Clinical and physiological characteristics of factors limiting the restoration of impaired functions in patients after cerebral stroke
https://doi.org/10.18699/SSMJ20250612
Abstract
Stroke remains one of the most disabling and socially significant diseases, which necessitates the development and implementation of comprehensive rehabilitation methods. The main challenges of recovery are associated with a wide range of neurological disorders, including motor dysfunctions, cognitive and psychoemotional disorders, and sleep disorders in patients after a stroke. Motor disorders have differences in development and rehabilitation of upper and lower limbs. Therefore, the recovery of upper limbs is the most complicated problem due to the specifics of the neural organization and features of movement coordination. Most modern methods of neurorehabilitation have proven their efficiency, but the availability of some of the most effective techniques may be limited. Cognitive and psychoemotional disorders, including depression and anxiety, significantly reduce patient motivation and worsen the prognosis for recovery. Sleep disorders, such as insomnia and obstructive apnea, also negatively affect the rehabilitation process. Prospects for solving these problems include the development of personalized rehabilitation programs, the integration of cognitive and motor rehabilitation methods, as well as their use to correct the psychoemotional state of patients and various sleep disorders.
About the Author
D. V. Sokolov
Grodno State Medical University
Belarus
Belarus
Dmitry V. Sokolov
230009, Grodno, Maksima Gorkogo st., 80
References
1. Feigin V.L., Brainin M., Norrving B., Martins S., Sacco R.L., Hacke W., Fisher M., Pandian J., Lindsay P. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int. J. Stroke. 2022;17(1):18–29. doi: 10.1177/17474930211065917
2. Melnikova E.A., Starkova E.Yu., Razumov A.N. Modern view on upper limb physical rehabilitation after stroke. Literature review. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul’tury = Problems of Balneology, Physiotherapy, and Exercise Therapy. 2023;100(1):42–53. [In Russian]. doi: 10.17116/kurort202310001142
3. Kandyba D.V. Basics of care for a patient with a stroke. Rossiyskiy semeynyy vrach = Russian Family Doctor. 2019;23(2):5–14. [In Russian]. doi: 10.17816/RFD2019205-14
4. Gizatullin R.R., Akhmadeeva L.R., Baikov D.E., Khafizov M.M., Akhmadeeva E.N. Diffusion tensor magnetic resonance imaging for predicting outcomes after cerebral stroke. Sovremennye problemy nauki i obrazovaniya = Modern Problems of Science and Education. 2022;6(1):102–102. [In Russian]. doi: 10.17513/spno.32271
5. Pizov N.A. Rehabilitation after stroke. Meditsinskiy sovet = Medical Council. 2023;(21):28–33. [In Russian]. doi: 10.21518/ms2023-429
6. Isakova E.V., Egorova Yu.V. Visual and acoustic feedback on the support reaction for upper and lower extremities: a case study of a female patient after a stroke. Al’manakh klinicheskoy meditsiny = Almanac of Clinical Medicine. 2021;49(6):435–442. [In Russian]. doi: 10.18786/2072-0505-2021-49-016
7. Classen J., Schnitzler A., Binkofski F., Werhahn K.J., Kim Y.S., Kessler K.R., Benecke R. The motor syndrome associated with exaggerated inhibition within the primary motor cortex of patients with hemiparetic. Brain. 1997;120(4):605–619. doi: 10.1093/brain/120.4.605
8. Kollen B., van de Port I., Lindeman E., Twisk J., Kwakkel G. Predicting improvement in gait after stroke. Stroke. 2005;36(12):2676–2680. doi: 10.1161/01.STR.0000190839.29234.50
9. Haggard P., Cockburn J., Cock J., Fordham C., Wade D. Interference between gait and cognitive tasks in a rehabilitating neurological population. J. Neurol. Neurosurg. Psychiatry. 2000;69(4):479–486. doi: 10.1136/jnnp.69.4.479
10. Posteraro L., Formis A., Grassi E., Bighi M., Nati P., Proietti Bocchini C., Todeschini E., Bidini C., Corsini D., Agosti M., Franceschini M. Quality of life and aphasia. Multicentric standardization of a questionnaire. Eur. Medicophysica. 2006;42(3):227–230.
