Tools for Assessing the Function of the Upper Extremity in Patients with Stroke: the Prognostic Role of Finger Extension
Abstract: The purpose of the study was to determine the prognostic role of finger extension and to assess the function of the upper extremity in patients with stroke. Materials and methods. The study was performed on the basis of the Medical Center "Expert Health" and clinical units of Petro Mohyla Black Sea National University, Mykolaiv, Ukraine during 2020-2021. 89 patients who underwent acute cerebrovascular accident by ischemic type with paresis of the upper extremity were examined. All patients were examined in acc… Show more
Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
Cited by 1 publication
References 17 publications
Relevance. There are studies on the positive effect of electric current on neuronal excitability and activity of the cerebral cortex, depending on the chosen mode. But it is not known whether there will be a positive clinical effect from transcranial electrical stimulation of the brain in patients who have suffered an ischemic stroke. Objective: evaluation of the clinical effectiveness of the complex method of neurorehabilitation of post-stroke patients. Material and methods. Treatment of 150 patients with ischemic type of acute violation of cerebral circulation was carried out. The total sample was randomly divided into four clinical groups: І (n=30) – traditional therapy, ІІ (n=40) – application against the background of traditional therapy of neuroprotection in the acute and early recovery period with peptidergic compounds (cerebrolysin 40 ml per day), ІІІ ( n=40) – application of traditional therapy with transcranial micropolarization of the brain, IV (n=40) – application against the background of traditional therapy of combined neuroprotection in the acute and early recovery period with peptidergic compounds in combination with micropolarization of the brain. All patients during the observation period were repeatedly assessed the motor function of the upper limb using the Action Research Arm Test (ARAT), in its own modification with the assessment of the extension function of the fingers of the hand. Additionally, functional recovery after a stroke was assessed using the STREAM (Stroke Rehabilitation Assessment of Movement) scale, assessment of the function of the upper limb using the Fugl-Meyer FMA-UE test and the lower limb using the FMA-LE test. Disturbances in the motor-coordination sphere were additionally assessed using the stabilometry method on the ST-150 platform, using the following subtests: Romberg test, combined coordination-motor test, static test, dynamic test, as well as the foot reception test. Statistical processing was performed by the method of variance analysis. Results. As a result of rehabilitation measures, locomotion function and fine motility of the upper limb are restored in all patients. Recovery of upper extremity fine motility and stato-dynamic indicators in patients who received neuroprotective effects during the treatment of stroke is permanent. Positive dynamics are monitored throughout the entire period of catamnetic observation. The use of peptidergic drugs has a greater neurorehabilitation effect than the isolated use of micropolarization. The combined use of micropolarization and peptidergic metabolic support in patients with ischemic stroke significantly improves the functional results of rehabilitation at all stages of observation. According to the FMA-UE test, statistically significant differences compared to controls were observed in the subtests of mobility in the carpal joint and fingers of the hand, as well as voluntary movements with synergy. In patients of the I group, the score on the AII subscale was 15.2 ± 0.2 points, in the II group – 17.3 ± 0.3 points, in the III group – 17.3 ± 0.4 points, and in patients in the IV group – 17, 2±0.3 points (p<0.05). The score on subscale B (mobility of the wrist) for patients of group I was 8.2±0.1 points, group II – 9.0±0.1 points, group III – 9.4±0.1 points, group IV – 9.5±0.1 points (p<0.05). According to subscale C (mobility of the fingers of the hand), the average score in the I group was 11.8±0.2 points, in the II group – 13.0±0.3 points, in the III group – 13.5±0.2 points, and in the IV group – 13.6±0.2 points (p<0.05). According to the data of the FMA-LE test in domain EII (voluntary movements with synergy) in the control (I) group one year after ischemic stroke, the score corresponded to the level of 10.3±0.3 points, in the II group - 13.0±0.4 points, in group III – 13.5±0.3 points, in group IV – 13.6±0.4 points (p<0.05). For the EIII domain (voluntary movements with mixed synergy), the indicators increased to 2.8±0.1 points in the I group, to 3.2±0.1 points in the II group, to 3.3±0.1 points in the III group, up to 3.5±0.1 points – in the IV group (p<0.05). The total FMA-LE score was 74.2±2.4 points for the I group, 78.5±2.6 points for the II group, 79.5±3.2 points for the III group, and 80 for the IV group 80.7±2.5 points (p<0.05). Conclusions. As a result of rehabilitation measures, all patients recover locomotion function, fine motility of the upper limb. The greatest increase in indicators is characteristic of the EFAT subtest, which evaluates the function of straightening the fingers of the hand.The use of peptidergic drugs has a greater neurorehabilitation effect than the isolated use of micropolarization. The combined use of micropolarization and peptidergic metabolic support in patients with ischemic stroke significantly improves the functional results of early rehabilitation.
