[Restoration of the complicated locomotor functions of the upper extremities in the patients surviving ischemic stroke].

During the late and residual periods of stroke, it is necessary to pay attention to the training of complex spatial movements along with the traditional restoration of the balance and strength of para-articular muscles and the mobility of the paretic limb joints. The objective of the present study was to evaluate the effectiveness of robotic therapy for the recovery of the functions of the upper extremities in the late and residual periods of stroke. The study involved 52 patients who had survived ischemic stroke in the middle cerebral artery. The patients were divided randomly into 2 groups. All of them performed therapeutic physical exercises based on the standard technique during 5 days a week for 3 weeks. In addition, the treatment included massage, laser and pulsed current therapy. The patients of the main group (n=36) were additionally trained to perform complex spatial movements with special emphasis on their speed, fluidity, precision, and agility with the use of the Multi Joint System (MJS) robotic electromechanical device (40 min, 5 days/wk x 3wk). The analysis of the results of the study has demonstrated the statistically significant difference in the degree of improvement of the range of motion (ROM) in the elbow and shoulder joints, the speed and the accuracy of these movements between the patients of the main and control groups. It is concluded that the instrumental restoration of complex spatial movements of the upper extremities during the late and residual periods of stroke contributes not only to the improvement of the functional capabilities but also to the enhancement of independence and personal adjustment of the stroke patients.

[The principal approaches to the treatment of post-stroke shoulder pain syndrome].

Post-stroke pain syndrome is one of the serious complications of stroke preventing the restoration of motor activity, routine everyday and professional independence of the patients. This review is focused on pathogenesis of central and peripheral shoulder pain syndromes on the affected side of the body and the principal approaches to their treatment during the post-stroke recovery period. The paper describes the main manual and robotic methods for the treatment of shoulder pain depending on its pathogenesis and the typical therapeutic protocols. The special emphasis is laid on the necessity of the pathogenetic approach to the pain alleviation as well as clinical significance of the correction of biomechanical disorders in the upper body and the restoration of the functional ability of the upper limbs in the patients presenting with post-stroke hemiparesis associated with pain syndrome.