[Possibilities of physiotherapy methods for improving the microcirculation of the affected limb in patients with spasticity after acute cerebral circulation during the late recovery period].

Unlabelled: The significant prevalence of acute cerebral circulatory disorders, the complexity and persistence of disorders of the functions of the upper and lower extremities, which are accompanied by prolonged and persistent disability, is an important medical and social problem.

Objective: Development of optimized programs of medical rehabilitation in patients after acute cerebrovascular accident in the late recovery period.

Material And Methods: The study included 200 patients who suffered acute cerebral circulatory disorders, with increased muscle tone in the lower extremity by the type of spasticity in the late recovery period, who were divided into five groups comparable in clinical and functional characteristics and age: the 1 group (=40) - patients who, in addition to the standard complex of therapy and rehabilitation, the same in all five groups and including therapeutic physical culture, medical massage and kinesiotherapy, received low-frequency electrostatic massage, complex multimodal effects from the Alpha-capsule apparatus, training on a multifunctional biofeedback (BFB) platform and training of the stereotype of walking on to the track by the method of imposition; the 2 group (=40) - patients who, in addition to the standard complex, received low-frequency electrostatic massage from the Khivamat apparatus and exposure to broadband modulation currents; the 3 group (=40) - patients who, in addition to the standard complex, received a complex multimodal effect from the Alpha-capsule; the 4 group (=40) - patients who, in addition to the standard complex, received training on a multifunctional platform with barefoot and training of the stereotype of walking on the track by the method of imposition; the 5 group (=40) - patients who received only a standard complex of therapy and rehabilitation.

Results: At all control points (after the course of treatment, after 6 and 12 months), in addition to general clinical and neurological studies, microcirculation parameters were evaluated by laser Doppler flowmetry. In dynamics, it was revealed that in the 1, 2, and 4 groups there was a significant improvement in microcirculation in the affected limbs, to a lesser extent, this significant improvement in microcirculation was noted in the 3 group; in patients of the 5 group, only a positive trend was noted.

Conclusion: Inclusion in the standard rehabilitation complex of low-frequency electrostatic massage, multimodal physiotherapy and training on a multifunctional platform with BFB COBS in combination with walking stereotype training with video instruction using the system with BFB C-Mill in patients who have suffered acute cerebrovascular accident, with motor disorders in the form of hemiparesis with increased muscle tone of the lower extremity in the late recovery period causes a significant improvement in microcirculation in the arteriolar-venular bed of the affected lower extremities, which may underlie the improvement of static-locomotor indicators and contribute to the expansion of the volume of movements in the joints of the lower extremities.