Miryutova N F, Vorobyev V A, Samoilova I M, Zaitsev A A, Alaitseva S V, Dostovalova O V, Minchenco N N
The Siberian Federal Research and Clinical Center of the Russian Federal Medical Biological Agency, Seversk, Tomsk region, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2018;95(6):4-12. doi: 10.17116/kurort2018950614.
When choosing the algorithm of rehabilitative measures, the localization of the stroke, brain reserve, and neuroplasticity as well as clinical characteristics (motor, postural, speech, cognitive impairments), etc. are taken into consideration. Monitoring the health status of the patients is an integral component of and an important condition for the successful post-stroke rehabilitation.
The objective of the present study was to evaluate the clinical, functional and psychological status of the patients with stroke during the early and late restorative periods.
The neurological disorders were characterized based on the National Institutes of Health Stroke Scale (NIHSS), the results of hand-grip dynamometry, the Frenchay arm test, and the modified Ashworth scale of muscle spasticity in the combination with the data on the activity of everyday life and the psychological status of the patients. Sstabilograpy, encephalography, and diagnostic transcranial magnetic stimulation (TMS) were carried out. The level of health of the patients was evaluated as the integral measure representing the sum of scores of ranked characters.
A total of 106 patients who had undergone ischemic stroke were available for the examination. During the early post-stroke period the gross disturbances of attention and vertical stabilization were documented. In addition, the dependence of equilibrium on the function of visual analyzer was revealed together with the large number of correlations between the clinical-psychological indicators and the functional parameters associated with neurological deficiency and disability. In the late rehabilitation period, the improvement of attention, the enhanced capability for maintaining equilibrium, and the positive influence of visual memory on the degree of dependence on the assistance of other persons were apparent in the majority of the patients even though some of them exhibited the signs of severe depression.
Taking account of the aforementioned clinical, functional and psychological characteristics of the patients surviving ischemic provides a basis for the differential approach to the correction of the complex of rehabilitative measures.
在选择康复措施算法时，会考虑中风的部位、脑储备、神经可塑性以及临床特征（运动、姿势、言语、认知障碍）等因素。监测患者的健康状况是中风后成功康复的一个组成部分和重要条件。
本研究的目的是评估中风患者在早期和晚期恢复阶段的临床、功能和心理状况。
根据美国国立卫生研究院卒中量表（NIHSS）、握力测量结果、Frenchay上肢测试以及改良Ashworth肌肉痉挛量表，结合患者日常生活活动数据和心理状况，对神经功能障碍进行特征描述。进行了静态姿势描记法、脑电图和诊断性经颅磁刺激（TMS）。将患者的健康水平评估为代表排序特征分数总和的综合指标。
共有106例缺血性中风患者接受了检查。在中风后的早期，记录到了注意力和垂直稳定性的严重紊乱。此外，还发现平衡对视觉分析器功能的依赖性，以及临床心理指标与与神经功能缺陷和残疾相关的功能参数之间存在大量相关性。在晚期康复阶段，大多数患者的注意力有所改善，维持平衡的能力增强，视觉记忆对他人协助依赖程度有积极影响，尽管其中一些患者表现出严重抑郁的迹象。
考虑到缺血性中风存活患者的上述临床、功能和心理特征，为采用差异化方法纠正康复措施组合提供了依据。
