[Pharmacotherapy in post-stroke rehabilitation]. / Farmakoterapiya v postinsul'tnoi reabilitatsii.

The article presents data on the conditions of use and efficacy of botulinum toxin preparations, oral muscle relaxants, selective serotonin reuptake inhibitors, acetylcholinesterase inhibitors and a glutamatergic transmission modulator in post-stroke neurorehabilitation, and provides recommendations for their rational and safe use. The clinical efficacy of Mexidol, which has a polymodal effect on a wide range of post-stroke disorders, especially in long-term sequential therapy, is discussed. A complex use of post-stroke rehabilitation methods with the determination of individual tactics based on the clinical picture of the patient and the defined rehabilitation goals is recommended. The inclusion of Mexidol in the complex therapy of patients with stroke consequences for tasks related to improving motor, affective and cognitive functions and self-care and quality of life looks promising. It is necessary to continue high-quality clinical studies to assess the pharmaceuticals efficacy in relation to post-stroke disorders.

[Validation of the Russian version of the Fugl-Meyer Assessment of Physical Performance for assessment of patients with post-stroke paresis]. / Validatsiya russkoyazychnoi versii shkaly Fugl-Meiera dlya otsenki sostoyaniya patsientov s postinsul'tnym parezom.

OBJECTIVE: To perform linguistic and cultural adaptation of the Fugl-Meyer Assessment of Physical Performance. MATERIALS AND METHODS: The study for assessment of psychometric properties included 53 post-stroke patients with neurological deficit presented by hemiparesis of different severity. The patients were assessed twice: at admission and after 14 days of treatment and rehabilitation procedures. The Russian version of the Fugl-Meyer Assessment of Physical Performance was developed with consideration of language and cultural characteristics. RESULTS AND CONCLUSION: Results of assessment of psychometric properties of the Russian-language version show its high validity, reliability and sensitivity. The developed Russian-language version of Fugl-Meyer Assessment of Physical Performance is recommended for using by neurologists and rehabilitation specialists both in everyday clinical practice and in clinical studies of patients with post-stroke paresis. The results obtained in the study show necessity for pre-training of specialists who perform assessment of patients with post-stroke paresis using the Fugl-Meyer Assessment of Physical Performance.

[Post-stroke rehabilitation training with a brain-computer interface: a clinical and neuropsychological study]. / Interfeis mozg-komp'iuter v postinsul'tnoi reabilitatsii: kliniko-neiropsikhologicheskoe issledovanie.

AIM: To evaluate the clinical efficacy of BCI-supported mental practice and to reveal specific cognitive impairment which determine mental practice ineffectiveness and inability to perform MI. MATERIAL AND METHODS: Fifty-five hemiplegic patients after first-time stroke (median age 54. 0 [44.0; 61.0], time from onset 6.0 [3.0; 13.0] month) were randomized into two groups - BCI and sham-controlled. Severity of arm paresis was measured by Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA) and Action Research Arm Test (ARAT). Twelve patients from the BCI group were examined using neuropsychological testing. After assessment, patients were trained to imagine kinesthetically a movement under control of BCI with the feedback presented via an exoskeleton. Patients underwent 12 training sessions lasting up to 30 min. In the end of the study, the scores on movement scales, electroencephalographic results obtained during training sessions were analyzed and compared to the results of neuropsychological testing. RESULTS: Evaluation of the UL clinical assessments indicated that both groups improved on ARAT and FMA (sections A-D, H, I) but only the BCI group showed an improvement in the ARAT's grasp score (p=0.012), pinch score (p=0.012), gross movement score (p=0,002). The significant correlation was revealed between particular neuropsychological tests (Taylor Figure test, choice reaction test, Head test) and online accuracy rate. CONCLUSION: These results suggest that adding BCI control to exoskeleton-assisted physical therapy can improve post-stroke rehabilitation outcomes. Neuropsychological testing can be used for screening before mental practice admission and promote personalized rehabilitation.

[Brain-Computer Interface: the First Clinical Experience in Russia].

Motor imagery is suggested to stimulate the same plastic mechanisms in the brain as a real movement. The brain-computer interface (BCI) controls motor imagery by converting EEG during this process into the commands for an external device. This article presents the results of two-stage study of the clinical use of non-invasive BCI in the rehabilitation of patients with severe hemiparesis caused by focal brain damage. It was found that the ability to control BCI did not depend on the duration of a disease, brain lesion localization and the degree of neurological deficit. The first step of the study involved 36 patients; it showed that the efficacy of rehabilitation was higher in the group with the use of BCI (the score on the Action Research Arm Test (ARAT) improved from 1 [0; 2] to 5 [0; 16] points, p = 0.012; no significant improvement was observed in control group). The second step of the study involved 19 patients; the complex BCI-exoskeleton (i.e. with the kinesthetic feedback) was used for motor imagery trainings. The improvement of the motor function of hands was proved by ARAT (the score improved from 2 [0; 37] to 4 [1; 45:5] points, p = 0.005) and Fugl-Meyer scale (from 72 [63; 110 ] to 79 [68; 115] points, p = 0.005).