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6JOURNAL OF CARDIORESPIRATORY RESEARCH
ЖУРНАЛ КАРДИОРЕСПИРАТОРНЫХ ИССЛЕДОВАНИЙ
УДК. 616.8-00/616. 9
Пулатов Садриддин Сайфуллаевич
Кандидат медицинских наук Бухарский государственный медицинский институт
Бухара, Узбекистан Камалова Малика Илхомовна Кандидат медицинских наук Самаркандский государственный медицинский университет Самарканд, Узбекистан
РАННЯЯ ВЕРТИКАЛИЗАЦИЯ БОЛЬНЫХ С ИШЕМИЧЕСКИМ ИНСУЛЬТОМ НА ФОНЕ ИБС
For citation: Pulatov S.S., Kamalova M.I. EARLY VERTICALIZATION OF PATIENTS WITH ISCHEMIC STROKE AGAINST THE BACKGROUND OF ISCHEMIC STROKE. Journal of cardiorespiratory research. 2022, vol 3, issue 3, pp.82-84
http: //dx. doi.org/10.5281/zenodo. 7145935
АННОТАЦИЯ
Цель исследования: на фоне ранней вертикализации изучить адаптацию сердечно - сосудистой системы у больных полушарных изменений ишемическим инсультом.
Материалы и методы: В нашем клиническом исследовании приняли участие 40 пациента, которые лечились с диагнозом "острое нарушение мозгового кровообращения ишемического типа на фоне ИБС" в филиале РНМПНЦ Бухары в январе - сентября 2022 года
Результаты и обсуждение: у пациентов с ишемическим инсультом, у которых на ИБС в процессе вертикализации сохранялось 1530° в первые дни пассивной вертикализации, 93,8% пациентов были в контрольной группе, 55% были в контрольной группе, а через 5-7 дней исследования было достигнуто 90° в вертикальном положении, наблюдается 65,6% в формировании.
Выводы: таким образом, ишемический инсульт протекает относительно медленно в процессе головокружения у пациентов на фоне которого были ИБС, а также длительного течения ортостатической недостаточности, являются относительно низкое восстановление неврологических дефектов по шкале головокружения и NIHSS, более длительные процессы ранней реабилитации и снижение их эффективности.
Ключевые слова: инсульт, сердечно - сосудистые заболевания, реабилитация, вертикализация.
Pulatov Sadriddin Sayfullaevich
Candidate of Medical Sciences Bukhara State Medical Institute Bukhara, Uzbekistan Kamalova Malika Ilkhomovna
Candidate of Medical Sciences Samarkand State Medical University Samarkand, Uzbekistan
EARLY VERTICALIZATION OF PATIENTS WITH ISCHEMIC STROKE AGAINST THE BACKGROUND OF ISCHEMIC
STROKE
ANNOTATION
Purpose of the study: to study the adaptation of the cardiovascular system in patients with hemispheric changes in ischemic stroke against the background of early verticalization.
Materials and Methods. The study involved 40 patients who were treated for the diagnosis of "acute stroke of ischemic type against the background of coronary artery disease" at the Republican Scientific and Practical Centre Bukhara branch in January-September 2022.
Results and discussion. In patients with ischemic stroke who had 15°-30° in the first days of passive upright standing 93.8% of patients were in the control group, 55% were in the control group and after 5-7 days of the study was achieved 90° in the upright standing, observed 65.6% in the formation.
Conclusions: Thus, ischemic stroke proceeds relatively slowly in vertigo patients with a background of CHD, as well as a prolonged course of orthostatic insufficiency, are relatively low recovery of neurological defects on the vertigo and NIHSS, longer processes of early rehabilitation and reduced effectiveness.
Keywords: stroke, cardiovascular disease, rehabilitation, verticalization.
Pulatov Sadriddin Sayfullaevich
Tibbiyot fanlari nomzodi Buxoro davlat tibbiyot instituti Buxoro, O'zbekiston Kamalova Malika Ilxomovna
Tibbiyot fanlari nomzodi Samarqand davlat tibbiyot universiteti Samarqand, O'zbekiston
YURAK ISHEMIK KASALLIGI FONIDA ISHEMIK IINSULT BOLGAN BEMORLARNI ERTA VERTIKALIZASIYA QILISH
ANNOTASIYA
Tadqiqot maqsadi: erta vertikalizasiya fonida ishemik insult bilan og'rigan bemorlarda yurak-qon tomir tizimining moslashuvini o'rganish.
Materiallar va uslublar: Bizning klinik tadqiqodimizda 2022 yil yanvar - iyun oylarida RShTYolM Buxoro filialida "Bosh miya qon aylanishining o'tkir buzilishi, ishemik turi, yurak ishemik kasalligi tashxisi bilan davolanayotgan 40 nafar bemor ishtirok etdi.