Relevance. There are studies on the positive effect of electric current on neuronal excitability and activity of the cerebral cortex, depending on the chosen mode. But it is not known whether there will be a positive clinical effect from transcranial electrical stimulation of the brain in patients who have suffered an ischemic stroke. Objective: evaluation of the clinical effectiveness of the complex method of neurorehabilitation of post-stroke patients. Material and methods. Treatment of 150 patients with ischemic type of acute violation of cerebral circulation was carried out. The total sample was randomly divided into four clinical groups: І (n=30) – traditional therapy, ІІ (n=40) – application against the background of traditional therapy of neuroprotection in the acute and early recovery period with peptidergic compounds (cerebrolysin 40 ml per day), ІІІ ( n=40) – application of traditional therapy with transcranial micropolarization of the brain, IV (n=40) – application against the background of traditional therapy of combined neuroprotection in the acute and early recovery period with peptidergic compounds in combination with micropolarization of the brain. All patients during the observation period were repeatedly assessed the motor function of the upper limb using the Action Research Arm Test (ARAT), in its own modification with the assessment of the extension function of the fingers of the hand. Additionally, functional recovery after a stroke was assessed using the STREAM (Stroke Rehabilitation Assessment of Movement) scale, assessment of the function of the upper limb using the Fugl-Meyer FMA-UE test and the lower limb using the FMA-LE test. Disturbances in the motor-coordination sphere were additionally assessed using the stabilometry method on the ST-150 platform, using the following subtests: Romberg test, combined coordination-motor test, static test, dynamic test, as well as the foot reception test. Statistical processing was performed by the method of variance analysis. Results. As a result of rehabilitation measures, locomotion function and fine motility of the upper limb are restored in all patients. Recovery of upper extremity fine motility and stato-dynamic indicators in patients who received neuroprotective effects during the treatment of stroke is permanent. Positive dynamics are monitored throughout the entire period of catamnetic observation. The use of peptidergic drugs has a greater neurorehabilitation effect than the isolated use of micropolarization. The combined use of micropolarization and peptidergic metabolic support in patients with ischemic stroke significantly improves the functional results of rehabilitation at all stages of observation. According to the FMA-UE test, statistically significant differences compared to controls were observed in the subtests of mobility in the carpal joint and fingers of the hand, as well as voluntary movements with synergy. In patients of the I group, the score on the AII subscale was 15.2 ± 0.2 points, in the II group – 17.3 ± 0.3 points, in the III group – 17.3 ± 0.4 points, and in patients in the IV group – 17, 2±0.3 points (p<0.05). The score on subscale B (mobility of the wrist) for patients of group I was 8.2±0.1 points, group II – 9.0±0.1 points, group III – 9.4±0.1 points, group IV – 9.5±0.1 points (p<0.05). According to subscale C (mobility of the fingers of the hand), the average score in the I group was 11.8±0.2 points, in the II group – 13.0±0.3 points, in the III group – 13.5±0.2 points, and in the IV group – 13.6±0.2 points (p<0.05). According to the data of the FMA-LE test in domain EII (voluntary movements with synergy) in the control (I) group one year after ischemic stroke, the score corresponded to the level of 10.3±0.3 points, in the II group - 13.0±0.4 points, in group III – 13.5±0.3 points, in group IV – 13.6±0.4 points (p<0.05). For the EIII domain (voluntary movements with mixed synergy), the indicators increased to 2.8±0.1 points in the I group, to 3.2±0.1 points in the II group, to 3.3±0.1 points in the III group, up to 3.5±0.1 points – in the IV group (p<0.05). The total FMA-LE score was 74.2±2.4 points for the I group, 78.5±2.6 points for the II group, 79.5±3.2 points for the III group, and 80 for the IV group 80.7±2.5 points (p<0.05). Conclusions. As a result of rehabilitation measures, all patients recover locomotion function, fine motility of the upper limb. The greatest increase in indicators is characteristic of the EFAT subtest, which evaluates the function of straightening the fingers of the hand.The use of peptidergic drugs has a greater neurorehabilitation effect than the isolated use of micropolarization. The combined use of micropolarization and peptidergic metabolic support in patients with ischemic stroke significantly improves the functional results of early rehabilitation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
Contact Info
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Product
Resources
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.