11. Ghika-Schmid F., Ghika J., Regli F., Bogousslavsky J. Hyperkinetic movement disorders during and after acute stroke: The Lausanne Stroke Registry. J. Neurol. Sci. 1997;146(2):109–116. doi: 10.1016/s0022-510X(96)00290-0
12. Levin O.S., Bogolepova A.N. Poststroke motor and cognitive impairments: clinical features and current approaches to rehabilitation. Zhurnal nevrologii i psikhiatrii im S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(11):99–107. [In Russian]. doi: 10.17116/jnevro202012011199
13. Ingwersen T., Wolf S., Birke G., Schlemm E., Bartling C., Bender G., Meyer A., Nolte A., Ottes K., Pade O., … Thomalla G. Long-term recovery of upper limb motor function and self-reported health: results from a multicenter observational study 1 year after discharge from rehabilitation. Neurol. Res. Pract. 2021;3(1):66. doi: 10.1186/s42466-021-00164-7
14. Montero-Odasso M., Almeida Q.J., Bherer L., Burhan A.M., Camicioli R., Doyon J., Fraser S., MuirHunter S., Li K.Z.H., Liu-Ambrose T., … Canadian Gait and Cognition Network. Consensus on Shared Measures of Mobility and Cognition: From the Canadian Consortium on Neurodegeneration in Aging (CCNA). J. Gerontol. Ser. A. 2019;74(6):897–909. doi:10.1093/gerona/gly148
15. Mullick A.A., Subramanian S.K., Levin M.F. Emerging evidence of the association between cognitive deficits and arm motor recovery after stroke: A meta-analysis. Restor. Neurol. Neurosci. 2015;33(3):389–403. doi: 10.3233/RNN-150510
16. Ruan Y., Shi Y., Guo Y.F., Sun S.Y., Huang Z.Z., Wang Y.Z., Zheng Y., Wu F. Association between grip strength, rapid gait speed and cognition in people aged 50 and above in Shanghai during 2009–2010. Zhonghua Yu Fang Yi Xue Za Zhi. 2020;54(12):1414–1420. doi: 10.3760/cma.j.cn112150-20200714-01003
17. Liu Q., Liu Z., Cheng H., Xu Y., Wang F., Liu L., Hu X. The impact of reminiscent music therapy and robot-assisted rehabilitation on older stroke patients: a protocol for a randomized controlled trial. Front. Neurol. 2024;15:1345629. doi: 10.3389/fneur.2024.1345629
18. Nakayama H., Jørgensen H.S., Raaschou H.O., Olsen T.S. Recovery of upper extremity function in stroke patients: The Copenhagen stroke study. Arch. Phys. Med. Rehabil. 1994;75(4):394–398. doi: 10.1016/0003-9993(94)90161-9
19. Kovalenko A.P., Kamaeva O.V., Poleshchuk Yu.R., Kovlen D.V. Scales and tests in the rehabilitation and treatment of patients with spasticity of the upper limbs. Zhurnal nevrologii i psikhiatrii im S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(4):107–114.[In Russian]. doi: 10.17116/jnevro2020120041107
20. Zakharov A.V., Pyatin V.F., Kolsanov A.V., Poverennova I.E., Sergeeva M.S., Khivintseva E.V., Korovina E.S., Kutsepalova G.Yu. Using virtual reality as a method of accelerated rehabilitation among the patients after stroke. Nauka i innovatsii v meditsine = Science and Innovations in Medicine. 2016;1(3):62–66. [In Russian]. doi: 10.35693/2500-1388-2016-0-3-62-66
21. Kesar T.M., Stinear J.W., Wolf S.L. The use of transcranial magnetic stimulation to evaluate cortical excitability of lower limb musculature: Challenges and opportunities. Restor. Neurol. Neurosci. 2018;36(3):333–348. doi: 10.3233/RNN-170801
22. Song J., Nair V.A., Young B.M., Walton L.M., Nigogosyan Z., Remsik A., Tyler M.E., FarrarEdwards D., Caldera K.E., Sattin J.A., Williams J.C., Prabhakaran V. DTI measures track and predict motor function outcomes in stroke rehabilitation utilizing BCI technology. Front. Hum. Neurosci. 2015;9:195. doi: 10.3389/fnhum.2015.00195
