Application of therapeutic exercises and robot-assisted therapy after stroke

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Abstract

Background: Application of therapeutic exercises after stroke helps to restore movement of the affected limb and muscle strength, eliminate motor disorders and lost social and everyday functions, improve the psychological state, activate the patient, and reduce the risk of recurrent stroke. For rehabilitation of patients after a stroke, the use of robot-assisted devices provides verticalization of patients, elimination or reduction of paresis and paralysis of the limbs.

Objective: Assessment and restoration of the motor activity of the upper limb and social and everyday skills in people aged 55–60 years after a stroke.

Methods: All patients received standard therapy, including neuromuscular electrical myostimulation, limb massage and individual therapeutic exercise sessions to improve and restore fine motor skills. Also, training using the Armeo robotic complex was included in rehabilitation program of 6 patients of the experimental group. Before and after rehabilitation, the functions of the affected upper limb (abduction/adduction, flexion/extension of the shoulder and elbow joint, rotational and rotary movements of the hand) were assessed in both groups of post-stroke patients.

Results: The use of therapeutic exercises in passive and passive-active modes allowed to reduce muscle tone, improve abduction and adduction of the shoulder joint, flexion and extension of the shoulder and elbow joints, and stimulate more active movements due to the reflex influence of afferent impulses arising in the muscles and joints of the paralyzed limb. The use of the Armeo robotic complex allowed to increase the range of motion, compensate for movement deficiencies, the strength of the affected limb, reduce neurological deficit, and improve the psychoemotional state.

Conclusion: In order to restore impaired functions of the upper limb, robot-assisted therapy was used, which allowed to increase the effectiveness of rehabilitation through repetitive cyclic exercises, improve the activity and quality of life of patients. After rehabilitation with the use of therapeutic exercises, social and everyday skills significantly expanded in both groups of patients.

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About the authors

M. V. Eremin

Russian State Social University

Email: 89151479832@mail.ru
ORCID iD: 0000-0001-9791-4615

Cand. Sci. (Pedagogy), Associate Professor

Russian Federation, Moscow

Svetlana V. Shmeleva

K.G. Razumovsky Moscow State University of Technology and Management

Author for correspondence.
Email: 89151479832@mail.ru
ORCID iD: 0000-0003-0390-194X

Dr. Sci. (Med.), Professor

Russian Federation, Moscow

I. N. Tuzov

Russian State Social University

Email: 89151479832@mail.ru
ORCID iD: 0000-0002-5789-7838

Cand. Sci. (Pedagogy), Associate Professor

Russian Federation, Moscow

Yu. G. Trofimenko

Burnazyan Federal Medical and Biological Center of the Federal Medical and Biological Agency of Russia

