RESUMEN
Static motor disorders are the main cause of falls and decrease of daily activity in patients after previous ischemic stroke. OBJECTIVE: To study impact of robotic mechanotherapy with functional electrostimulation (FES) on rebalancing in patients in acute and early recovery periods of ischemic stroke. MATERIAL AND METHODS: The number of patients equal 60, divided into 2 groups, were examined. Study group included 30 patients, who were treated in an exoskeleton with FES; control group consisted of 30 patients, whose walking and balance recovering was carried out with exercise therapy. RESULTS: The study group showed a more pronounced improvement of balance indicators by Tinetti scale compared to the control group (11 [8; 13] against 8 [6; 12]; p=0.0281) at the end of treatment. Patients of study group demonstrated significantly better results both by Tinetti scale and stabilometrical parameters in acute period of stroke compared to the control group. CONCLUSION: Application of exoskeleton with FES in patients in acute and early periods of ischemic stroke contributes (to a better balance recovery), which may be achieved by long-lasting verticalization and large repetition of the correct walking pattern during rehabilitative trainings.
Asunto(s)
Terapia por Estimulación Eléctrica , Dispositivo Exoesqueleto , Accidente Cerebrovascular Isquémico , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Resultado del TratamientoRESUMEN
Lower extremity dysfunction after a stroke can vary from mild to extremely severe and significantly reduce the functional independence of patients. The restoration of walking is one of the key components of rehabilitation, it requires a balanced approach and the participation of a multidisciplinary team. In the last decade, new rehabilitation methods have appeared that meet high safety standards and have a minimum set of contraindications. One of the promising methods is robotic mechanotherapy. The article presents an overview of modern technologies of robotic mechanotherapy, its types and recommendations for use in medical rehabilitation.
Asunto(s)
Dispositivo Exoesqueleto , Procedimientos Quirúrgicos Robotizados , Robótica , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular/terapiaRESUMEN
Rehabilitation of patients after an ischemic stroke is a complex and time consuming process that requires coordinated interaction between specialists of different specialisations. Functional outcomes in patients can vary from asymptomatic lesions to complete incapacity and depend on the location of the stroke, premorbid background, the time of initiation of therapy, its duration, and other factors. Goals of medical rehabilitation include not only motor rehabilitation, but also the restoration of cognitive, affective, visual, speech and many other disorders. The development of rehabilitation methods that have a minimum number of contraindications or no contraindications remains relevant. One of the promising methods that complement traditional rehabilitation is virtual reality technology. The article describes modern technologies of virtual reality and methods of their application in medical rehabilitation.
Asunto(s)
Accidente Cerebrovascular Isquémico , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Realidad Virtual , Humanos , Accidente Cerebrovascular Isquémico/etiología , Rehabilitación de Accidente Cerebrovascular/métodos , TecnologíaRESUMEN
BACKGROUND: Parkinson's disease is a neurodegenerative disease manifested by a whole group of motor, cognitive, affective, and other disorders. Many of them cannot be controlled by modern pharmacotherapy in full measure. New treatments, including nondrug ones, are needed. OBJECTIVE: To evaluate the impact of rhythmic transcranial magnetic stimulation on motor, cognitive, and affective disorders in Parkinson's disease. MATERIAL AND METHODS: The investigation enrolled 55 patients with Stage III Parkinson's disease according to the Hoehn and Yahr scale. The patients were randomly divided into 2 groups: a study group (n=35) and a control one (n=20). The groups were matched for age, disease type and duration, and symptom severity. The basic therapy for Parkinson's disease included Levodopa in combination with dopamine receptor agonists and monoamine oxidase B inhibitors. All the patients in the study group underwent a cycle of therapeutic transcranial magnetic stimulation. Both patient groups underwent clinical and neurological examinations and tests using various scales. All the patients were followed up for 6 months. RESULTS: The patients who had undergone a cycle of magnetic stimulation showed a significant improvement in motor functions. There was a decrease in the total MDS-UPDRS-III scores by an average of 6.4 (p<0.05) and that in the GABS scores by 5.9 (p<0.05). CONCLUSION: Rhythmic transcranial magnetic stimulation can be considered as an additional treatment for Parkinson's disease. No significant side effects were noted during and after stimulation.
Asunto(s)
Enfermedad de Parkinson/terapia , Estimulación Magnética Transcraneal , Humanos , Enfermedad de Parkinson/fisiopatología , Resultado del TratamientoRESUMEN
In this literature review, the authors summarize the data on affective disorders in Parkinson's disease (frequency, clinical presentations, treatment), the results on using transcranial magnetic stimulation, its safety in Parkinson's disease.