VVM 4-2011

  • Published on
    06-Mar-2016

  • View
    228

  • Download
    0

Embed Size (px)

DESCRIPTION

4 2011 .

Transcript

  • .

    4 (44) 2011

  • , !

    , , . 2012 , - , - .

    2010 . 500 , , , , . , .

    , , -.

    , , - (anti-aging medicine).

    . () - , 3- (23 , ), - (68 , , ), - (2630 , , ). 25 , , , ( ) , .. .

    7 2011 , 90- - . , . - 100 , : . , . , 32.

    , - 2- - , - 2012 . .

    ...

    ,

  • 4 2011

    . , ...,

    . . .

    . , ..., . . .

    ..., . . .

    ... . .

    2002

    : -

    , -

    , . . - ,

    , , ,

    .

    , 125040, , . , . 8, . 35

    .: (495) 742-44-40, . 137e-mail:info@asvomed.ru

    , .

    77-13601 20 2002 . 18.08.2011. 6084 1/8. 1.

    . 10 . . 1000 . 7264. ,

    214000, . , . , 16, .: (4812) 59-99-07, 38-28-65, 38-14-53.

    . ., ... . ., ..., -. . ., ..., . . ., ... . ., ..., . . ., ..., . . ., ... . ., ..., . . ., ..., . . ., ..., . . ., ... . ., ..., . . ., ..., . . ., ..., . . ., ..., . . ., ..., . . ., ..., . . ., ..., . . ., ... . ., ..., . . ., ..., . . ., ..., . . ., ..., .

    . ., ..., . . ., ... . ., ..., -. (. ) . ., ... . ., ..., . (. ) . ., ..., . (. ) . ., ..., . . ., ..., . . ., ..., . (. ) . ., ..., -. . ., ..., . (. ) . ., ..., . (. ) . ., ..., . (. .-) . ., ..., . . ., ..., . . ., ..., . . ., ..., . . ., ..., . . ., ..., . , -. . ., ..., . . ., ..., . (. ) . ., ...

  • 4 2011

    2

    616-036.82/.85 14.00.33.

    .., -, ...

    - , .

    -

    . (, ) - [1]. , , - . - -, , , - . , - . Erigo, - .

    - . - , - [2]. , , [37]. -, - . [8]. - - Erigo. - .

    -

    Erigo - .

    90 (52 38

    ) (NIHSS 15 ), - () - 20052010 . :

    133, ;

    2 37 , Erigo;

    3 () 25 , ( - 410- - ).

    -, , (NIHSS), () , , - . 66,110,5 , NIHSS 19,15,3 , 11,52,1 .

    - () ( - / -). - , - , . - 48 (53,3%) - , 3 -, 2 . : 23 (25,5%) , 25 (27,7%) , 5 - . - : 6 - , 31 (34,4%) - .

    1 2 , - , . - [9]. - , - - . , , . -, , . 3 - 1 2. ( - - ).

    - (). : =1/3*+2/3*. - - , 140 . . 10 . . -

  • 4 2011

    3

    , 120 . . - 10 . . .

    1 2 - , 24- -. . : 40 , , 10 . 3-10 3040 1014 . Erigo ( ) - - . - , / ( ).

    21,4% , 10% , - . - .

    - . 11 ( 1 5, 2 6 ) - - Codman.

    - - , - , , (SpO

    2), ().

    Philips.

    - (V) - 10 - 2. - , - -.

    1, 3 6 ( - ). 57 .

    - SPSS Statistics 17. . . - t- - , , , . -.

    . -

    . - Erigo - (. 1). 7 - 3 Erigo (p=0,04). - , (- , / ). , - c 32,18,3 19,27,6 / (p=0,03). - ( 3 ) - . .

    -: , - 34 , ( ).

    , . (. . 1).

    1.

    1 ( ) 2 ( Erigo)

    ( 5

    )

    ( 5 )

    , . . 1107,1* 926,5*, 1057,2 1126,7* 1036,6*, 1067,0

    726,8* 888,1* 756,7 707,1* 907,5* 766,3

    SpO2

    97100% 97100% 97100% 97100% 97100% 97100%

    162,3 183,1 172,7 152,1 183,2 152,9

    V , /

    55,110,1 54,412,8 55,29,5 54,98,9 55,210,1 55,19,2

    V , /

    32,59,4 27,213,7 33,410,1 31,210,2 28,49,5 33,211,0

    , . . 132,5* 83,1* 92,4 143,1* 82,4* 102,6

    : 1. V, , .

    2. * p

  • 4 2011

    4

    - 3 ( , 1 2 3 -

    ), (p=0,09).

    2.

