THE EFFECTIVENESS OF USING THE MODEL OF PATHOGENETICALLY SUBSTANTIATED REHABILITATION OF SENSORIMOTOR DISORDERS IN THE PATIENTS AFTER ISCHEMIC STROKE

Abstract

The objective of the present study was to evaluate the effectiveness of pathogenetically substantiated rehabilitation of sensorimotor disorders in the patients who had experienced ischemic stroke. Material and methods. A total of 220 patients presenting with hemiparesis following ischemic stroke were available for the examination. The control group was comprised of 35 healthy subjects. All the patients underwent the rehabilitative treatment which included robotized mechanotherapy, stabilography, neuro-muscular stimulation, physical therapy, ergotherapy, massage, etc. Before and after the course of rehabilitation therapy, transcranial magnetic stimulation (MS) was applied and the characteristics of somatosensory evoked potentials (SSEP) were measured in all the patients. Results. Rehabilitation with the use of a personified, pathogenetically grounded approach contributed to a better replenishment of the neurological deficit. In those patients who received the personalized neurorehabilitative treatment significant changes of TMS parameters (central motor conduction time at rest and TMS facilitation test) but not SSEP were registered. Conclusions. The effectiveness of the model of pathogenetically substantiated rehabilitation of sensorimotor disorders in patients after ischemic stroke was confirmed. We have demonstrated a higher effectiveness of restorative therapy of sensorimotor deficit. The somatosensory functions less efficiently responded to the treatment which suggests the necessity of identification of the sensory deficit and taking it into consideration together with neurophysiological monitoring of the rehabilitation process with the use of TMS and SSEP for the enhancement of the effectiveness of ongoing rehabilitation in this category of the patients.

Keywords

ischemic stroke / sensorimotor disturbances / neurorehabilitation / transcranial magnetic stimulation / somatosensory evoked potentials

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