23. Bovonsunthonchai S., Hiengkaew V., Vachalathiti R., Vongsirinavarat M., Tretriluxana J. Effect of speed on the upper and contralateral lower limb coordination during gait in individuals with stroke. Kaohsiung J. Med. Sci. 2012;28(12):667–672. doi: 10.1016/j.kjms.2012.04.036
24. Kairatova G.K., Khismetova Z.A., Zhumanbaeva Zh.M., Zholdasbekova A.S., Brimzhanova M.D., Smailova D.S. Scientific aspects of patient rehabilitation after stroke. Review literature. Nauka i zdravookhranenie = Science and Healthcare. 2022;24:103–111. [In Russian]. doi: 10.34689/SH.2022.24.2.013
25. Cho K.H., Hong M.R., Song W.K. Upper limb robotic rehabilitation for chronic stroke survivors: a single-group preliminary study. J. Phys. Ther. Sci. 2018;30(4):580–583. doi: 10.1589/jpts.30.580
26. Buma F., Kwakkel G., Ramsey N. Understanding upper limb recovery after stroke. Restor. Neurol. Neurosci. 2013;31(6):707–722. doi: 10.3233/RNN130332
27. Aprile I., Guardati G., Cipollini V., Papadopoulou D., Monteleone S., Redolfi A., Garattini R., Sacella G., Noro F., Galeri S., Carrozza M.C., Germanotta M. Influence of cognitive impairment on the recovery of subjects with subacute stroke undergoing upper limb robotic rehabilitation. Brain Sci. 2021;11(5):587. doi: 10.3390/brainsci11050587
28. Li W., Zhu G., Lu Y., Wu J., Fu Z., Tang J., Zhang G., Xu D. The relationship between rehabilitation motivation and upper limb motor function in stroke patients. Front. Neurol. 2024;15:1390811. doi: 10.3389/fneur.2024.1390811
29. Zhai Y., Song L., Tong P., Peng K. Nursing influences on motor function recovery in patients on post stroke hemiplegia. Rev. Bras. Med. Esporte. 2023;29(2):e2023_0025. doi: 10.1590/15178692202329012023_0025
30. Prokopenko S.V., Mozheiko E.Yu., Alekseevich G.V. Methods of assessment of movement functions in the upper limb. Zhurnal nevrologii i psikhiatrii im S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(7):101–107. [In Russian]. doi: 10.17116/jnevro201611671101-107
31. Hyakutake K., Morishita T., Saita K., Fukuda H., Shiota E., Higaki Y., Inoue T., Uehara Y. Effects of home-based robotic therapy involving the single-joint hybrid assistive limb robotic suit in the chronic phase of stroke: a pilot study. BioMed. Res. Int. 2019;2019:5462694. doi: 10.1155/2019/5462694
32. Hsieh Y., Lin K., Wu C., Shih T., Li M., Chen C. Comparison of proximal versus distal upper-limb robotic rehabilitation on motor performance after stroke: a cluster controlled trial. Sci. Rep. 2018;8(1):2091. doi: 10.1038/s41598-018-20330-3
33. Miriutova N.F., Chistyakova V.A., Vorob’ev V.A., Zaytsev A.A. The comprehensive step-by-step rehabilitation of the patients after acute disturbances of the cerebral circulation. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul’tury = Problems of Balneology, Physiotherapy and Exercise Therapy. 2017;94(2):4–11. [In Russian]. doi: 10.17116/kurort20179424-11
34. Jokinen H., Melkas S., Ylikoski R., Pohjasvaara T., Kaste M., Erkinjuntti T., Hietanen M. Post-stroke cognitive impairment is common even after successful clinical recovery. Eur. J. Neurol. 2015;22(9):1288–1294. doi: 10.1111/ene.12743
35. Bogolepova A.N., Levin O.S. Cognitive rehabilitation of patients with focal brain damage.. Zhurnal nevrologii i psikhiatrii im S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(4):115–122. [In Russian]. doi: 10.17116/jnevro2020120041115
