Clinical and pathophysiological foundations and advanced developments in the rehabilitation of patients after ischemic stroke
https://doi.org/10.51793/OS.2021.29.67.004
Abstract
In cerebral infarction, occlusion of the cerebral artery leads to focal ischemia. The ischemic focus is represented by the central zone of necrosis, which is surrounded by an area of the so-called ischemic penumbra, the neurons of which are potentially viable, but the blood supply to this zone remains for a long time at a level below the functional threshold values. Rehabilitation plays a crucial role in improving quality of life in patients after acutevascular brain disorder, as well as their relatives and others. Understandingof legal basis, most modern methods of post-stroke rehabilitation, as well as an understanding of the pathogenesis of neuronal damage and recovery allow to optimize work with these patients. The data accumulated to date indicate that with properly selected timely treatment, the restoration of lost functions after a stroke is not only desirable, but also to a large extent possible. A condition for successful rehabilitation is the use of all available methods of non-drug exposure and drug therapy.
About the Authors
E. G. Demianovskaia
Clinical Hospital of Infectious Diseases No. 1, Moscow Healthcare Agency; Central state medical Academy of Department of President Affairs
Россия
Россия
Moscow
A. S. Vasiliev
Central state medical Academy of Department of President Affairs
Россия
Россия
Moscow
References
1. https://www.who.int/healthinfo/global_burden_disease/projections2002/en/.
2. Roth G. A., Mensah G. A., Johnson C. O., et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study // J Am Coll Cardiol. 2020; 76 (25): 2982-3021. DOI: 10.1016/j.jacc.2020.11.010.
3. Kuriakose D., Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives // Int J Mol Sci. 2020; 21 (20): 7609. Published 2020 Oct 15. DOI: 10.3390/ijms21207609.
4. Hata R., Maeda K., Hermann D., Mies G., Hossmann K. A. Dynamics of regional brain metabolism and gene expression after middle cerebral artery occlusion in mice // J Cereb Blood Flow Metab. 2000; 20: 306-315. https://doi.org/10.1097/00004647-200002000-00012.
5. Xing C., Arai K., Lo E. H., Hommel M. Pathophysiologic cascades in ischemic stroke // Int J Stroke. 2012; 7 (5): 378-385. DOI: 10.1111/j.1747-4949.2012.00839.x.
6. Lipton P. Ischemic cell death in brain neurons // Physiol Rev. 1999; 79: 1431- 1568. https://doi.org/10.1152/physrev.1999.79.4.1431.
7. Dreier J. P. The role of spreading depression, spreading depolarization and spreading ischemia in neurological disease // Nat Med. 2011; 17: 439-447.
8. Iadecola C., Park L., Capone C. Threats to the mind: aging, amyloid, and hypertension // Stroke. 2009; 40: S40-44.
9. Lo E. H., Dalkara T., Moskowitz M. A. Mechanisms, challenges and opportunities in stroke // Nat Rev Neurosci. 2003; 4: 399-415.
10. Duris K., Lipkova J., Jurajda M. Cholinergic anti-inflammatory pathway and stroke // Curr Drug Deliv. 2017; 14 (4): 449-457.
11. Yuan M., Zhang X. X., Fu X. C., Bi X. Enriched environment alleviates poststroke cognitive impairment through enhancing α7-nAChR expression in rats // Arq Neuropsiquiatr. 2020; 78 (10): 603-610.
12. Zhang J., Liu J., Li D., Zhang C., Liu M. Calcium antagonists for acute ischemic stroke // Cochrane Database Syst Rev. 2019; 2 (2): CD001928.
13. Muir K. W., Lees K. R. Excitatory amino acid antagonists for acute stroke // Cochrane Database Syst Rev. 2003; 2003 (3): CD001244.
14. Del Zoppo G. J. Acute anti-inflammatory approaches to ischemic stroke // Ann NY Acad Sci. 2010; 1207: 143-148.
15. Marcos-Contreras O. A., Greineder C.F., Kiseleva R. Y., et al. Selective targeting of nanomedicine to inflamed cerebral vasculature to enhance the blood-brain barrier // Proc Natl Acad Sci USA. 2020; 117 (7): 3405-3414.
16. Patel A. T., Duncan P. W., Lai S. M., Studenski S. The relation between impairments and functional outcomes poststroke // Arch. Phys. Med. Rehabil. 2000; 81: 1357-1363.
