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№1' 2021

NEUROLOGY

International Medical Journal, Vol. 27., Iss. 1, 2021, P. 56−62.

DOI (https://doi.org/10.37436/2308-5274-2021-1-10)

STAGES OF REHABILITATION OF PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENT

Kharkiv Medical Academy of Postgraduate Education, Ukraine

One of the urgent tasks of modern medicine is organizing the rehabilitation for patients who have suffered a stroke at different stages of rehabilitation. Restoration of impaired functions in such patients occurs in the first 3−5 months from the onset of the disease, that is influenced by a number of factors: duration of the stroke, size of the lesion and pool of lesions, active participation in the process of a patient him−/herself. The main principles of rehabilitation include its early onset in an acute period of stroke; regularity and duration; complexity and multidisciplinarity (formation of multidisciplinary teams); adequacy of rehabilitation measures, i.e. creation of individual programs taking into account the severity of neurological deficit and dysfunction; stages. Different methods of recovery are applied to each patient individually or in combination, or sequentially according to the rehabilitation program, which is based on the analysis of the patient's condition by all members of the multidisciplinary team, taking into account the results of functional testing and objective examination. Medical support, postural correction, kinesitherapy, mechanotherapy (including robotic), field therapy, hardware physiotherapy, massage, acupuncture according to the indications, functional neurotraining and cardiotraining, neuropsychological training are used. The results of research confirm that the integrated use of kinesitherapy, physical factors, balneotherapy, the methods of psychological rehabilitation of patients after stroke provides a faster recovery of neurological deficit, activates non−specific brain systems, restores mental and somatic functions of the body. Therefore, in addition to health, the patient needs to renew his ability to work and social status.

Key words: acute cerebrovascular accident, medical rehabilitation, stages of rehabilitation.

REFERENCES

1. From apoplexy to stroke: historical perspectives and new research frontiers / R. K. Leak et al. // Prog Neurobiol. 2014. Vol. 115. R. 1−5. doi: 10.1016/j.pneurobio.2013.12.003

2. Karenberg A. Historic review: select chapters of a history of stroke // Neurol. Res. Pract. 2020. Vol. 2. R. 34. doi: https://doi.org/10.1186/s42466−020−00082−0

3. The definition of stroke / A. P. Coupland et al. // J. R. Soc. Med. 2017. Vol. 110 (1). R. 9−12. doi: 10.1177/0141076816680121

4. World Health Organization. 2017. The top 10 causes of death. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/ webcite.

5. Mishchenko T. S. Epidemiologiya tserebrovaskulyarnykh zabolevanii i organizatsiya pomoshchi bol'nym s mozgovym insul'tom v Ukraine // Ukr. vіsn. psikhonevrologії. 2017. № 1 (90). S. 22−24. URL: http://nbuv.gov.ua/UJRN/Uvp_2017_25_1_5

6. Epidemiology of stroke in Europe and trends for the 21st century / Y. Béjot et al. // Presse Med. 2016. Vol. 45 (12 Pt 2). e391−e398. doi: 10.1016/j.lpm.2016.10.003

7. Unіfіkovanii klіnіchnii protokol medichnoї dopomogi. Іshemіchnii іnsul't (ekstrena, pervinna, vtorinna (spetsіalіzovana) medichna dopomoga, medichna reabіlіtatsіya). Nakaz Mіnіsterstva okhoroni zdorov'ya Ukraїni vіd 03.08.2012 № 602. URL: http:zakon.gov.ua/rada/show/v0602282−12

8. GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990−2016: a systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. 2019. Vol. 18 (5). R. 439−458. doi: 10.1016/S1474−4422(19)30034−1

9. Mіzhnarodna statistichna klasifіkatsіya khvorob ta sporіdnenikh problem okhoroni zdorov'ya. Desyatii pereglyad. T. 1, ch. 1. K.: Zdorov'ya, 1998. 685 s.

10. Vіnichuk S. M. Fartushna O. Є. Epіdemіologіya tranzitornikh іshemіchnikh atak u strukturі gostrikh porushen' mozkovogo krovoobіgu v Ukraїnі ta іnshikh kraїnakh // Mіzhnarod. nevrologіchnii zhurn. 2017. № 5. S. 105−111. doi: 10.22141/2224−0713.5.91.2017.110863

11. Mikitei O. M. Osoblivostі rozvitku faktorіv riziku u patsієntіv z povtornim іshemіchnim іnsul'tom // Skhіdno−єvropeis'kii nevrologіchnii zhurn. 2015. № 2. S. 27−30.

12. Fartushna O. Є., Vіnichuk S. M. Viyavlennya ta usunennya vaskulyarnikh chinnikіv riziku − vazhlivii napryamok pervinnoї profіlaktiki tranzitornikh іshemіchnikh atak ta/chi іnsul'tu // Ukr. medichnii chasopis. 2015. № 1 (105). S. 23−27.

