METHOD FOR RESTORING THE FUNCTION OF WALKING AND BALANCE IN THE ACUTE PERIOD OF ISCHEMIC STROKE Russian patent published in 2023 - IPC A61N1/00 A61H3/00 

FIELD: medicine; neurology; rehabilitation.

SUBSTANCE: invention can be used for the rehabilitation of patients with severe spastic hemiparesis in the acute period of ischemic stroke. Locomotor therapy is carried out. Simultaneously with it, cutaneous electrical stimulation of the gluteus maximus, quadriceps, gastrocnemius, biceps and anterior tibial muscles of the affected lower limbs is carried out through both active and indifferent electrodes. Locomotor therapy is carried out using the ExoAtlet I exoskeleton with built-in electrical stimulation. In the exoskeleton settings, the step length is selected from three points which are short, medium and long. By the same principle, the following walking speed is adjusted: slow, medium and high. At the first training session, all patients are given a short step length and walking with a pause between the steps. Starting from the second training session, the walking speed is increased to continuous, and the stride length is set to a level comfortable for the patient. In subsequent sessions, the walking speed is selected individually depending on the patient's state of health and the state of the cardiovascular system (hypertensive reactions — an increase in heart rate (HR) of more than 100%, an increase in systolic blood pressure to 180–200 mm Hg, a slight increase or unchanged diastolic blood pressure, hypotonic reactions — an increase in heart rate of more than 120%, unchanged or slight decrease in systolic and diastolic blood pressure). The walking time is 30 minutes and is divided into 3 equal parts of 10 minutes each with obligatory breaks of 5 minutes, which the patient spends in a sitting position. Starting from the second session, functional electrical stimulation of the muscles of the affected lower limb is carried out in a mode corresponding to the natural contraction of the muscles of a healthy person in a motor act. Active and indifferent electrodes are applied to the skin perpendicular to the course of the muscle fibers, while the active electrode of the pair is placed on the belly of the muscle, and the indifferent electrode is distal to the location of the active electrode. Electrical stimulation is carried out with a unipolar low-frequency rectangular pulse current with an amplitude in the range of 30 to 80 mA, a duration of 100 to 150 μs and a repetition rate of 50 to 80 Hz.

EFFECT: method provides improvement of adaptation and the state of the cardiovascular system, increased efficiency of rehabilitation treatment of patients, improved functional result of rehabilitation with simultaneous socialization of the patient due to the restoration of adequate support ability of the lower limb, improved balance, reduced tone of paretic muscles, the possibility of real movement of a person in space.

1 cl, 2 ex