Effect of kinesitherapy on orthostatic dysautoregulation after supratentorial unilateral ischemic stroke

The purpose of the study is to investigate the influence of therapeutic exercises on orthostatic dysautoregulation after supratentorial unilateral ischemic stroke (SUIS).
Material and methods: A study was conducted with 67 patients with supratentorial unilateral cerebral stroke in a chronic period (SUISChP) - the experimental group (EG) included 56 patients (32 men and 24 women), with a duration of the condition of 7.8±2.0 months, in which the specialized kinesitherapy program was applied (SKT) for 10 days under control, and then continued to be performed at home as an adapted exercise program for a period of 3 weeks. The control group (CG) consists of 11 patients (9 men and 2 women), with a duration of the condition of 7.3±1.5 months, treated in a routine way, using a usual 10-day kinesitherapy program. They only had control follow-ups without performing a kinesitherapy program after the 10-day treatment.
To determine the type of orthostatic reactivity, the classification of O. Thulesius (1976) is used, which is based on the change in heart rate (HR) and systolic arterial pressure (SBP) when changing the initial position from lying down to standing.
Results: The study shows that after the applied specialized kinesitherapy, which was later continued as a program of exercises at home, patients with SUISChP and pathological orthostatic autoregulation normalized their orthostatic reactivity, which was most pronounced at the 1st month from the start of treatment (p< 0.001). In patients from the control group, who did not perform long-term SKTP, a return to the initial state was established at the end of the monitored period.
Conclusion: Specialized kinesitherapy had a significant positive effect on orthostatic autoregulation on the 10th day, which was more pronounced in EG. At the end of the 1st month, the effect accumulates in the EG and is exhausted in the control patients.

Key words: kinesitherapy, orthostatic dysautoregulation, supratentorial unilateral stroke, ischemic stroke