Научная статья на тему 'АLGORITHM FOR PATIENTS WITH STROKE TREATED WITH INTRAVENOUS THROMBOLYSIS'

АLGORITHM FOR PATIENTS WITH STROKE TREATED WITH INTRAVENOUS THROMBOLYSIS Текст научной статьи по специальности «Клиническая медицина»

CC BY
40
9
i Надоели баннеры? Вы всегда можете отключить рекламу.
Журнал
World science
Область наук
Ключевые слова
THROMBOLYSIS / PHYSICAL THERAPY / ACUTE ISCHEMIC STROKE

Аннотация научной статьи по клинической медицине, автор научной работы — Filipova Mariela, Popova Daniela

Ischemic stroke as an object of this type of manipulation is described anatomically, etiological, clinical state and plan for a better understanding of the procedure and methodology of physiotherapy. Discussed are the most common pathologies in the disease - the lack of motor options or restricted range of motion, lack of tone in the muscles, difficulty or impossible gait, speech disorder and sensory disturbances. Special attention is paid to the medical treatment of ischemic stroke.

i Надоели баннеры? Вы всегда можете отключить рекламу.
iНе можете найти то, что вам нужно? Попробуйте сервис подбора литературы.
i Надоели баннеры? Вы всегда можете отключить рекламу.

Текст научной работы на тему «АLGORITHM FOR PATIENTS WITH STROKE TREATED WITH INTRAVENOUS THROMBOLYSIS»

PHYSICAL EDUCATION AND SPORT

ALGORITHM FOR PATIENTS WITH STROKE TREATED WITH INTRAVENOUS THROMBOLYSIS

Filipova Mariela Popova Daniela

SWU "Neofit Rilski "Blagoevgrad

Abstract. Ischemic stroke as an object of this type of manipulation is described anatomically, etiological, clinical state and plan for a better understanding of the procedure and methodology of physiotherapy.

Discussed are the most common pathologies in the disease - the lack of motor options or restricted range of motion, lack of tone in the muscles, difficulty or impossible gait, speech disorder and sensory disturbances. Special attention is paid to the medical treatment of ischemic stroke. Keywords: thrombolysis, physical therapy, acute ischemic stroke

Kinesitherapy begins in the subacute stage of the disease (2-3 days) . The hospital stay is 7-10 days of onset. Expected recovery after 48th hour. Restoration of patients with standard therapy and kinesitherapy standart program. lasts from 12-16 months.

Purpose of kinesitherapy: Rapid recovery of the patient, without residual focal neurologic symptoms or mild neurological deficits. Tasks of kinesitherapy:

1. Save passive joint amplitudes of the affected limbs.

2. Stimulation and fixing normal synkinetic scheme.

3. Volitional control.

4. Prevention of complications of respiratory (bronchopneumonia).

5. Prevention of thrombophlebitis.

6. Improve coordination.

7. Training in sitting and walking on flat terrain with help.

8. Training in self-service.

9. Coaching distal prehensile function of the hand. Kinesitherapy:

1. Treatment by position;

2. Corrective postures Bobath;

3. Massage;

4. Kinesiotaping in m.deltoideus, on the muscles controlled by the n.facialis's lower branch;

5. Mobilization of the shoulder j oint;

6. Passive exercises in the shoulder joint;

7. Breathing exercises;

8. Active movements of relief starting position;

9. Method of Kabat;

10. Static active exercises;

11. Active exercises for upper and lower extremities;

12. Mobilization of wrist - helps to increase extension in the wrist;

13. Methodology for Brunnstrom;

14. Verticalization;

15. Mirror therapy;

16. Exercises for fine hand movements's exercises to restore sensation to the hand - method of Perfeti. Use different types of grips;

17. Facebuilding exercises - mainly lower branch of n.facialis. Kinesio taping can be applied in the same area;

18. Exercises for healthy limbs;

19. Exercises for coordination in seating position;

20. Locomotor exercise. Training in walking on flat terrain with a mobile penetration;

21. Training activities of daily living;

Results and Discussion

Expected outcomes for patients treated by thrombolysis in the first hours of a dose, and kinesitherapy's program starts aggressively on the second day. About 3 - 6 months the patients remain without persistent focal symptoms and disorders without focus and aphasia. In our program achieved rapid progress by the motor deficit. On the third day of the acute condition to increase the density of the procedure and reduce the preparatory and final part. Dominated by special exercises and elements of standard methodologies. Each procedure requires the active participation of the patient and proper execution of the exercises. In this period, learning activities of daily living exercises for upper and lower extremities, which was subsequently supported locomotion, activities of daily living and restoration of functional independence of the patient. Trained patient alone to conduct some exercises with support from the healthy limb, exercise for the healthy limb to avoid apraksia. There are breathing exercises, idiomotor exercises (mirror therapy) to support brain plasticity. Some of the exercises have made with a kinsio tape on the injured limb, whereby the skin rises above the muscle and tendon and creates additional interspace and facilitates lymphatic drainage and maintain the damaged area. Coordination exercises. The patient is trained in the proper walking. On taking up his starting position and execution of exercises, adjust the proper execution of the exercises. The final part is performed breathing exercises to avoid hypoxia.

After analyzing the results of the research there is a significant improvement in motor deficit (muscle strength, muscle tone, coordination and activities of daily life) patients in the EG and KG 1 and degradation of performance was observed. Highest percentage recovery are achieved in patients with rt-PA. Most of patients in which we applied our specialized methods of physical therapy for the prevention and treatment of complications, have improved motor deficits at hospital discharge and follow-up of third, sixth, ninth month and 1 year. Statistically significant positive change we reported in EG and KG 1 at hospital discharge.