Natijalar: ishemik insult bilan og'rigan bemorlarda YulK fonida bemorlarda, passiv vertikallashuvning dastlabki kunlarida vertikalizasiya jarayonida yurak-qon tomir tizimida15-30° saqlanib qolgan, bemorlarning 93,8% nazorat guruhida, 55% nazorat guruhida va 5-7 kunlik tadqiqotdan so'ng 90° vertikal holatda, 65,6% kuzatilgan.
Xulosa qilib aytganda, ishemik insult bilan og'rigan bemorlarda YulK fonida kechayotgan bemorlarda vertikalizasiya jarayoni nisbatan sekin bo'lib, uzoq davom etishi, shuningdek ortostatik yetishmovchiliklar, namoyon bo'lishi vertikalizasiya va NIHSS shkalasi bo'yicha nevrologik nuqsonlarning nisbatan kam tiklanganligi, erta reabilitasiya jarayonlarini uzoqroq davom etishi va samardorligi kamayishiga sabab bo'ladi.
Kalit so'zlar: insult, qandli diabet, reabilitasiya, vertikalizasiya.
Relevance. Stroke is the leading cause of acquired permanent disability worldwide. Although treatment of acute stroke has greatly improved, the majority of patients today remain disabled, with significant impact on functional independence and quality of life. Because the absolute number of stroke survivors is likely to continue to increase due to demographic changes in our aging society, new strategies are needed to improve neurorehabilitation. The most important factor in functional recovery after stroke is neural remodeling. A better understanding of the mechanisms that enable plasticity and recovery is needed to develop new, neurobiologically based strategies that promote functional recovery. Clinicians are increasingly interested in using aerobic exercise to improve functional outcomes after stroke. Several studies have demonstrated the effectiveness of exercise training in individuals in the chronic poststroke period. However, information on the response to exercise in earlier stages of recovery is limited. There is evidence that exercise tolerance, as measured by peak oxygen consumption in maximum-load tests, is reduced in this population. There is also evidence, although limited, that exercise capacity soon after stroke can be both feasible and safe if appropriate screening and monitoring are used. Moreover, there are early indications that activity level functions such as walking speed, mobility and balance can be improved with such programs. The goal of verticalization is to maximize the gravitational gradient. Further research is needed to figure out the most appropriate timing and design of fitness programs for people in the early post-stroke period.
Purpose of the study: against the background of early verticalization to study the adaptation of the cardiovascular system in patients with hemispheric changes ischemic stroke.
Materials and Methods: The study was conducted during 20202022 from January to September Our clinical study involved 40 patients who were treated with the diagnosis of "acute cerebral circulation disorder of ischemic type on the background of CHD" in the branch of RNMPNTs Bukhara. Consecutive patients with a vegetative state or a state of minimal consciousness were enrolled in the intensive care unit on the third day after the acquired brain injury. They were randomized to receive conventional physical therapy alone or in combination with
fifteen 30-minute sessions of verticalization using a tilt table with robotic stepping. After stabilization, patients were transferred to our neurorehabilitation unit for individual treatment. Outcome criteria (Glasgow Coma Scale, Coma Recovery Scale Revised -CRSr-, Disability Rating Scale (DRS- and cognitive functioning levels) were assessed at day three after injury (T0), on discharge from the ICU (T1) and on discharge from the rehabilitation center (T2). Comparisons between and within groups were made using the Mann-Whitney U-test and Wilcoxon sign-rank test, respectively.
RESULTS: In patients with ischemic stroke with a background of CHD, verticalization improves the level of arousal and consciousness in patients with severe acquired brain injury and is safe in the intensive care unit. We evaluated the effectiveness of the very early step verticalization protocol on their functional and neurological outcome. Of the 40 patients included, 31 completed the study without adverse events (15 in the verticalization group and 16 in the conventional physical therapy group). Early verticalization began 12.4±7.3 (mean ± standard deviation) days after acquired brain injury. Length of stay in OIT was longer in the verticalization group (38.8 ± 15.7 vs. 25.1 ± 11.2 days, p = 0.01), while total length of stay (OIT + neurorehabilitation) was not significantly different (153.2 ± 59.6 vs. 134.0 ± 61.0). days, p = 0.41). All outcome measures improved significantly in both groups after the total period (T2 vs. T0, p<0.001 for all) and after ICU stay (T1 vs. T0, p<0.004 for all) and after neurorehabilitation (T2 vs. T1, p<0.004). all). Improvement was significantly better in the experimental group for CRSr (T2-T0 p=0.033, T1-T0 p=0.006) and (borderline) for DRS (T2-T0 p=0.040, T1-T0 p=0.058). A staged verticalization protocol initiated from the acute stages improves short- and long-term functional and neurological outcomes in patients with acquired brain injury and (borderline) for DRS (T2-T0 p = 0.040, T1-T0 p = 0.058).
Conclusions: Thus, the study showed that the use of "passive" rehabilitation measures that do not put stress on the cardiovascular system, such as positional treatment, breathing exercises, selective massage, neuromuscular electrostimulation, is safe and possible in stroke patients with varying severity of cardiac decompensation.
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