Issue №3-22, 2023

Original article

The Results of Targeted Training in the Rehabilitation of Patients with a Combination of Motor and Speech Disorders



1 ORCIDIrina P. Yastrebtseva, 1ORCIDEvgeny A. Biryukovh, 1ORCIDVictoria V. Belova, 1ORCIDLidiya Yu. Deryabkina

1Ivanovo State Medical Academy, Ivanovo, Russia


ABSTRACT

AIM. To evaluate the effectiveness of using a rehabilitation glove in patients with central paresis of the arm and motor aphasia due to ischemic stroke, and also to study the rate of motor production in the upper limb in these patients. 

MATERIALS AND METHODS. We examined 49 patients with hemiparesis and motor aphasia in the early recovery period of ischemic stroke in the left middle cerebral artery. Depending on the fact of conducting training with the use of a rehabilitation glove, patients were randomly distributed into two groups (1, where this training option was implemented, and 2 — without it), comparable in the severity of motor and speech disorders. Within each of them, patients were additionally divided into subgroups, depending on the degree of paresis in the distal part of the affected upper limb: L-mild (in group 1L — 18 people, 2L — 16) and U-moderate (in group 1U — 8, and 2U — 7 patients). On days 1 and 10 of training, all patients underwent functional testing. Treatment and rehabilitation were carried out according to the order of care. Patients of groups 1L and 1U additionally received a course of 10 sessions, including 2 exercises of 15 minutes each for a paretic arm 5 times a week. 

RESULTS. Patients of groups 1L and 1U demonstrated statistically significant improvements in the Medical Research Committee Scale, the ARAT Arm Motor Activity Test, the Wasserman Speech Impairment Rating Scale, and the Montreal Cognitive Function Rating Scale. According to amplitude indicators, there was a tendency towards their increase in all groups. A decrease in the number of errors and an increase in the percentage of correct task completion accompanied the development of a motor act. They stabilized in patients with mild paresis of the hand by 5–6 sessions and in patients with moderate paresis by 6–7 sessions. 

CONCLUSION. In patients with mild to moderate paresis of the right hand in combination with motor aphasia in the early recovery period of ischemic stroke, when using a rehabilitation glove, there was an improvement in the strength and motor activity of the paretic hand, cognitive functions and speech. Stabilization of task performance indicators should be taken into account when determining the duration of training and timely correction of the motor rehabilitation program


KEYWORDS: paresis, motor aphasia, motor activity, stroke, rehabilitation, robotic complex, rehabilitation glove

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation:

Yastrebtseva I.P., Biryukov E.A., Belova V.V., Deryabkina L.Yu. The results of targeted training in the rehabilitation of patients with a combination of motor and speech disorders. Bulletin of Rehabilitation Medicine. 2023; 22(3): 49-58. https://doi.org/10.38025/2078-1962-2023-22-3-49-58 (In
Russ.).



References:

1.Thayabaranathan T., Kim J., Cadilhac D.A., Thrift A.G. et al. Global stroke statistics 2022. International Journal of Stroke. 2022; 17(9): 946–956. https://doi.org/10.1177/17474930221123175

2. [Uteyliev E.S., Konysbaeva K.K., Zhangalieva D.R., Khabieva T.H. Epidemiology and Prevention of Ischemic Stroke. Vestnik KazNMU. 2017; (4): 122–125 (In Russ.).]

3. [Kastey R.M., Dusembekov E.K., Zetov A.Sh. et al. Epidemiological Aspects and Factors of Development of Acute Disorders of Cerebral Circulation. Vestnik KazNMU. 2020; (2): 591–596 (In Russ.).]

4. [Kayerova E.V., Zhuravskaya N.S., Kozina E.A., Shakirova O.V. Restoration of Upper Limb Motor Function After Stroke. Bulletin of Rehabilitation Medicine. 2021; 20(1): 21–26. https://doi.org/10.38025/2078-1962-2021-20-1-21-26 (In Russ.).]