Email: 89151479832@mail.ru
ORCID iD: 0009-0000-0522-639X

Cand. Sci. (Med.), Senior Researcher

Russian Federation, Moscow

E. D. Bakulina

Russian State Social University

Email: 89151479832@mail.ru
ORCID iD: 0000-0003-2352-7449

Cand. Sci. (Pedagogy), Associate Professor

Russian Federation, Moscow

E. V. Morozova

Moscow State University of Humanities and Economics

Email: 89151479832@mail.ru

Cand. Sci. (Sociology), Associate Professor

Russian Federation, Moscow

A. A. Karpinsky

Russian University of Transport

Email: 89151479832@mail.ru
ORCID iD: 0000-0002-2144-8248

Senior Lecturer

Russian Federation, Moscow

References

  1. Ястребцева И.П., Кочетков А.В., Николаева С.В. Функциональное восстановление моторики после инсульта с позиций доказательной медицины. Доктор Ру. Неврология Психиатрия. 2016;4(121):26–9. [Yastrebtseva I.P., Kochetkov A.V., Nikolaeva S.V. Functional restoration of motor skills after stroke from the standpoint of evidence-based medicine. Dr. Ru. Neurol Psych. 2016;4(121):26–9. (In Russ.)].
  2. Мельникова Е.А., Старкова Е.Ю., Разумов А.Н. Современный подход к физической реабилитации функций верхней конечности после инсульта. Обзор литературы. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2023;100(1):42–53. [Melnikova E.A., Starkova E.Yu., Razumov A.N. Modern approach to physical rehabilitation of upper limb functions after stroke. Literature review. Issues Balneol Physiother Ther Physical Education. 2023;100(1):42–53. (In Russ.)].
  3. Латышева В.Я., Чечетин Д.А., Ядченко Н.М. и др. Реабилитация двигательной активности пациентов в постинсультном периоде: практическое руководство для врачей. Гомель, 2015. 78 с. [Latysheva V.Ya., Chechetin D.A., Yadchenko N.M., et al. Rehabilitation of patients’ motor activity in the post-stroke period: a practical guide for doctors. Gomel, 2015. 78 p. (In Russ.)].
  4. Сальков В.Н., Шмелева С.В., Коноваленко С.В. Детский церебральный паралич. Причины. Клинические проявления. Лечение и реабилитация. 2020. 150 с. [Salkov V.N., Shmeleva S.V., Konovalenko S.V. Infantile cerebral palsy. Reasons. Clinical manifestations. Treatment Reha-bilitat. 2020. 150 p. (In Russ.)].
  5. Гольцов А.В., Шмелева С.В. Образ физического «Я» как фактор адаптивного ресурса лич-ности инвалидов с поражением опорно-двигательного аппарата. Человеческий капитал. 2017;3(99):102–3. [Goltsov A.V., Shmeleva S.V. The image of the physical self as a factor of the adaptive resource of the personality of the disabled with damage to the musculoskeletal system. Hum Capital. 2017;3(99):102–3. (In Russ.)].
  6. Лупанова К.В., Снопков П.С., Михайлова А.А., Сидякина И.В. Методы восстановления тонкой моторики у пациентов, перенесших инсульт. Вопросы курортологии, физической культуры. 2022;99(6–2):56–64. [Lupanova K.V., Snopkov P.S., Mikhailova A.A., Sidyakina I.V. Methods of restoring fine motor skills in stroke patients. Issues Balneol Physical Educat. 2022;99(6–2):56–64. (In Russ.)].
  7. Ковалева И.В. Современные решения повышения качества оказания медицинской помощи пациентам с инсультом. Лечащий врач. 2024;3(27):101–4. [Kovaleva I.V. Modern solutions for improving the quality of medical care for stroke patients. Lechaschi Vrach. 2024;3(27):101–4. (In Russ.)]. https://dx.doi.org/10.51793/OS.2024.27.3.018
  8. Shimanovskaya Ya.V., Shmeleva S.V., Vakulenko A.N., et al. Physiological basis of the correction of postural disorders by regular ordered muscular activity. Proposit Represent. 2020;8(Suppl. 2):681.
  9. Рудь Д.В., Преснов О.Г. Применение ЛФК в комплексной реабилитации больных после инсульта. Вестник науки. 2018. [Rud D.V., Presnov O.G. The use of physical therapy in complex rehabilitation of patients after stroke. Bull Sci. 2018. (In Russ.)].
  10. Maskayeva T.Yu., Shmeleva S.V., Zolotova M.Yu., et al. The impact of physical exercises on changes in the functional state of the human body and posture Revista Inclusion. 2020;7(Suppl. 4–3):127–36.
  11. Goltsov A.V., Shmeleva S.V., Udodov A.G., et al. Physical «I» at disabled people with a late lesion musculoskeletal system Prensa. Med Argentina. 2018;104(3):1000289.
  12. Лезова Н.С., Лунина Н.В. Физическая реабилитация мужчин среднего возраста после ишемического инсульта в раннем восстановительном периоде. Российский журнал спортивной науки: Медицина, Физиология, Тренировка. 2022;1(2). [Lezova N.S., Lunina N.V. Physical rehabilitation of middle-aged men after ischemic stroke in the early recovery period. Rus J Sports Sci: Med Physiol Training. 2022;1(2). (In Russ.)]. https://dx.doi.org/10.51871/2782-6570_2022_01_02_6
  13. Белокопытова С.В. Роботизированная механотерапия в нейрореабилитации для восстановления функции ходьбы. Медицина и здравоохранение: материалы III междунар. науч. конф. (Казань, май 2015 г.). Казань, 2015. С. 96–7. [Belokopytova S.V. Robotic mechanotherapy in neurorehabilitation to restore walking function. Medicine and healthcare: proceedings of the III International Scientific Conference (Kazan, May 2015). Kazan, 2015. P. 96–7. (In Russ.)].
  14. Бушкова Ю.В., Казакова З.Д., Стаховская Л.В. и др. Возможности функционального восстановления верхней конечности у пациентов после инсульта с применением нейрокомпьютерного интерфейса мозг-компьютер-экзоскелет кисти с многоканальной биологической обратной связью. Фарматека 2018;14:32–38. [Bushkova Yu.V., Kazakova Z.D., Stakhovskaya L.V. et al. Possibilities of functional restoration of the upper limb in Patients after Stroke using a Neuro-computer interface brain-computer-Exoskeleton of the hand with Multichannel Biofeedback. Farmateka. 2018;14:32–38. (In Russ.)]. https://dx.doi.org/10.18565/pharmateca.2018.14.32-38

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