[Effects of functional electrical therapy on upper extremity functional motor recovery in patients after stroke--our experience and future directions].

INTRODUCTION: New neurorehabilitation together with conventional techniques provide methods and technologies for maximizing what is preserved from the sensory motor system after cerebrovascular insult. The rehabilitation technique named functional electrical therapy was investigated in more than 60 patients in acute, subacute and chronic phase after cerebrovascular insult. The functional sensory information generated by functional electrical therapy was hypothesized to result in the intensive functional brain training of the activities performed. FUNCTIONAL ELECTRICAL THERAPY: Functional electrical therapy is a combination of functional exercise and electrical therapy. The functional electrical therapy protocol comprises voluntary movement of the paretic arm in synchrony with the electrically assisted hand functions in order to perform typical daily activities. The daily treatment of 30 minutes lasts three weeks. The outcome measures include several tests for the evaluation of arm/hand functionality: upper extremity function test, drawing test, modified Aschworth scale, motor activity log and passive range of movement. RESULTS OF FUNCTIONAL ELECTRICAL THERAPY STUDIES: Results from our several clinical studies showed that functional electrical therapy, if applied in acute and subacute stroke patients, leads to faster and greater improvement of functioning of the hemiplegic arm/hand compared to the control group. The outcomes were significantly superior at all times after the treatment for the higher functioning group. DISCUSSION: Additional well-planned clinical studies are needed to determine the adequate dose of treatment (timing, duration, intensity) with functional electrical therapy regarding the patient's status. A combination with other techniques should be further investigated.

[Effects of physical training on the lipid profile of patients after myocardial infarction].

INTRODUCTION: Positive effects of physical training on blood lipoprotein have been clearly demonstrated and they are constituive elements in prevention and treatment of hyperlipoproteinemia. The aim of this study was to evaluate the effects of physical training (PT) on lipid risk factors in patients with myocardial infarction (MI) during posthospital rehabilitation (PHR) and prolonged rehabilitation (48 months). MATERIAL AND METHODS: The prospective clinical study included 230 patients after MI. Patients were divided into two groups: group A (180 patients) participated in organized PT (PHR and prolonged rehabilitation at home) that lasted 48&6.4 months and the control group (50 patients) without PT. The intensity of PT was recommended to be 70% of maximal heart rate obtained during the exercise test (ET). Evaluation of lipid profile was done after the last control (48+/-6.4 months after MI). Parameters in the control group were compared with the parameters in the examined group of patients. RESULTS: Hyperlipidemia, as a risk factor, was present in 39% of patients of group A and in 38% of patients ofthe control group just after MI. A statistically significant difference wasn't established in lipoprotein levels in examined groups of patients before MI (p>0.05). Prolonged PT leads to significant deacrese of total cholesterol (p< 0.01), LDL/cholesterol (p < 0.05) and triglycerides (p<0.01), but increase in HDL/holesterol (p 0.01), in patients after MI with organized rehabilitation in comparison with the control group. CONCLUSION: Prolonged PT has a beneficial effect on hyperlipoproteinemia inl patients after MI. We have to practice PT over the "threshold" of physical activities if we want to achieve optimal results.