EFFECTIFVENESS OF TRANSCRANIAL MAGNETIC STIMULATION IN REHABILITATION OF STROKE PATIENTS
Introduction. Stroke is a major cause of disability in the worldwide and in Kazakhstan and is resistant disadaptation.
The aim: To study the effectiveness of TMS in the rehabilitation of patients with ischemic stroke in the early recovery period.
Methods. In an experimental randomized controlled study forty-four patients with ischemic stroke were examined in the early recovery period.
Patients of the experimental group (n = 22 patients) received a course of rehabilitation, including exercise therapy, physical therapy with kinesitherapy, massage, magnetic therapy, individual lessons in the fine motor skills on the method Montessori, electrical muscle stimulation and additionally (>5Hz) frequency TMS on unaffected and (<1Hz) on affected part of the hemisphere (in the projection of the motor cortex and central gyrus) on the apparatus «Neuro-MS/D». NIHSS scale, Barthel Index, Rankin Scale disability, muscle strength, the MMSE scale and the Clock "drawing" test used for evaluation the effectiveness of treatment. Statistical analysis was performed using the Mann-Whitney test.
Results. The experimental group showed statistically significant improvements in the NIHSS scale (p=0,026), the index Barthel (p=0,042), the modified Rankin scale (p=0,049), the strength of the hand muscles (p=0,040), the strength of the leg muscles (p=0,021), the scale MMSE (p=0,007) and the clock drawing test (p=0,042) after intervention. Statistically significant differences were did’t found in patients of control group.
Conclusions: So, we found a statistically significant positive effect of TMS on motor deficit, daily activities, and the level of cognitive disorders in patients with ischemic stroke in the Kazakh sample.
Asel K. Akimzhanova 1, http://orcid.org/0000-0003-3248-575
Andrej M. Grjibovski 2-5, http://orcid.org/0000-0002-5464-0498
Talgat N. Khaibullin 1, http://orcid.org/0000-0003-1886-0538
Nasiba S. Izatullayeva 6,
Maria I. Gordienko 6,
Kuat D. Akimzhanov1, http://orcid.org/0000-0002-8608-0771
1 Semey State Medical University, Semey, Kazakhstan;
2 Norwegian Institute of Public Health, Oslo, Norway;
3 Northern State Medical University, Arkhangelsk, Russia;
4 International Kazakh-Turkish University, Turkestan, Kazakhstan;
5 North-Eastern Federal University, Yakutsk, Russia;
6 Consultative diagnostic clinic "In-Vitro+" Semey, Kazakhstan;
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22. Brott T., Adams H.P., Olinger C.P. et al. Measurements of acute cerebral infarction- a clinical examination scale. Stroke. 1989, 20, pp. 864-870.
23. Giovanni Pennisi, Ciuseppe Rapisarda, Rita Bella, et all. Absence of response to early transcranial magnetic stimulation in ischemic stroke patients prognostic value hand motor recovery. Stroke. 1999, 30. рр. 2666-2670.
24. Le Q., Qu Y., Tao Y., Zhu S. Effects of repetitive transcranial magnetic stimulation on hand function recovery and excitability of the motor cortex after stroke: a meta-analysis. Am. J. Phys. Med. Rehabil. 2014, 93, pp. 422–430.
25. Feigin V.L., Forouzanfar M.H., Krishnamurthi R.Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014, 18, 383, pp. 245-54.
26. Goff D.C., Lloyd-Jones D.M., Bennett G., Coady S., et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014, 63, pp. 2935–2959.
27. Hao Z., Wang D., Zeng Y., et.el. Repetitive transcranial magnetic stimulation for improving function after stroke. Cochrane Database Syst. Rev, 2013, V. 5:CD008862
28. Hsu W.Y., Cheng C.H., Liao K.K. et al. Effects of repetitive transcranial magnetic stimulation on motor functions in patients with stroke: a meta-analysis. Stroke. 2012, 43, pp.1849–1857.
29. James T.H. Ornaldo B.C. Swayne, Binith Cheeran. Human theta burst stimulation enhances subsequent motor learning and increasec performance variability. Cerebral cortex. 2011, 21, pp.1627-1638.
30. Lovenstone S. Cauthier S. Manegment of dementia-London. Martin Duits Ltd. 2000, pp.145.
31. Machoney F., Barthel D. Functional evalution: the Barthel Index. Md State Med J. 1965, 14, pp. 61-65.
32. Official periodical: World Health Organization: Ten Leading causes of death // Information byulleten. 2014. № 310. URL: http: www. who. int/eb/who_constitution_ru.pdf (date of the application: 15.04.2015).
33. Rankin J. Cerebral vascular accidents in patients over the age of 60: II Prognosis. Scott. Med. J. 1957, 2, pp. 200-215.
34. Terao Y., Ugawa Y. Basic mechanisms of TMS. J. Clin. Neurophysiol. 2002, 19, pp.322-43.
35. Wan-Yu Hsu, Chia-Hsiung Cheng, Kwong-Kum Liao. Effects of repetitive transcranial magnetic stimulation on motor functions in patients with stroke a meta-analysis. Stroke.2012, 43, pp.1849-1857.
36. Ware JE Jr., Sherboune C.D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 30 (6), pp.473-483.
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Акимжанова А.К., Гржибовский A.М., Хайбуллин Т.Н., Изатуллаева Н.С., Гордиенко М.И., Акимжанов К.Д. Эффективность транскраниальной магнитной стимуляции в реабилитации пациентов с мозговым инсультом / / Наука и Здравоохранение. 2016. №4. С. 50-65. Akimzhanova A.K., Grjibovski A.M., Khaibullin T.N., Izatullayeva N.S., Gordienko M.I., Akimzhanov K.D. Effectifveness of transcranial magnetic stimulation in rehabilitation of stroke patients. Nauka i Zdravookhranenie [Science & Healthcare]. 2016, 4, pp. 50-65. Әкімжанова Ә.Қ., Гржибовский A.М., Хайбуллин Т.Н., Изатуллаева Н.С., Гордиенко М.И., Әкімжанов Қ.Д. Ми инсульті болған науқастардың қалпына келтіру кезінде транскраниальді магнитті стимуляцияның тиімділігі / / Ғылым және Денсаулық сақтау. 2016. №4. Б. 50-65.Related publications:
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