36. Jacquin A., Binquet C.,` Rouaud O., GraulePetot A., Daubail B., Osseby G.V., Bonithon-Kopp C., Giroud M., Béjot Y. Post-stroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke. J. Alzheimer’s Dis. 2014;40(4):1029–1038. doi: 10.3233/JAD-131580
37. Renton T., Tibbles A., Topolovec-Vranic J. Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review. PLoS ONE. 2017;12(5):e0177290. doi: 10.1371/journal.pone.0177290
38. Kovalenko E.A., Bogolepova A.N. Dynamics of post-stroke cognitive deficit and the main factors that influence it. Farmateka = Pharmateca. 2018;(5):46–52. [In Russian]. doi: 10.18565/pharmateca.2018.5.46-52
39. Rohde D., Gaynor E., Large M., Mellon L., Hall P., Brewer L., Bennett K., Williams D., Dolan E., Callaly E., Hickey A. The impact of cognitive impairment on poststroke outcomes: a 5-year follow-up. J. Geriatr. Psychiatry. Neurol. 2019;32(5):275–281. doi: 10.1177/0891988719853044
40. Zekry D., Duyckaerts C., Belmin J., Geoffre C., Herrmann F., Moulias R., Hauw J.J. The vascular lesions in vascular and mixed dementia: the weight of functional neuroanatomy. Neurobiol. Aging. 2003;24(2):213–219. doi: 10.1016/S0197-4580(02)00066-0
41. Tang E.Y., Amiesimaka O., Harrison S.L., Green E., Price C., Robinson L., Siervo M., Stephan B.C. Longitudinal effect of stroke on cognition: a systematic review. J. Am. Heart Assoc. 2018;7(2):e006443. doi: 10.1161/JAHA.117.006443
42. Sibolt G., Curtze S., Melkas S., Putaala J., Pohjasvaara T., Kaste M., Karhunen P.J., Oksala N.K.J., Erkinjuntti T. Poststroke dementia is associated with recurrent ischaemic stroke. J. Neurol. Neurosurg. Psychiatry. 2013;84(7):722–726. doi: 10.1136/jnnp-2012304084
43. Rostamian S., Mahinrad S., Stijnen T., Sabayan B., de Craen A.J.M. Cognitive impairment and risk of stroke. Stroke. 2014;45(5):1342–1348. doi: 10.1161/sTROKEAHA.114.004658
44. Cappa S.F., Benke T., Clarke S., Rossi B., Stemmer B,. Heugten C.M. EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. Eur. J. Neurol. 2005;12(9):665–680. doi: 10.1111/j.14681331.2005.01330.x
45. Zakharova-Luneva E., Cooke D.M., Okano S., Hurst C., Geffen S., Eagles R. The relationship between cognition and functional outcomes in rehabilitation: FIMCog vs. MoCA. Geriatr. Gerontol. Int. 2020;20(4):336–342. doi: 10.1111/ggi.13884
46. Paprocka-Borowicz M., Wiatr M., Ciałowicz M., Borowicz W., Kaczmarek A., Marques A., Murawska-Ciałowicz E. Influence of physical activity and socio-economic status on depression and anxiety symptoms in patients after stroke. Int. J. Environ. Res. Public Health. 2021;18(15):8058. doi: 10.3390/ijerph18158058
47. Sagen-Vik U., Finset A., Moum T., Vik T.G., Dammen T. The longitudinal course of anxiety, depression and apathy through two years after stroke. J. Psychosom. Res. 2022;162:111016. doi: 10.1016/j.jpsychores.2022.111016
48. Nakase T., Tobisawa M., Sasaki M., Suzuki A. Outstanding symptoms of poststroke depression during the acute phase of stroke. PLoS ONE. 2016;11(10):e0163038. doi: 10.1371/journal.pone.0163038
49. Robinson R.G. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol. Psychiatry. 2003;54(3):376–387. doi: 10.1016/s0006-3223(03)00423-2
50. Narodova E.A., Shnaider N.A., Narodova V.V., Erakhtin E.E., Karnaukhov V.E., Dmitrenko D.V. The role of brain hemispheric specialization in emotional regulation. Doktor.Ru. 2020;19(4):23–28. [In Russian]. doi: 10.31550/1727-2378-2020-19-4-23-2851.
