Poststroke rehabilitation: the processes of neuroplasticity and the possibility of increasing functional recovery. Results of open randomized control comparative study
- Autores: Ekusheva E.V.1,2
-
Afiliações:
- Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Types of Health Care and Medical Technologies of FMBA of Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- Edição: Volume 26, Nº 3 (2019)
- Páginas: 57-64
- Seção: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/297034
- DOI: https://doi.org/10.18565/pharmateca.2019.3.57-64
- ID: 297034
Citar
Texto integral
![Acesso aberto](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_open.png)
![Acesso é fechado](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_unlock.png)
![Acesso é fechado](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
Resumo
Background. Rehabilitation measures based on the neuroplasticity phenomenon are important for recovery of patients after ischemic stroke (IS), and the recovery rate after IS is primarily determined by functional activity and effective use of existing neuronal connections. Objective. Evaluation of the effect of Cytoflavin on the functional recovery rate when it is included in the complex therapy of patients in the early and late recovery periods of IS. Methods. The study include 60 patients with IS, randomized to 2 groups with or without the use of Cytoflavin as part of a comprehensive rehabilitation therapy for 35 days. Clinical and neurophysiological examination was carried out before and after the course of therapy. Results. The use of Cytoflavin in the complex therapy of patients after IS led to a significant reduction in neurological deficit, improvement of activity and patient independence, which was accompanied by a significant improvement in the functional activity of the efferent and afferent conduction systems (according to data obtained using neurophysiological examination methods) and contributed to an increase in plasticity of the whole system of voluntary motor activity, increasing the efficiency of further neurorehabilitation process and the likelihood of better recovery and a good outcome. Conclusion. The data obtained allow to recommend the use of Cytoflavin in addition to the background therapy of patients in the early and late recovery periods of IS.
Palavras-chave
Texto integral
![Acesso é fechado](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
Sobre autores
Evgenia Ekusheva
Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Types of Health Care and Medical Technologies of FMBA of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: ekushevaev@mail.ru
MD, Professor, Head of the Department of Nervous Diseases at the Academy of Postgraduate Education
Bibliografia
- Бархатов Ю.Д., Кадыков А.С. Прогностические факторы восстановления нарушенных в результате ишемического инсульта двигательных функций. Анналы клинической и экспериментальной неврологии. 2017;11(1):80-89. Doi:10.1016/ S0140-6736(14)61682-2
- Скворцова В.И. Реперфузионная терапия ишемического инсульта. Медицинский консилиум. 2004;6(8):610-14
- Пирадов М.А., Танашян М.М., Кротенкова М.В. и др. Передовые технологии нейровизуализации. Анналы клинической и экспериментальной неврологии. 2015;9(4):11-17
- Екушева Е.В. Сенсомоторная интеграция при поражении центральной нервной системы клинические и патогенетические аспекты. Автореферат дисс. докт. мед. наук. М., 2016. 48 с
- Leipert J. Pharmacotherapy in restorative neuroiogy. Curr Opin Neurol. 2008;21:639-43. doi: 10.1097/WCO.0b013e32831897a3.
- Дамулин И.В., Екушева Е.В. Клиническое значение феномена нейропластичности при ишемическом инсульте. Анналы клинической и экспериментальной неврологии. 2016;10(1):57-64.
- Smith M.-C., Stinear C. Plasticity and motor recovery after stroke: Implications for physiotherapy N. Zealand J. Physiother. 2016;44(3):166-73. doi: 10.15619/nz]p/44.3.06.
- McDonnell M., Koblar S., Ward N.S., et al. An investigation of cortical neuroplasticity following stroke in adults: is there evidence for a critical window for rehabilitation. BMC Neurology 2015;109(15):109. doi: 10.1186/s12883-015-0356-7.
- Hosp J.A., Luft A.R. Cortical plasticity during motor learning and recovery after ischemic stroke. Neural Plasticity. 2011;2011:1-9. Doi.10.1155/2011/871296.
- Di Pino G., Pellegrino G., Assenza G., Capone F. Modulation of brain plasticity in stroke: a novel model for neurorehabilitation. Nat Rev Neurol. 2014;10:597-608. Doi:10.1038/ nrneurol.2014.162.
- Войтенков В.Б., Скрипченко Н.Б., Карташев А.В. Нейропластичность и феномен диашиза при поражении центральной нервной системы. Неврологический журнал. 2016;4:6-11. doi: 10.18821/1560-9545-2016-21-4-188-193.
- Wasaka T., Kakigi R. Sensorimotor Integration. In: Magnetoencephalography. From signals to dynamic cortical networks. Eds. S. Supek, C.J. Aine. Berlin, Heidelberg:Springer-Verlag, 2014. P. 727-42.
- Екушева Е.В., Дамулин И.В. К вопросу о межполушарной асимметрии в условиях нормы и патологии. Журнал неврологии и психиатрии им. С.С. Корсакова. 2014;114(3):92-97.
- Hara Y. Brain plasticity and rehabilitation in stroke patients. J. Nippon Med School. 2015;82(1):4-13. Doi: 10.1272/ J.ms.82.4.
- Pundik S., McCabe J.P., Hrovat K., et al. Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity Front Neurol. 2015;9:1-13. doi: 10.3389/fnhum.2015.00394.
- Мазин П.В., Шешунов И.В., Мазина Н.К. Метааналитическая оценка клинической эффективности Цитофлавина при неврологических заболеваниях. Журнал неврологии и психиатрии им. С.С. Корсакова. 2017;117(3):28-39. Doi: 10.17116/ J.evro20171173128-39.
- Одинак М.М., Скворцова В.И., Вознюк И.А. и др. Оценка эффективности Цитофлавина у больных в остром периоде ишемического инсульта. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010;110(12):29-36.
- Румянцева С.А., Коваленко А.Л., Силина Е.В. и др. Эффективность комплексной антиоксидантной энергокоррекции разной длительности при лечении инфаркта мозга (результаты многоцентрового рандомизированного исследования). Журнал неврологии и психиатрии им. С.С. Корсакова. 2015;115(8):45-52. Doi: 10.17116/ J.evro20151158145-52.
- Федин А.И., Румянцева С.А., Пирадов М.А. и др. Эффективность нейрометаболического препарата Цитофлавина при инфарктах мозга (многоцентровое плацебо-контролируемое рандомизированное исследование). Вестник Санкт-Петербургской ГМА им. И.И. Мечникова. 2005;1:13-9.
- Oldfield R.C. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9(1):97-113.
- Rossini P.M., Altamura C., Ferreri F. et al. Neuroimaging experimental studies on brain plasticity in recovery from stroke. Eur J. Physical RehabilitMed. 2007;43:241-54.
- Scalha T.B., Miyasaki E., Lima N.M. et al. Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke. Arq. Neuropsiquiatr. 2011;69(4):624-62.
- Koziol L.F., Budding D.E., Chidekel D. Sensory integration, sensory processing, and sensory modulation disorders: putative functional neuroanatomic underpinnings. Cerebellum. 2011;10(4):770-92. Doi.10.1007/s12311- 011-0288-8.
Arquivos suplementares
![](/img/style/loading.gif)