<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2018-12-18-22</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-2558</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НЕВРОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>NEUROLOGY</subject></subj-group></article-categories><title-group><article-title>Вопросы реабилитации пациентов после инсульта в амбулаторных условиях</article-title><trans-title-group xml:lang="en"><trans-title>Issues in rehabilitation of patients after stroke in the out-patient setting</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пизова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pizova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор</p></bio><bio xml:lang="en"><p>MD, Prof.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Yaroslavl State Medical University, Federal State Budgetary Educational Institution of Higher Education of the Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>24</day><month>07</month><year>2018</year></pub-date><volume>0</volume><issue>12</issue><fpage>18</fpage><lpage>22</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Пизова Н.В., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Пизова Н.В.</copyright-holder><copyright-holder xml:lang="en">Pizova N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/2558">https://www.med-sovet.pro/jour/article/view/2558</self-uri><abstract><p>В статье рассмотрены вопросы реабилитации пациентов после инсульта на амбулаторном этапе. Представлены ключевые принципы постинсультной реабилитации: функциональный подход, частота и интенсивность тренировок. Рассмотрены основные методы реабилитации: лечебная физкультура, физиотерапия, лекарственная терапия и др. Определена оптимальная интенсивность и длительность тренировок. Отмечены особенности физической реабилитации паретичной руки. Показана эффективность комплексной реабилитации с использованием физических и медикаментозных методов в восстановлении утраченных функций. Рассмотрено применение препарата Вазобрал в процессе реабилитации пациентов после инсульта.</p><p> </p></abstract><trans-abstract xml:lang="en"><p>This article considers some current issues regarding rehabilitation of patients after a stroke during out-patient stage. It presents the key principles of post-stroke rehabilitation: functional approach, frequency and intensity of the training. The main methods of rehabilitation include exercise therapy, physiotherapy, pharmaceutical therapy, etc. The optimal intensity and duration of the training was determined. The article presents the features of physical rehabilitation of the paretic arm. It shows the effectiveness of complex rehabilitation using physical and pharmaceutical methods in restoring lost functions. The use of Vasobral in the process of rehabilitation of patients after a stroke is discussed.</p><p> </p></trans-abstract><kwd-group xml:lang="ru"><kwd>инсульт</kwd><kwd>постинсультная реабилитация</kwd><kwd>амбулаторный этап</kwd></kwd-group><kwd-group xml:lang="en"><kwd>stroke</kwd><kwd>post-stroke rehabilitation</kwd><kwd>outpatient stage</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R. et al. Heart disease and stroke statistics-2017 update: A report from the american heart association. Circulation, 2017,135(10): e146–e603.</mixed-citation><mixed-citation xml:lang="en">Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R. et al. Heart disease and stroke statistics-2017 update: A report from the american heart association. Circulation, 2017,135(10): e146–e603.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Elkins JS, Johnston SC. Thirty-year projections for deaths from ischemic stroke in the United States. Stroke, 2003, 34(9): 2109–2112.</mixed-citation><mixed-citation xml:lang="en">Elkins JS, Johnston SC. Thirty-year projections for deaths from ischemic stroke in the United States. Stroke, 2003, 34(9): 2109–2112.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Veerbeek JM, Kwakkel G, van Wegen EEH, Ket JC, Heymans MW. Early prediction of outcome of activities of daily living after stroke: A systematic review. Stroke, 2011, 42(5): 1482–1488.</mixed-citation><mixed-citation xml:lang="en">Veerbeek JM, Kwakkel G, van Wegen EEH, Ket JC, Heymans MW. Early prediction of outcome of activities of daily living after stroke: A systematic review. Stroke, 2011, 42(5): 1482–1488.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke, 2005, 36: 1330–1340.</mixed-citation><mixed-citation xml:lang="en">Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke, 2005, 36: 1330–1340.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Kauhanen M, Korpelainen JT, Hiltunen P, Brusin E, Mononen H, Määttä R. et al. Poststroke depression correlates with cognitive impairment and neurological deficits. Stroke, 1999, 30: 1875–1880.