17. Поляев Б. А., Аристакесян (Лайшева) О. А., Парастаев С. А., Калашникова О. М., Горбунов А. В., Турылева М. М., Моисеев С. Н., Самсонова Е. А. Новая кинезотерапевтическая методика «Баланс». / В Сборнике, посвященном 10-летию РДКБ. М., 1995. С. 138. [Polyayev B. A., Aristakesyan (Laysheva) O. A., Parastayev S. A., Kalashnikova O. M., Gorbunov A. V., Turyleva M. M., Moiseyev S. N., Samsonova Ye. A. Novaya kinezoterapevticheskaya metodika «Balans». [New kinesiotherapy technique «Balance»] / V Sbornike, posvyashchennom 10-letiyu RDKB. M., 1995. P. 138.]
18. Васильев А. С. Оптимизация сохраненных двигательных функций у больных, перенесших полушарный ишемический инсульт / Материалы научно-практической конференции, посвященной 400-летию кремлевской медицины. М., 2000. С. 290-292. [Vasil'yev A. S. Optimizatsiya sokhranennykh dvigatel'nykh funktsiy u bol'nykh, perenesshikh polusharnyy ishemicheskiy insul't [Optimization of preserved motor functions in patients with hemispheric ischemic stroke] Materialy nauchno-prakticheskoy konferentsii, posvyashchennoy 400-letiyu kremlevskoy meditsiny. M., 2000. Pp. 290-292.]
19. Святогор В. А. Метод биоуправления потенциалом головного мозга и его клиническое применение // Биологическая обратная связь. 2000; 1: 5-7. [Svyatogor V. A. Metod bioupravleniya potentsialom golovnogo mozga i yego klinicheskoye primeneniye [Method of biocontrol of the brain potential and its clinical application] Biologicheskaya obratnaya svyaz'. 2000; 1: 5-7.]
20. Nankaku M., Tanaka H., Ikeguchi R., Kikuchi T., Miyamoto S., Matsuda S. Effects of walking distance over robot-assisted training on walking ability in chronic stroke patients // J ClinNeurosci. 2020; 81: 279-283.
21. Colomer C., Baldoví A., Torromé S., Navarro M. D., Moliner B., Ferri J., Noé E. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis // Neurologia. 2013; 28 (5): 261-267.
22. Lee H. C., Kuo F. L., Lin Y. N., Liou T. H., Lin J. C., Huang S. W. Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study // Am J OccupTher. 2021; 75 (1): 7501205020p1-7501205020p11.
23. Foreman M. H., Engsberg J. R. The Validity and Reliability of the Microsoft Kinect for Measuring Trunk Compensation during Reaching // Sensors (Basel). 2020; 20 (24): 7073. Published 2020 Dec 10.
24. Jochumsen M., Janjua T. A. M., Arceo J. C., Lauber J., Buessinger E. S., Kæseler R. L. Induction of Neural Plasticity Using a Low-Cost Open Source Brain-Computer Interface and a 3D-Printed Wrist Exoskeleton // Sensors (Basel). 2021; 21 (2): 572. Published 2021 Jan 15.
25. Инсульт: Руководство для врачей / Под ред. Л. В. Стаховской, С. В. Котова. МИА, 2018. [Insul't: Rukovodstvo dlya vrachey [Stroke: A Guide for Physicians] / Pod red. L. V. Stakhovskoy, S. V. Kotova. MIA, 2018.]
26. Старчина Ю. А. Применение препарата Церетон в неврологической практике // Неврология, нейропсихиатрия, психосоматика. 2011; 2: 81-85. [Starchina Yu. A. Primeneniye preparata Tsereton v nevrologicheskoy praktike [Application of the drug Cereton in neurological practice] // Nevrologiya, neyropsikhiatriya, psikhosomatika. 2011; 2: 81-85.]
27. Teasell R. W., Kalra L. What’s new stroke rehabilitation // Stroke. 2004, 35: 2: 383-385.
Review
For citations:
Demianovskaia E.G., Vasiliev A.S. Clinical and pathophysiological foundations and advanced developments in the rehabilitation of patients after ischemic stroke. Lechaschi Vrach. 2021;(5):17-20. (In Russ.) https://doi.org/10.51793/OS.2021.29.67.004
Views:
271
JATS XML
Email this article 
