Improving orthostatic reactions after supratentorial unilateral stroke in the chronic period

Vasileva, Dance and Lubenova, Daniela (2018) Improving orthostatic reactions after supratentorial unilateral stroke in the chronic period. In: Fourth National Congress with international participation, Bulgarian Society of Neurosonology and Cerebral Hemodynamics, 5-7.10.2018, National Palace of Culture, Sofia, Bulgaria.

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Abstract

Haemodynamics in postural change causes autonomic neural responses to the cardiovascular system that leads to changes in blood pressure and causes a barrefactive-mediated effect. Orthostatic autoregulation is an adaptive and compensatory mechanism against the gravitational redistribution of blood during the transition from horizontal to upright position of the body. The physical activity causes changes in the cerebral blood flow, which depends on the type, intensity and duration. The aim of this study is to evaluate the effect of the specialized kinesitherapy methodology (SKTM) on the orthostatic reactions in patients with supratentorial unilateral stroke in the chronic period (SUSChP). Material and Methods: The study was conducted with 67 patients with SUSChP (56 patients included in the experimental group - 32 men and 24 women, with duration of the disease 7.8 ± 2.0 months, and 11 patients in the controled group - 9 men and 2 women, with duration of the disease 7.3 ± 1.5 months). Depending on the type of orthostatic reaction, the studied patients were previously divided according to the Thulesius classification. Disorder in the orthostatic reactivity was found in all patients. Some had sympathicotonic orthostatic reactivity (SOR), and other patients had hypertonic orthostatic reactivity (HOR). The patients from the experimental group were treated with a specialized 10-day KT, which was later performed as an adapted exercise program at home for a period of 1 month. Patients from the controlled group performed a regular 10-day KT. SKTM is based on the fundamental principles of modern neurorehabilitation, namely: to be individualized, intensive , specifically - tailored and focused on the individual needs of the patient; with active participation from the patient and his family, with continuous care to complete the needs of the patient throughout his life and achieve recovery and relief of late complications from the disease. Specialized kinesitherapeutic methodology conforms to the principles of motor learning: specificity of the task, active participation of the patient, repetitive tasks, complex adaptation, also to provide feedback from the variety of "contextual interference". Results: This study shows that the applied 10-day specialized kinesitherapy in clinical conditions, continued later as an adapted exercise program at home, permanently improves the orthostatic dysregulation in patients with SUSChP, as opposed to a controlled group where the application of a regular 10-day kinesitherapy, resulted in a short-term improvement on the final day of treatment, after which a tendency to return to baseline occurred in subgroups with SOR and HOR. Conclusion: The application of specialized kinesitherapy with moderate intensity and one-month duration of persistence resulted in a significant improvement in orthostatic reactivity in patients with supraterritorial single-sided stroke in the chronic period and orthostatic dysregulation. Keywords: Kinesitherapy, Orthostatic reactions, Stroke, Chronic period.

Item Type: Conference or Workshop Item (Poster)
Uncontrolled Keywords: Keywords: Kinesitherapy, Orthostatic reactions, Stroke, Chronic period.
Subjects: Medical and Health Sciences > Basic medicine
Medical and Health Sciences > Clinical medicine
Medical and Health Sciences > Health sciences
Medical and Health Sciences > Other medical sciences
Divisions: Faculty of Medical Science
Depositing User: Dance Vasileva
Date Deposited: 16 Oct 2018 07:39
Last Modified: 16 Oct 2018 07:39
URI: http://eprints.ugd.edu.mk/id/eprint/20552

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