</mixed-citation><mixed-citation xml:lang="en">Kauhanen M, Korpelainen JT, Hiltunen P, Brusin E, Mononen H, Määttä R. et al. Poststroke depression correlates with cognitive impairment and neurological deficits. Stroke, 1999, 30: 1875–1880.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Aström M, Adolfsson R, Asplund K. Major depression in stroke patients. A 3-year longitudinal study. Stroke, 1993, 24: 976–982.</mixed-citation><mixed-citation xml:lang="en">Aström M, Adolfsson R, Asplund K. Major depression in stroke patients. A 3-year longitudinal study. Stroke, 1993, 24: 976–982.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Kuvalekar K, Kamath R, Ashok L, Shetty B, Mayya S, Chandrasekaran V. Quality of life among persons with physical disability in Udupi Taluk: a cross sectional study. J Family Med Prim Care, 2015, 4: 69–73.</mixed-citation><mixed-citation xml:lang="en">Kuvalekar K, Kamath R, Ashok L, Shetty B, Mayya S, Chandrasekaran V. Quality of life among persons with physical disability in Udupi Taluk: a cross sectional study. J Family Med Prim Care, 2015, 4: 69–73.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Denti L, Agosti M, Franceschini M. Outcome predictors of rehabilitation for first stroke in the elderly. Eur J Phys Rehabil Med, 2008, 44: 3–11.</mixed-citation><mixed-citation xml:lang="en">Denti L, Agosti M, Franceschini M. Outcome predictors of rehabilitation for first stroke in the elderly. Eur J Phys Rehabil Med, 2008, 44: 3–11.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Koh GC, Chen C, Cheong A, Choo TB, Pui CK, Phoon FN. et al. Trade-offs between effectiveness and efficiency in stroke rehabilitation. Int J Stroke, 2012, 7: 606–614.</mixed-citation><mixed-citation xml:lang="en">Koh GC, Chen C, Cheong A, Choo TB, Pui CK, Phoon FN. et al. Trade-offs between effectiveness and efficiency in stroke rehabilitation. Int J Stroke, 2012, 7: 606–614.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Shah S, Vanclay F, Cooper B. Efficiency, effectiveness, and duration of stroke rehabilitation. Stroke, 1990, 21: 241–246.</mixed-citation><mixed-citation xml:lang="en">Shah S, Vanclay F, Cooper B. Efficiency, effectiveness, and duration of stroke rehabilitation. Stroke, 1990, 21: 241–246.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Micieli G, Cavallini A, Quaglini S, Guideline Application for Decision Making in Ischemic Stroke (GLADIS) Study Group: Guideline compliance improves stroke outcome: a preliminary study in 4 districts in the Italian region of Lombardia. Stroke, 2002, 33: 1341–1347.</mixed-citation><mixed-citation xml:lang="en">Micieli G, Cavallini A, Quaglini S, Guideline Application for Decision Making in Ischemic Stroke (GLADIS) Study Group: Guideline compliance improves stroke outcome: a preliminary study in 4 districts in the Italian region of Lombardia. Stroke, 2002, 33: 1341–1347.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Ullberg T, Zia E, Petersson J, Norrving B. Changes in functional outcome over the first year after stroke: an observational study from the Swedish stroke register. Stroke, 2015, 46(2): 389-94.</mixed-citation><mixed-citation xml:lang="en">Ullberg T, Zia E, Petersson J, Norrving B. Changes in functional outcome over the first year after stroke: an observational study from the Swedish stroke register. Stroke, 2015, 46(2): 389-94.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Pettersen R, Dahl T, Wyller TB. Prediction of long-term functional outcome after stroke rehabilitation. Clinical Rehabilitation, 2002, 16(2): 149-59.</mixed-citation><mixed-citation xml:lang="en">Pettersen R, Dahl T, Wyller TB. Prediction of long-term functional outcome after stroke rehabilitation. Clinical Rehabilitation, 2002, 16(2): 149-59.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC. et al. American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2016, 47: e98–169.</mixed-citation><mixed-citation xml:lang="en">Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC. et al. American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2016, 47: e98–169.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Prvu Bettger JA, Kaltenbach L, Reeves MJ, Smith EE, Fonarow GC, Schwamm LH et al. Assessing stroke patients for rehabilitation during the acute hospitalization: findings from the get with the guidelines-stroke program. Arch Phys Med Rehabil, 2013, 94: 38–45.</mixed-citation><mixed-citation xml:lang="en">Prvu Bettger JA, Kaltenbach L, Reeves MJ, Smith EE, Fonarow GC, Schwamm LH et al. Assessing stroke patients for rehabilitation during the acute hospitalization: findings from the get with the guidelines-stroke program. Arch Phys Med Rehabil, 2013, 94: 38–45.