Objective. To develop a set of exercises based on the combined use of methods of hardware mechanotherapy, manual kinesitherapy and functional reciprocal neuromuscular electrical stimulation, focused on stroke pathobiomechanical phenotypes (PBF).
Materials and methods. This work was based on the theoretical and practical aspects of a new direction of medical rehabilitation (MR) — “adaptive kinesitherapy” (АК). The use of the new MR method was tested on 32 patients with stroke (20 patients made up the comparison group). An objective assessment of the patients’ condition was carried out using clinical scales.
Results. In the course of the analysis of works devoted to AK, three blocks of exercises were developed. The first block includes: three-stage hip flexion, two-stage hip extension, two-stage ankle mobilization, stepping locomotion, flexion of the knee and hip joints, dynamic pelvic lift, flip to the healthy side, and can be recommended for patients with moderate to severe motor disorders corresponding to the PBF 1. The second block: three-stage hip flexion, two-stage hip extension, flip to the healthy side, frontal balance, axial movement 1, axial movement 2, stepping locomotion, dynamic verticalization can be recommended for patients with moderate movement disorders corresponding to the PBF 2. The third block includes: frontal balance, axial movement 1, axial movement 2, lateral step, step locomotion, step around the axis, spatial orientation, identify stimulus cation and can be recommended for patients with moderate to mild motor impairments corresponding to the PBF 3. The use of a new MR for after stroke patients, regardless of the established PBF, has a positive effect on the level of daily activity (p<0,006), mobility level (p<0,001) and gait stereotype function (p<0,001). AK in patients with PBF1 increases the effectiveness of stroke treatment by 5 times (p<0,02), and in patients with PBF2 and PBF3 (p<0.02) (p<0,003) by 8 times, with high quality (0,92) forecast models.
Conclusion. The developed set of exercises for adaptive kinesitherapy is based on the combined use of apparatus mechanotherapy, manual kinesitherapy and functional reciprocal neuromuscular electrical stimulation, and is a method of personalized medical rehabilitation.Ключевые слова:
Автор(ы): U. A. LUKASHEVICH