51. St-Onge M.P., Grandner M.A., Brown D., Conroy M.B., Jean-Louis G., Coons M., Bhatt D.L.; American Heart Association Obesity, Behavior Change, Diabetes, and Nutrition Committees of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the american heart association. Circulation. 2016;134(18):e367– e386. doi: 10.1161/CIR.0000000000000444
52. Hermann D.M., Bassetti C.L. Role of sleep-disordered breathing and sleep-wake disturbances for stroke and stroke recovery. Neurology. 2016;87(13):1407– 1416. doi: 10.1212/WNL.0000000000003037
53. Leng Y., Cappuccio F.P., Wainwright N.W.J., Surtees P.G., Luben R., Brayne C., Khaw K.T. Sleep duration and risk of fatal and nonfatal stroke. Neurology. 2015;84(11):1072–1079. doi: 10.1212/WNL.0000000000001371
54. Baylan S., Griffiths S., Grant N., Broomfield N.M., Evans J.J., Gardani M. Incidence and prevalence of post-stroke insomnia: A systematic review and meta-analysis. Sleep Med. Rev. 2020;49:101222. doi: 10.1016/j.smrv.2019.101222
55. Harris A.L., Elder J., Schiff N.D., Victor J.D., Goldfine A.M. Post-stroke apathy and hypersomnia lead to worse outcomes from acute rehabilitation. Transl. Stroke Res. 2014;5(2):292–300. doi: 10.1007/s12975-013-0293-y
56. Tang W.K., Hermann D.M., Chen Y.K., Liang H.J., Liu X.X., Chu W.C.W., Ahuja A.T, Abrigo J., Mok V., Ungvari G.S., Wong K.S. Brainstem infarcts predict REM sleep behavior disorder in acute ischemic stroke. BMC Neurol. 2014;14:88. doi: 10.1186/14712377-14-88
57. Gupta A., Shukla G., Mohammed A., Goyal V., Behari M. Restless legs syndrome, a predictor of subcortical stroke: a prospective study in 346 stroke patients. Sleep Med. 2017;29:61–67. doi: 10.1016/j.sleep.2015.05.025
58. Dalgaard F., North R., Pieper K., Fonarow G.C., Kowey P.R., Gersh B.J., Mahaffey K.W., Pokorney S., Steinberg B.A., Naccarrelli G., … Piccini J.P. Risk of major cardiovascular and neurologic events with obstructive sleep apnea among patients with obstructive sleep apnea among patients with atrial fibrillation. Am. Heart J. 2020;223:65–71. doi: 10.1016/j.ahj.2020.01.00159.
59. Ifergane G., Ovanyan A., Toledano R., Goldbart A., Abu-Salame I., Tal A., Stavsky M., Novack V. Obstructive sleep apnea in acute stroke. Stroke. 2016;47(5):1207–1212. doi: 10.1161/STROKEAHA.115.011749
60. Labarca G., Saavedra D., Dreyse J., Jorquera J., Barbe F.. Efficacy of CPAP for improvements in sleepiness, cognition, mood, and quality of life in elderly patients with osa: systematic review and meta-analysis of randomized controlled trials. Chest. 2020;158(2):751– 764. doi: 10.1016/j.chest.2020.03.049
61. Duss S.B., Seiler A., Schmidt M.H., Pace M., Adamantidis A., Müri R.M., Bassetti C.L. The role of sleep in recovery following ischemic stroke: A review of human and animal data. Neurobiol. Sleep Circadian Rhythms. 2017;2:94–105. doi: 10.1016/j.nbscr.2016.11.003
62. Kostenko E.V. Influence chronopharmacology therapy methionine (melaxen) on the dynamics of sleep disturbance, cognitive and emotional disorders, brain-derived neurotrophic factor (BDNF) in patients with cerebral stroke in the early and late recovery periods. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(3):56–64. [In Russian]. doi: 10.17116/jnevro20171173156-64
63. Tazartukova A.D., Strakhovskaya L.V. Long-term outcome prediction in patients with stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(9-2):37–41. [In Russian]. doi: 10.17116/jnevro201811809237
64. Joa K.L., Kim W.H., Choi H.Y., Park C.H., Kim E.S., Lee S.J., Kim S.Y., Ko S.H., Jung H.Y. The effect of sleep disturbances on the functional recovery of rehabilitation inpatients following mild and moderate stroke. Am. J. Phys. Med. Rehabil. 2017;96(10):734– 740. doi: 10.1097/PHM.0000000000000744
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