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Iyer M, Bhavsar GP, Bennett KJ, Probst JC. Disparities in home health service providers among Medicare beneficiaries with stroke. Home Health Care Serv Q, 2016, 35: 25–38.</mixed-citation><mixed-citation xml:lang="en">Iyer M, Bhavsar GP, Bennett KJ, Probst JC. Disparities in home health service providers among Medicare beneficiaries with stroke. Home Health Care Serv Q, 2016, 35: 25–38.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Skolarus LE, Feng C, Burke JF. No racial difference in rehabilitation therapy across all post-acute care settings in the year following a stroke. Stroke, 2017, 48: 3329–35.</mixed-citation><mixed-citation xml:lang="en">Skolarus LE, Feng C, Burke JF. No racial difference in rehabilitation therapy across all post-acute care settings in the year following a stroke. Stroke, 2017, 48: 3329–35.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Dewey HM, Sherry LJ, Collier JM. Stroke rehabilitation 2007: what should it be? Int J Stroke, 2007, 2: 191-200.</mixed-citation><mixed-citation xml:lang="en">Dewey HM, Sherry LJ, Collier JM. Stroke rehabilitation 2007: what should it be? Int J Stroke, 2007, 2: 191-200.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Smith LN, James R, Barber M, the Guideline Development Group. Rehabilitation of patients with stroke: summary of SIGN guidance. BMJ, 2010, 340: c2845.</mixed-citation><mixed-citation xml:lang="en">Smith LN, James R, Barber M, the Guideline Development Group. Rehabilitation of patients with stroke: summary of SIGN guidance. BMJ, 2010, 340: c2845.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Khedr EM, Ahmed MA, Fathy N, Rothwell JC. Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke. Neurology, 2005, 65(3): 466-468.</mixed-citation><mixed-citation xml:lang="en">Khedr EM, Ahmed MA, Fathy N, Rothwell JC. Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke. Neurology, 2005, 65(3): 466-468.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Mansur CG, Fregni F, Boggio PS, Riberto M, Gallucci-Neto J, Santos CM. et al. A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients. Neurology, 2005, 64(10): 1802-1804.</mixed-citation><mixed-citation xml:lang="en">Mansur CG, Fregni F, Boggio PS, Riberto M, Gallucci-Neto J, Santos CM. et al. A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients. Neurology, 2005, 64(10): 1802-1804.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Scheidtmann K., Fries W., Muller F., Koenig E. Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: A prospective, randomised, double-blind study. Lancet, 2001, 358(9284): 787-790.</mixed-citation><mixed-citation xml:lang="en">Scheidtmann K., Fries W., Muller F., Koenig E. Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: A prospective, randomised, double-blind study. Lancet, 2001, 358(9284): 787-790.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D. et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA, 2006, 296(17): 2095-2104.</mixed-citation><mixed-citation xml:lang="en">Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D. et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA, 2006, 296(17): 2095-2104.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke, 1995, 26(6): 982-989.</mixed-citation><mixed-citation xml:lang="en">Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke, 1995, 26(6): 982-989.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Dobkin BH. Clinical practice. Rehabilitation after stroke. N Engl J Med, 2005, 352(16): 1677-1684.</mixed-citation><mixed-citation xml:lang="en">Dobkin BH. Clinical practice. Rehabilitation after stroke. N Engl J Med, 2005, 352(16): 1677-1684.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Krakauer JW. Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr Opin Neurol, 2006, 19(1): 84-90.</mixed-citation><mixed-citation xml:lang="en">Krakauer JW. Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr Opin Neurol, 2006, 19(1): 84-90.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Belda-Lois J, Mena-del Horno S, Bermejo-Bosch I, Moreno JC, Pons JL, Farina D. et al. Rehabilitation of gait after stroke: a review towards a top-down approach. J Neuroeng Rehabil, 2011, 13(8): 66.</mixed-citation><mixed-citation xml:lang="en">Belda-Lois J, Mena-del Horno S, Bermejo-Bosch I, Moreno JC, Pons JL, Farina D. et al. Rehabilitation of gait after stroke: a review towards a top-down approach. J Neuroeng Rehabil, 2011, 13(8): 66.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Pennycott A, Wyss D, Vallery H, Klamroth-Marganska V, Riener R. Towards more effective robotic gait training for stroke rehabilitation: a review. J Neuroeng Rehabil, 2012, 9: 65.</mixed-citation><mixed-citation xml:lang="en">Pennycott A, Wyss D, Vallery H, Klamroth-Marganska V, Riener R. Towards more effective robotic gait training for stroke rehabilitation: a review. J Neuroeng Rehabil, 2012, 9: 65.