    1 ( ) 2 ( Erigo) 3 ()

    (1 ) 5,93,3* 6,13,5 1,11,9*,

    (3 ) 8,24,1* 8,94,9 4,83,5*,

    (6 ) 11,55,1 12,15,9 8,54,3

    ( )

    21,2% 8,1%*, 36%*

    ( )

    15,1%* 13,5% 28%*,

    3% 2,7% 4%

    33,3% 32,4% 36%

    : * p

  • 4 2011

    5

    1. Hachisuka K. Robot-aided training in rehabilitation. J. Brain Nerve. 2010; 2:133140.2. Jorgensen H.S., Nakayama H., Raaschou H.O., Vive-Larsen J., St0ier M., Olsen T.S.. Outcome and time course of recovery in stroke. Part I:

    outcome. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995; 76: 399-405.3. Salter K., Jutai J., Hartley M., et al. Impact of early vs. delayed admission to rehabilitation on functional outcomes in persons with stroke. J Rehabil

    Med. 2006; 38(2): 113117.4. Paolucci S, Antonucci G, Grasso MG, et al. Early versus delayed inpatient stroke rehabilitation: A matched comparison conducted in Italy. Arch Phys

    Med Rehabil. 2000; 81(6): 695700.5. Johansson B.B. Brain plasticity and stroke rehabilitation. The Willis Lecture. Stroke. 2000; 31(1): 223230.6. Biernaskie J., Corbett D.. Enriched rehabilitative training promotes improved forelimb motor function and enhanced dendritic growth after focal

    ischemic injury. The Journal of neuroscience. 2001; 21(14): 527280.7. Risedal A., Mattsson B., Dahlqvist P., Nordborg C., Olsson T., Johansson B.B. Environmental influences on functional outcome after a cortical

    infarct in the rat. Brain research bulletin. 2002; 58(3): 31521.8. .., .., .. ( ) -

    . // . 2008; 5: 7375.9. Adams H.P., Adams R.J., Brott T., Zoppo G.J. del, Furlan A., Goldstein L.B., et al. Guidelines for the early management of patients with ischemic

    stroke: A scientific statement from the Stroke Council of the American Stroke Association. Stroke. 2003; 34(4):105683.

    -

    , , - . - . . Erigo , . - : , , - .

    : , , , .

    SummaryTactics of rehabilitation in acute and hyperacute periods of stroke are discussed in article. Hardware-based methods

    of verticalization are compared, their efficiency and safety are estimated. Gathered data confirm high efficiency of early mobilization. Safety is provided by multimodal monitoring of physiological rates. Erigo device is preferable to tilt table, including lower risk of hemodynamic abnormalities and deep vein of lower limbs thrombosis prophylactics. Predictors of hypotension episodes are: tilt table verticalization, impaired cardiac function, preliminary hemodynamic instability.

    Key words: hyperacute period of stroke, rehabilitation, hardware-based methods of verticalization, safety.

    . : 125367, , ., . 3. : 8(499)190-08-81, : 193-76-31. E-mail: sidneuro@mail.ru.

    S-E-T- 616,15-009,7-085.849.112-85.382

    1,2 .., , - , ...;2,3 .., , ..., - ;2 .., ;3 .., ..., 1 . .. - , . 2 . 36 . , . 3 , .

    -

    , - Sling Exercise Therapy (S-E-T-) - , - , - .

    ,

    ( )

    [1]. - , - , - , [2, 3]. - [49]. - , , .

  • 4 2011

    6

    , , - - ( 20 L-), . - , - , . - , , , , - .

    - - , - , - , [59].

    - [10].

    - - Sling Exercise Therapy S-E-T- , - .

    - , 36, S-E-T- - .

    - - , , - , - .

    , -, , - , , - .

    - , .

    - , - , . , - , , , . ( ) - -, - . , , - .

    - - S-E-T- - , -

    .

    - - , , S-E-T- - , -.

    - :

    1. - S-E-T- - TERAPI MASTER.

    2. S-E-T-.

    3. S-E-T- - , - .

    4. TERAPI MASTER, - .

    -

    3 , - 1 3 , .

    (n =34) -, - / 10 1 / 15 .

    2- (n=36) , - ( 36 ).

    1- 2- , 5- , - TERAPI MASTER (Nordisk Terapi).

    3- (n =30) - - , .

    - -, NIH-NINDS, , . , , -, . - .

    - (, , -) ( , , , -, , RW) - (, , ).

    - - - STATISTICA 5,0 BIOSTATISTICA, MicrosoftI Excel XP. - / -. () -

  • 4 2011

    7

    . ( < 0,025).

    . - 14 - , 21- .

    1- 96% - , 32% , - (66% 12% ). - , S-E-T- 74%, 22% .

    - 54% . - , ,

    , - . - , -.

    , - 1- - 22% . 2- 36%. 45%.

    1- , S-E-T- , 9,8 1,64 , 2- S-E-T- - 8,2 2,82, 6,1 1,48. - . - , - . 1 . 2.

    1- ( - S-E-T-) - ( < 0,010,05) (. 1).

    1. 1- , S-E-T-

    1( = 34)

    3 ( = 30)

    1. 2 (4%) 0 2 (4%) 0

    2. 33 (95%) 14 (40%) 29 (94%) 19 (63%)

    3. 16 (46%) 8 (21%) 14 (44%) 11 (35%)

    4.