[Correction of gait stereotype and reduction of the risk of falling in patients with equinovarus foot placement and central hemiparesis]. / Korrektsiya stereotipa khod'by i snizhenie riska padeniya u bol'nykh s ekvinovarusnoi ustanovkoi stopy pri tsentral'nom gemipareze.

OBJECTIVE: To test a new approach to gait stereotype correction for patients with central hemiparesis with talipes equinovarus. MATERIAL AND METHODS: The study was performed in a group of patients with formed talipes equinovarus and post-stroke hemiparesis. Footwear with orthopaedic elements was offered to the patients. Evaluation of spatial and temporal gait parameters was performed and the risk of falls was assessed. RESULTS: In the process of work, data were obtained confirming the effectiveness of using specialized shoes for equinovarus foot placement. The risk of falling significantly decreased when walking; walking became more symmetrical due to an increase in the anterior extension of the paretic limb. CONCLUSION: Application of this method does not decrease the tone in the paretic limb but optimises the gait stereotype, facilitates the increases of its velocity and decreases the risk of falling.

[Laser analyzer as an objective method for evaluating walking parameters in patients with post-stroke disorders]. / Lazernyi analizator kak ob"ektivnyi metod issledovaniya parametrov khod'by u bol'nykh s postinsul'tnymi narusheniyami.

OBJECTIVE: To estimate the informativity, sensitivity and specificity of the method of assessing gait function in patients with ataxia and post-stroke hemiparesis using the LA-1 «Laser Analyzer of Kinematic Gait Parameters¼. MATERIALS AND METHODS: Main tempo-rhythm and spatial gait parameters were assessed in groups of healthy people of young (n=30) and middle (n=30) age. At the second stage, the gait parameters of healthy people were compared with those of patients with ataxia due to vertebrobasilar stroke (n=30) and with post-stroke hemiparesis (n=30). The following parameters were evaluated: the average length and duration of step, the standard deviation of step length, the standard deviation of step duration, coefficient of variability for step length & duration. RESULTS: The high sensitivity and specificity of the method were established. Standard values were determined for all indicators in groups of healthy people and statistically significant features of the main gait parameters for these syndromes were identified. There were an increase in the step length and duration, standard deviation of step length and duration, step variability coefficients, and a decrease in walking speed. Conclusion. The results are in line with those of earlier studies on the gait change in patients with post-stroke disorders. The LA-1 method can be recommended for clinical use.

[The new approach in the treatment of walking disorders in Parkinson's disease]. / Novyi podkhod k lecheniiu narushenii khod'by pri bolezni Parkinsona.

AIM: To evaluate the efficacy of a proprietary method based on stimulation of the hindfoot when lifting the foot from the surface of the support and bringing it forward in the treatment of walking disorders in patients with Parkinson's disease (PD). MATERIAL AND METHODS: The study included 19 patients with walking disorders, akinetic-rigid and mixed form of PD. The stage of the disease on the Hoehn-Yahr scale at the time of the study was 2.56±0,41. During the treatment of walking disorders using the proprietary method, correction of anti-parkinsonian therapy was not carried out. Correction of walking disorders was carried out by using 'activating platforms', which allow mechanical stimulation of the hindfoot at the moment of lifting the foot from the surface of the support. Neurological examination, computer stabilometry (CS), gait function evaluation by means of the LA-1 laser analyzer of kinematic parameters of gait, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Unified Parkinson's Disease Rating Scale (UPDRS) were used before and after treatment. RESULTS: A significant decrease in core values of LA-1 and positive dynamics on BBS, DGI, UPDRS was revealed after treatment. CONCLUSION: The original method based on stimulation of foot lifting from the surface and moving the foot forward, effectively improves the pattern of walking in patients with PD and can be recommended as a non-pharmacological method of treatment of impaired walking at the third stage of PD.

[Projects of distant rehabilitation in neurology. The website of in-home rehabilitation in the territory of Krasnoyarsk Region]. / Proekty distantsionnoi reabilitatsii v nevrologii. Sait domashnei neiroreabilitatsii 'NeiroDom' na territorii Krasnoiarskogo kraia.

At the present time, distant rehabilitation is a relevant direction in restorative medicine. The article considers existing projects in remote rehabilitation, including a self-rehabilitation method developed by academician K.V. Lyadov, the Guided Self-Rehabilitation Contracts system (GSC) etc. The authors present an original project of a remote rehabilitation website 'NeuroHouse' designed for the restoration of balance and gait functions, wrist fine motor skills and speech, spasticity management in patients with neurological diseases. The project combines proprietary rehabilitation methods and classical exercise therapy. This website will make it possible to implement the third ambulatory stage of medical rehabilitation at home.

[Stiff-person syndrome: a clinical observation]. / Sindrom rigidnogo cheloveka: osobennosti klinicheskogo techeniia.

