life by criteria reflecting physical health. CONCLUSION: In patients receiving programmed hemodialysis, the addition of a probiotic component in the diet therapy restores the evolutionarily determined structure of the microbiocenosis, normalizes its functions, and leads to an overall improvement in health and quality of life.