13. Bіla kniga z fіzichnoї ta reabіlіtatsіinoї meditsini v Єvropі. Al'yans Єvropeis'kikh organіv Fіzichnoї ta Reabіlіtatsіinoї Meditsini; pіd red. K. Gutenbrunner, E. B. Uord, M. E. Chemberlen // Ukr. zhurn. fіzichnoї ta reabіlіtatsіinoї meditsini. 2018. № 2 (dodatok). S. 5−206.

14. Su F., Xu W. Enhancing Brain Plasticity to Promote Stroke Recovery // Front. Neurol. 2020. Vol. 11. R. 554089. doi: 10.3389/fneur.2020.554089

15. Belagaje S. R. Stroke Rehabilitation // Continuum (Minneap Minn). 2017. Vol. 23. R. 238−253. doi: 10.1212/CON.0000000000000423

16. Early Rehabilitation After Stroke: a Narrative Review / E. R. Coleman et al. // Curr. Atheroscler. Rep. 2017. № 19(12). S. 59. doi: 10.1007/s11883−017−0686−6

17. Lynch E., Hillier S., Cadilhac D. When should physical rehabilitation commence after stroke: a systematic review // Int. J. Stroke. 2014. Vol. 9 (4). R. 468−78. doi: 10.1111/ijs.12262

18. Rodіn V. O., Anan'єva T. G. Fіzichna reabіlіtatsіya khvorikh pіslya perenesenogo іshemіchnogo іnsul'tu v rann'omu vіdnovlyuval'nomu perіodі // Slobozhans'kii naukovo−sportivnii vіsn. 2011. № 1. S. 92−95.

19. Reabіlіtatsіya pіslya іshemіchnogo іnsul'tu. Protokol z medichnoї reabіlіtatsії pri іshemіchnomu іnsul'tі // Ukr. medichnii chasopis. 2015. URL: https://www.umj.com.ua/wp/wp−content/uploads/2015/10/Insult_I_Reabilitatsia.pdf?upload=

20. Volkova S., Blazhko D. Fіzichna reabіlіtatsіya khvorikh pіslya gostrogo porushennya mozkovogo krovoobіgu // Sportivna nauka Ukraїni. 2017. № 1. S. 9−15.

21. Tsitskishvili N. I., Osadchenko I. V. Fizicheskaya reabilitatsiya dvigatel'nykh narushenii u muzhchin s ishemicheskim insul'tom na statsionarnom etape sredstvami robototekhniki // Nauka i sport: sovremennye tendentsii. 2019. № 1. S. 120−125.

22. Inpatient trunk exercises after recent stroke: An update meta−analysis of randomized controlled trials / D. C. B. Souza et al. // NeuroRehabilitation. 2019. Vol. 44 (3). R. 369−377. doi: 10.3233/NRE−182585

23. Effects of exercise therapy on balance capacity in chronic stroke: systematic review and meta−analysis / H. J. Duijnhoven et al. // Stroke. 2016. Vol. 47 (10). R. 2603−10. doi: 10.1161/STROKEAHA.116.013839

24. Sharififar S., Shuster J. J., Bishop M. D. Adding electrical stimulation during standard rehabilitation after stroke to improve motor function. A systematic review and meta−analysis // Ann. Phys. Rehabil. Med. 2018. Vol. 61 (5). R. 339−344. doi: 10.1016/j.rehab.2018.06.005

25. Gerstenecker A., Lazar R. M. Language recovery following stroke // Clin. Neuropsychol. 2019. Vol. 33 (5). R. 928−947. doi: 10.1080/13854046.2018.1562093

26. Firileva Zh. E., Rodichkin P. V., Buznik G. V. Fizicheskaya reabilitatsiya i farmakoterapiya kognitivnykh funktsii i astenicheskikh rasstroistv u patsientov, perenesshikh insul't // Obzory po klinicheskoi farmakologii i lekarstvennoi terapii. 2019. № 1. S. 87−92.

27. Evolution of cognitive rehabilitation after stroke from traditional techniques to smart and personalized home−based information and communication technology systems: Literature review / J. M. Cogollor et al. // JMIR Rehabil. Assist. Technol. 2018. Vol. 5 (1). e4. doi: 10.2196/rehab.8548

28. Cognitive rehabilitation improves ischemic stroke−induced cognitive impairment: role of growth factors / F. Farokhi−Sisakht et al. // J. of Stroke and Cerebrovascular Diseases. 2019. Vol. 28. R. 104299. doi: 10.1016/j.jstrokecerebrovasdis.2019.07.015

29. What is the evidence for physical therapy poststroke? A systematic review and meta−analysis /J. M. Veerbeek et al. // PLoS One. 2014. Vol. 9 (2). e87987. doi: 10.1371/journal.pone.0087987

30. Aggressive lipid lowering therapy compared with angioplasty in stable coronary disease (AVERT) / L. S. McCormic et al. // N. Engl. J. Med. 1999. Vol. 341. P. 70−76.