Stiff-person syndrome (SPS) is a rare chronic neurological disease characterized by progressing muscle rigidity and painful muscle spasms. The signs of SPS are pain and stiffness in spinal, abdominal and cervical muscles, increased muscle tonus in extensor muscles of extremities, constant stiffness of paravertebral and abdominal muscles and muscle spasms. A clinical case of a SPS patient T., aged 23 years, is presented. The peculiarity of this case is additional left-sided peripheral upper extremity monoparesis, which is most likely associated with the development of left-sided compression-ischemic brachial plexopathy resulted from profound muscular tonic syndrome in the neck and shoulder girdles.

[Assessment of walking function in neurological practice]. / Otsenka funktsii khod'by v nevrologicheskoi praktike.

An accurate diagnosis of the existing defect of motor function in patients with neurological pathology is necessary for the optimal formulation of the rehabilitation program, selection of drug therapy and evaluation of the effectiveness of treatment. In current clinical practice, clinical scales such as the Dynamic Gait Index, the Rivermid Mobility Index, the Hauser Walk Index, the Stand Up and Go Test, the MDS-UPDRS III are used most often to assess walking function. Evaluation of walking function using valid scales is very accessible, however, it has such a disadvantage as subjectivity. That's why the study of motor functions by instrumental methods gains more prominence. The most well-known methods of objective walking assessment include an analysis of human movements using accelerometers, three-dimensional video analysis, sub-metric, goniometric and impregnation methods. Each of these methods has both advantages and disadvantages. The main requirement to objective methods of assessing walking functions in neurological pathology is the universality of the complex (the accuracy of measurements, regardless of the type of walking disorder), the ability to determine both temporal and spatial characteristics of the step, the ease of use. Considering these requirements, the use of the 'Induction Analyzer of the kinematic parameters of walking' seems promising in the diagnosis of motor disorders.

[Evaluation of a method based on the principle of CI therapy in the correction of walking function in patients with post-stroke hemiparesis syndrome]. / Otsenka effektivnosti primeneniya metoda, osnovannogo na printsipe CI-terapii, pri korrektsii funktsii khod'by u bol'nykh s sindromom gemipareza postinsul'tnogo proiskhozhdeniya.

AIM: To develop a new, effective, affordable method of neurorehabilitation for the correction of walking functions based on the principle of CI (constraint-induced movement therapy) therapy in patients with the syndrome of hemiparesis of post-stroke origin. MATERIAL AND METHODS: The study included 100 patients with moderate to marked syndrome of central hemiparesis in the recovery period of stroke. Patients were randomized into two groups. In the main group, the walk recovery was carried out using CI-therapy in complex with traditional methods of neurorehabilitation and in the comparison group, walk correction was performed by generally accepted methods of kinesiotherapy and physical therapy. Both groups were comparable by stage of stroke, the severity of paresis, age. RESULTS AND CONCLUSION: The risk of fall significantly decreased in both groups of patients. The length and paretic step time significantly decreased in the main group. The effectiveness of the restoration of the function of walking was higher in the main group that allows us to recommend the method of correction of the walk based on the principle of CI therapy in the complex neurorehabilitation.

[The investigation of kinematic features of gait in healthy subjects and patients with post-stroke atactic disorders]. / Issledovanie kinematicheskikh osobennosteĭ khod'by u zdorovykh ispytuemykh i patsientov s postinsul'tnoĭ ataksieĭ.

AIM: To study spatial/temporal parameters of gait in post-stroke vestibular-atactic syndrome. MATERIAL AND METHODS: Authors investigated the speed, rhythmic and angle parameters of the gait in healthy subjects (n=15) and in patients with atactic disorders in the recovery period of vertebrobasillar ischemic stroke (n=15). Physical examination with elements of anthropometry, clinical assessment of gait function with the Dynamic Gait Index, objective assessment of gait parameters using the system for 3D movement video analysis VICON Motion Capture Systems were used. RESULTS: There were a statistically significant decrease in the speed and pace of the gait, increase in the step duration and duration of the double support phase. The speed and rhythmic parameters of the left and right lower limb differed significantly. A delay of the moments of foot lifting from the surface was observed. Authors also revealed a decrease in the amplitude of flexion and extension in all segments of the lower limbs in the double step phase. CONCLUSION: These characteristics represent the activation of the «sitting¼ strategy and facilitate the objective assessment of the hyperfunction of the reactive postural synergies in patients with post-stroke atactic disorders.

[The use of stabilizing platforms in the correction of atactic disorders in patients with vertebrobasilar stroke].

Results of the treatment of atactic gait and balance disorders in post-stroke patients are presented. A method of neurorehabilitation using stabilizing platforms based on the excluding ankle joint postural strategy and support square is proposed. The efficacy of this method assessed by the computerized stabilometry and functional balance scale was comparable with the results of the generally accepted computerized dynamic posturography with visual biofeedback.