Efficacy of Metabolic Correction in the Early Recovery Period in Patients with Ischemic Stroke
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Efficacy of Metabolic Correction in the Early Recovery Period in Patients with Ischemic Stroke T. S. Poltavskaya, V. A. Bazhenov, and A. V. Volojanin
Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 120, No. 3, Iss. 2, Stroke, pp. 49–53, March, 2020. Original article submitted December 26, 2019. Accepted January 31, 2020. Objective. To assess the efficacy of including the formulation Cytoflavin in rehabilitation programs for patients in the early recovery period of ischemic stroke. Materials and methods. The results of rehabilitation measures were assessed in 100 patients (50 women and 50 men aged 18–85 years) in the early recovery period of ischemic stroke. Neurological and psychological investigations included the NIHSS, MMSE, and Rankin scales, the Rivermead mobility index, and a physical exercise tolerance test. Depending on the rehabilitation scheme, patients were divided into two groups. The study group included 50 patients receiving courses of verticalization and i.v. dropwise Cytoflavin infusions (20.0 ml in 250ml 5% glucose) for 14 days. The reference group consisted of 50 patients who received standard rehabilitation courses. Results and conclusions. Inclusion of Cytoflavin in the rehabilitation programs of patients with ischemic stroke increased treatment efficacy, which was apparent as decreases in the severity of neurological impairments (on the NIHSS) by 17.6% in the study group vs. 10.8% in the reference group (p < 0.05) and recovery of cognitive functions (on the MMSE) by 5.8% vs. 1.6% in the reference group (p < 0.05). In addition, there was an improvement in the recovery of arterial blood pressure, by 37.1% in the study group vs. 30.6% in the reference group (p < 0.05). Keywords: rehabilitation, early recovery period, ischemic stroke, verticalization, metabolic therapy, Cytoflavin.
Introduction. Stroke occupies second place as a cause of death and is leading cause of disability. Statistics indicate that 80–86% of patients surviving after stroke are disabled. Among the sequelae most commonly leading to disability (81.2%) are impairments to motor functions, this being a serious social problem which drives the search for optimum rehabilitation programs. Furthermore, only 14% of stroke patients achieve complete recovery of physical functions, of which 43–78% retain impaired cognitive functions of different severities: decreased attention, difficulty in performing complex tasks, impairments to information analysis and planning, and problems with organization, which can lead to significant decreases in quality of life [1–4]. Early rehabilitation, according to regulatory documents [5, 6], is used in patients with stroke [5], though provision of treatment during this period is accompanied by
problems linked not only with focal neurological deficit, but also impairments to the autonomic nervous system, which are apparent, for example, as the development of orthostatic hypotension. In this regard, autonomic training and early verticalization of patients – active or passive – a
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