5. [Mishina I.E., Mikhailovskaya T.V., Tochyonov M.Yu. Connection of Arterial Hypertension Parameters and Vital Activity Limitation in Acute Period of Ischemic Stroke. Bulletin of the Ivanovo Medical Academy. 2019; 24(3): 27–31 (In Russ.).]

6. [Levin O.S., Bogolepova A.N. Poststroke motor and cognitive impairments: clinical features and current approaches to rehabilitation. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2020; 120(11): 99–107. https://doi.org/10.17116/jnevro202012011199 (In Russ.).]

7. [Korolev E.S., Alifirova V.M., Latypova A.V., Cheban S.V. et al. Principles and global experience of applying robotic rehabilitation technologies in patients after stroke. Bulletin of Siberian Medicine. 2019; 18(2): 223–233. https://doi.org/10.20538/1682-0363-2019-2-223-233 (In Russ.).]

8. de Crignis A.C., Ruhnau S.T., Hösl M. et al. Robotic arm training in neurorehabilitation enhanced by augmented reality — a usability and feasibility study. Journal of NeuroEngineering and Rehabilitation. 2023; 20(1). https://doi.org/10.1186/s12984-023-01225-5

9. [Ekusheva E.V., Komazov A.A. The use of the “Anika” rehabilitation glove in stroke: the potentials for the improvement of functional recovery. Farmateka. 2019; (13): 30–33. https://doi.org/10.18565/pharmateca.2019.13.30-33 (In Russ.).]

10. [Fedin A.I., Solopova I.A., Tihonova D.Yu., Grishin A.A. Medical technology in neurorehabilitation of patients with movement disorders in acute stroke. Bulletin of Russian State Medical University. 2012; (1): 47–52 (In Russ.).]

11. Rodríguez-Hernández M., Polonio-López B., Corregidor-Sánchez A.I. et al. Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial. Journal of NeuroEngineering and Rehabilitation. 2023; (20). https://doi.org/10.1186/s12984-023-01170-3

12. [Grohovskij S.S., Kubryak O.V. Towards the Question of «Dose» Motor Rehabilitation After Stroke: Review. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018; 17(2): 66–71. https://doi.org/10.18821/1681-3456-2018-17-2-66-71 (In Russ.).]

13. [Prikaz Ministerstva zdravoohraneniya RF ot 31 iyulya 2020 g. № 788n “Ob utverzhdenii Poryadka organizacii medicinskoj reabilitacii vzroslyh” (In Russ.).]

14. Brihmat N., Loubinoux I., Castel-Lacanal E. et al. Kinematic parameters obtainedwith the ArmeoSpring for upper-limb assessment after stroke: a reliability and learningeffect study for guiding parameter use. Journal of NeuroEngineering and Rehabilitation. 2020; 17(1). https://doi.org/10.1186/s12984-020-00759-2

15. Liu X., Zhang W., Li W. et al. Effects of motor imagery based brain-computer interface on upper limb function and attention in stroke patients with hemiplegia: a randomized controlled trial. BMC Neurology. 2023; (23) :136. https://doi.org/10.1186/s12883-023-03150-5

16. Varalta V., Picelli A., Fonte C. et al. Effects of contralesional robot-assisted hand training in patients with unilateral spatial neglect following stroke: a case series study. Journal of NeuroEngineering and Rehabilitation. 2014. https://doi.org/10.1186/1743-0003-11-160

17. Buch E., Weber C., Cohen L.G. et al. Think to move: a neuromagnetic brain-computer interface (BCI) system for chronic stroke. Stroke. 2008; (39): 910–917. https://doi.org/10.1161/STROKEAHA.107.505313

18. Dimyan M.A., Cohen L.G. Neuroplasticity in the context of motor rehabilitation after stroke. Nature Reviews Neurology. 2011; 7(2): 76–85. https://doi.org/10.1038/nrneurol.2010.200




Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.