Post-stroke rehabilitation with a focus on motor and cognitive recovery

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Abstract

The relevance of neurorehabilitation research is determined by the high incidence of acute cerebrovascular pathologies, as well as the increasing risk of disability due to residual impairment after a stroke. Severe motor impairment in the limbs, static and gait disorders, and decreased intellectual and memory functions significantly reduce the quality of life of patients and increase the demand for rehabilitation services. The work considers the fundamental principles of neurorehabilitation: early initiation, comprehensiveness, consistency, interdisciplinary approach, and the appropriate combination of drug and non-drug therapies. The main approaches to motor rehabilitation for patients after a stroke are described in detail, and key areas for stroke recurrence prevention are highlighted. Physical rehabilitation methods include kinesitherapy, occupational therapy, gait training, mechanotherapy, neurodevelopment techniques, and motor control restoration using robotic devices based on biofeedback. Various physiotherapeutic approaches (massage, manual therapy, acupuncture, cryotherapy, magnetic and electrical stimulation technologies) are used as adjunctive methods to enhance the effectiveness of motor rehabilitation. Medicines and rehabilitation methods are presented through the prism of evidence-based medicine. Particular importance is given to the correction of cognitive disorders, since their preservation directly affects the success of recovery. Cognitive rehabilitation includes the use of external compensatory strategies, metacognitive training, environmental adaptation with scanning training and multisensory stimulation methods, speech exercises, as well as various computer programs and paper-based methods with training in concentration, rapid selection and switching of attention. The mechanism of action and proven efficacy of choline alfoscerate (Cereton), a multifunctional drug, are demonstrated; its use as part of a comprehensive rehabilitation program significantly improves patients’ cognitive state and enhances their adaptive capacity.

About the authors

Aleksandr E. Barulin

Volgograd State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: barulin23@mail.ru
ORCID iD: 0000-0001-7264-3580
Russian Federation, 1 Ploshchad’ Pavshikh Bortsov, Volgograd 400066

O. V. Kurushina

Volgograd State Medical University, Ministry of Health of Russia

Email: barulin23@mail.ru
ORCID iD: 0000-0003-4364-0123
Russian Federation, 1 Ploshchad’ Pavshikh Bortsov, Volgograd 400066

E. P. Chernovolenko

Volgograd State Medical University, Ministry of Health of Russia

Email: barulin23@mail.ru
ORCID iD: 0000-0001-6517-9062
Russian Federation, 1 Ploshchad’ Pavshikh Bortsov, Volgograd 400066

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