Современные технологии реабилитации пациентов с двигательными нарушениями в раннем восстановительном периоде мозгового инсульта (обзор)

Мозговой инсульт является одной из ведущих причин инвалидности среди взрослого населения во всем мире. Число пациентов, перенесших инсульт и нуждающихся в реабилитации, в том числе двигательной, растет ежегодно. Стандартные методы моторной реабилитации оказывают ограниченное влияние на восстановление утраченных двигательных функций конечностей. В связи с этим в последние годы предлагаются новые технологии постинсультной реабилитации. В настоящем обзоре обобщены имеющиеся в литературе данные о возможностях применения современных методов реабилитации пациентов с двигательными нарушениями в раннем восстановительном периоде мозгового инсульта. Существующие современные технологии разделены на методы, основанные на теории «межполушарной конкуренции» (ритмическая транскраниальная магнитная стимуляция, транскраниальная электрическая стимуляция постоянным током), и на теории «зеркальных нейронов» (системы виртуальной реальности и нейрокомпьютерные интерфейсы). Представлены нейрофизиологическое обоснование и возможные протоколы применения данных методов в клинической практике, результаты клинических исследований в зависимости от исходной степени тяжести двигательных нарушений и давности инсульта, а также факторы, влияющие на эффективность двигательной реабилитации при использовании данных методов.

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