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Возможности оптимизации программы реабилитационных мероприятий у пациентов в остром периоде ишемического инсульта
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Kotov S.V., Isakova E.V., Sheregeshev V.I. Possibilities for rehabilitation program for patients in acute period of ischemic stroke optimization. Consilium Medicum. 2018; 20 (9): 12–16. DOI: 10.26442/2075-1753_2018.9.12-16
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Ключевые слова: инсульт, реабилитация, когнитивные нарушения, механотерапия, когнитивная стимуляция, планшетные технологии.
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An optimized rehabilitation program for patients in acute period of ischemic stroke that includes early activization, mechanotherapy and cognitive stimulation with the use of tablet technologies and computer programs for memory, attention, perception, and count improvement resulted in statistically significant improvement of patients’ functional activity according to modified Rankin scale and Barthel index of activities of daily living at the end of training program performed during the hospital stay. Improvement was observed after 3 and 6 months of follow up. A statistically significant change in neuropsychological test results according to Montreal cognitive assessment scale and DigitSpan subtest of Wechsler scale was reported. The proposed program for stroke rehabilitation optimization that includes mechanotherapy and cognitive stimulation with the use of tablet technologies is effective, accessible and easy to use and is performed with minimal participation of healthcare staff at the beginning of the course. Later patients can practice independently. No adverse effects were observed during the study period.
Key words: stroke, rehabilitation, cognitive impairment, mechanotherapy, cognitive stimulation, tablet technology.
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7. Sjöholm A, Skarin M, Churilov L et al. Sedentary behaviour and physical activity of people with stroke in rehabilitation hospitals. Stroke Res Treat 2014; 2014: 591897. DOI: 10.1155/2014/591897
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9. Askim T, Bernhardt J, Salvesen O, Indredavik B. Physical activity early after stroke and its association to functional outcome 3 months later. J Stroke Cerebrovasc Dis 2014; 23 (5): e305–12. DOI: 10.1016/j.jstrokecerebrovasdis.2013.12.011
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12. Sawabe M, Momosaki R, Hasebe K et al. Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke. J Stroke Cerebrovasc Dis 2018. pii: S1052-3057(18)30215-5. DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.037
13. Simpson DB, Breslin M, Cumming T et al. Go home, sit less: The impact of home versus hospital rehabilitation environment on activity levels of stroke survivors. Arch Phys Med Rehabil 2018. pii: S0003-9993(18)30285-5. DOI: 10.1016/j.apmr.2018.04.012
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4. Lynch E, Hillier S, Cadilhac D. When should physical rehabilitation commence after stroke: a systematic review. Int J Stroke 2014; 9 (4): 468–78. DOI: 10.1111/ijs.12262
5. Wang C, Redgrave J, Shafizadeh M et al. Aerobic exercise interventions reduce blood pressure in patients after stroke or transient ischaemic attack: a systematic review and meta-analysis. Br J Sports Med 2018. pii: bjsports-2017-098903. DOI: 10.1136/bjsports-2017-098903
6. Hokstad A, Indredavik B, Bernhardt J et al. Hospital differences in motor activity early after stroke: a comparison of 11 Norwegian stroke units. J Stroke Cerebrovasc Dis 2015; 24 (6): 1333–40. DOI: 10.1016/j.jstrokecerebrovasdis.2015.02.009
7. Sjöholm A, Skarin M, Churilov L et al. Sedentary behaviour and physical activity of people with stroke in rehabilitation hospitals. Stroke Res Treat 2014; 2014: 591897. DOI: 10.1155/2014/591897
8. Askim T, Bernhardt J, Løge AD, Indredavik B. Stroke patients do not need to be inactive in the first two-weeks after stroke: results from a stroke unit focused on early rehabilitation. Int J Stroke 2012; 7 (1): 25–31. DOI: 10.1111/j.1747-4949.2011.00697.x
9. Askim T, Bernhardt J, Salvesen O, Indredavik B. Physical activity early after stroke and its association to functional outcome 3 months later. J Stroke Cerebrovasc Dis 2014; 23 (5): e305–12. DOI: 10.1016/j.jstrokecerebrovasdis.2013.12.011
10. Merkhol'ts Ia. Ranniaia reabilitatsiia posle insul'ta. Pod red. G.E.Ivanovoi. M.: MEDpress-inform, 2014. [in Russian]
11. Kumi-Yeboah A, Campbell KS. Emerging use of tablets in K-12 environments: issues and implications in K-12 schools. In: An H, Alon S, Fuentes D editors. Tablets in K-12 education: integrated experiences and implications. IGI Global, 2014; p. 46–63. DOI: 10.4018/978-1-4666-6300-8.ch004
12. Sawabe M, Momosaki R, Hasebe K et al. Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke. J Stroke Cerebrovasc Dis 2018. pii: S1052-3057(18)30215-5. DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.037
13. Simpson DB, Breslin M, Cumming T et al. Go home, sit less: The impact of home versus hospital rehabilitation environment on activity levels of stroke survivors. Arch Phys Med Rehabil 2018. pii: S0003-9993(18)30285-5. DOI: 10.1016/j.apmr.2018.04.012
14. Sheregeshev V.I., Pliasova Iu.V., Kotov S.V. i dr. Optimizatsiia reabilitatsionnogo protsessa u patsienta v ostrom periode insul'ta na osnove mekhanoterapii i kognitivnoi stimuliatsii. Al'manakh klinicheskoi meditsiny. 2016; 44 (3): 369–75. [in Russian]
15. Kotov S.V., Isakova E.V. Kliniko-ekonomicheskii analiz vedeniia bol'nykh insul'tom v statsionarakh Moskovskoi oblasti. Nevrol. zhurn. 2008; 13 (4): 51–3. [in Russian]
*kotovsv@yandex.ru
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S.V.Kotov*, E.V.Isakova, V.I.Sheregeshev
M.F.Vladimirskiy Moscow Regional Research Clinical Institute. 129110, Russian Federation, Moscow, ul. Shchepkina, d. 61/2
*kotovsv@yandex.ru