In EG achieved results visible recovery in the first days after intravenous thrombolysis and minimal complications.

The proven effectiveness of the applied our methodology allows us to recommend its application in a hospital setting in the acute period of the disease, and the application in an outpatient setting

Conclusion:

Venous thrombolysis is important for the rapid recovery of the patient. Early and aggressive use of the method has a good effect on the recovery of motor deficit and global opportunities for the patient in activities of daily living, which makes it independent and promotes more rapid socialization.

1. Adams, HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks EFM . Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38 , 2007:1655 - 1711 </br>

2. Bohammon and Smith, Physical therapy, Journal of American Physical therapy association, vol. 67, number 2 , feb.1987</br>

3. Eremiev M. Therapeutic approach to low back pain in the area with limited range of motion in the hip, Optimization of combining modern manual techniques in the treatment of musculoskeletal dysfunctions. NSA Press, S., 2011, ISBN-978-954-718-323-0, pp 70-78.</br>

4. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008 . Cerebrovasc Di</br>

5. Ivanova, E., M. Ryazkova, D. Kostadinov, Rehabilitation of patients with post stroke hemiparesis , Medicine and Sports , Sofia, 1983</br>

6. Kanchev, D. Soft tissue techniques - a specialized methodology of physical therapy in functional abnormalities officials formally in charge of the cervical spine and the results of the study, Optimization of combining modern manual techniques in the treatment of musculoskeletal dysfunctions. NSA, ISBN-978-954-718-323-0, 2011 pp. 46-54.</br>

7. Karaneshev, G., D. Miltcheva S. Iancheva diagnostic methods and research in therapeutic gymnastics , NSA , 1991</br>

8. Kraydjikova L., (2011), Manual methods of mobilization with muscle - skeletal dysfunction in the spine, Avangard prima, Sofia</br>

9. Shotekov , P. Neurology , MI " Arso " , 2004</br>

10. Stamenova P., Iv.Milanov, Bulgarian Neurology , Algorithms for diagnosis and treatment of major neurological diseases , Volume 12 / Issue 2, September 2012 p.51 - 58, 64 ;</br>

11. Tityanova , I. Velcheva B. Stamenov , NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010 , No. 1 , p.20 -33</br>

12. Topuzov I. Oxidative stress and sport. St. Ives. Rilski, Sofia, 2002

ЗДОРОВЬЕСБЕРЕГАЮЩАЯ НАПРАВЛЕННОСТЬ ФИТНЕС-ТЕХНОЛОГИЙ

Иванчикова С. Н.

Украина, г. Старобельск Государственное учреждение «Луганский национальный университет имени Тараса Шевченко»

Abstract. The article deals with the problem of a sharp decline in the population's health in recent decades, causing serious concern in the community. The author summarizes the new material on the subject in question, introduced into scientific circulation the concept of health-oriented fitness technology. Attention is drawn to the fact that the current direction of the sports and recreational fitness activities, helping to improve not only the motor, but also the general culture, broaden their horizons, forming powerful adaptation and integration of the organism, can best meet the needs of modern society. This is confirmed by the fact that in recent years an increasing number of new institutions of mass physical culture, using a wide range of the most diverse means of sports and health and fitness system. Health-fitness orientation of technology is in the process of formation of culture of health through the use offitness tools in the three component units of health culture.

Research carried out in the framework of the health departments, physical rehabilitation, life safety, health and civil protection of the Luhansk Taras Shevchenko National University "Methodology, theory and practice offormation of culture of health of children, students and adults," the Ministry of Education and science of Ukraine, the state registration number 0110U007020.

The author concludes that the health and fitness system fitness is rapidly transformed, and health-orientation of such activities is perceived as a whole, as a modern fitness has integrated a tool that focus not only on the physical component of the human body, but also to improve the mental, spiritual and social aspects of health.

Keywords: health, innovation, culture, direction, system, technology, fitness.

В последние десятилетия во всем мире наблюдается резкое снижение уровня здоровья населения, что вызывает серьезное беспокойство в обществе. Информационные и психоэмоциональные перегрузки, срыв адаптационно-приспособительных реакций, малоподвижность, переедание рафинированных продуктов и недополучение биологически ценных компонентов пищи, вредные привычки, экологические дисбалансы и иммунобиологические дисфункции стали своеобразным знамением нового времени и мощным ударом по качеству жизни. Во многих исследованиях в качестве перспективных направлений формирования здоровьесберегающего мировоззрения общества, говорится о его привлечении к современным видам спорта и физкультурно-оздоровительной деятельности [2, с. 73; 5, с. 350; 6, с. 117]. Именно такое современное направление физкультурно-оздоровительной деятельности как фитнес, по нашему мнению, может наиболее полно удовлетворить потребности современного общества, способствуя повышению не только двигательной, но и общей культуры, расширению кругозора, формированию мощных адаптационных и интеграционных возможностей организма. Неслучайно в последнее время появляется все больше новых заведений массовой физической культуры [7, с. 176; 8, с. 372], использующих широкий спектр самых разнообразных средств физкультурно-оздоровительной системы фитнес.

Изучение особенностей применения физкультурно-оздоровительной системы фитнес раскрыто в ряде работ ученых современности, среди которых М.Р. Батищева, В.В. Вишнев, В.И. Григорьев, В.Ю. Давыдов, В.М. Дюков, В.П. Краснов, Г.А. Краснова, Е.Н. Школа.

i Надоели баннеры? Вы всегда можете отключить рекламу.