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Mehrholz J, Pohl M, Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev, 2014, 23(1): CD002840.</mixed-citation><mixed-citation xml:lang="en">Mehrholz J, Pohl M, Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev, 2014, 23(1): CD002840.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">States RA, Salem Y, Pappas E. Overground gait training for individuals with chronic stroke: a Cochrane systematic review. J Neurol Phys Ther, 2009, 33(4): 179-186.</mixed-citation><mixed-citation xml:lang="en">States RA, Salem Y, Pappas E. Overground gait training for individuals with chronic stroke: a Cochrane systematic review. J Neurol Phys Ther, 2009, 33(4): 179-186.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">French B, Thomas L, Leathley M, Sutton C, McAdam J, Forster A. et al. Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. Journal of Rehabilitation Medicine, 2010, 42(1): 9-14.</mixed-citation><mixed-citation xml:lang="en">French B, Thomas L, Leathley M, Sutton C, McAdam J, Forster A. et al. Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. Journal of Rehabilitation Medicine, 2010, 42(1): 9-14.</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Galvin R, Cusack T, Stokes E. A randomised controlled trial evaluating family mediated exercise (FAME) therapy following stroke. BMC Neurology, 2008, 20(8): 22.</mixed-citation><mixed-citation xml:lang="en">Galvin R, Cusack T, Stokes E. A randomised controlled trial evaluating family mediated exercise (FAME) therapy following stroke. BMC Neurology, 2008, 20(8): 22.</mixed-citation></citation-alternatives></ref><ref id="cit33"><label>33</label><citation-alternatives><mixed-citation xml:lang="ru">Kwakkel G, van Peppen R, Wagenaar RC, Wood Dauphinee S, Richards C, Ashburn A, et al. Effects of augmented exercise therapy time after stroke: a meta-analysis. Stroke, 2004, 35(11): 2529-39.</mixed-citation><mixed-citation xml:lang="en">Kwakkel G, van Peppen R, Wagenaar RC, Wood Dauphinee S, Richards C, Ashburn A, et al. Effects of augmented exercise therapy time after stroke: a meta-analysis. Stroke, 2004, 35(11): 2529-39.</mixed-citation></citation-alternatives></ref><ref id="cit34"><label>34</label><citation-alternatives><mixed-citation xml:lang="ru">Kwakkel G. Impact of intensity of practice after stroke: issues for consideration. Disability and Rehabilitation, 2006, 28(13-14): 823-30.</mixed-citation><mixed-citation xml:lang="en">Kwakkel G. Impact of intensity of practice after stroke: issues for consideration. Disability and Rehabilitation, 2006, 28(13-14): 823-30.</mixed-citation></citation-alternatives></ref><ref id="cit35"><label>35</label><citation-alternatives><mixed-citation xml:lang="ru">Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet, 2011, 377(9778): 1693-702.</mixed-citation><mixed-citation xml:lang="en">Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet, 2011, 377(9778): 1693-702.</mixed-citation></citation-alternatives></ref><ref id="cit36"><label>36</label><citation-alternatives><mixed-citation xml:lang="ru">Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke, 2014, 45(7): 2053-58.</mixed-citation><mixed-citation xml:lang="en">Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke, 2014, 45(7): 2053-58.</mixed-citation></citation-alternatives></ref><ref id="cit37"><label>37</label><citation-alternatives><mixed-citation xml:lang="ru">Veerbeek JM, Koolstra M, Ket JC, van Wegen EE, Kwakkel G. Effects of augmented exercise therapy on outcome of gait and gait-related activities in the first 6 months after stroke: a meta-analysis. Stroke, 201, 42(11): 3311-5.</mixed-citation><mixed-citation xml:lang="en">Veerbeek JM, Koolstra M, Ket JC, van Wegen EE, Kwakkel G. Effects of augmented exercise therapy on outcome of gait and gait-related activities in the first 6 months after stroke: a meta-analysis. Stroke, 201, 42(11): 3311-5.</mixed-citation></citation-alternatives></ref><ref id="cit38"><label>38</label><citation-alternatives><mixed-citation xml:lang="ru">Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, et al. What is the evidence for physical therapy post-stroke? A systematic review and meta-analysis. PLoS One, 2014, 9(2): e87987.</mixed-citation><mixed-citation xml:lang="en">Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, et al. What is the evidence for physical therapy post-stroke? A systematic review and meta-analysis. PLoS One, 2014, 9(2): e87987.</mixed-citation></citation-alternatives></ref><ref id="cit39"><label>39</label><citation-alternatives><mixed-citation xml:lang="ru">De Weerdt W, Feys H. Assessment of physiotherapy for patients with stroke. Lancet, 2002, 359(9302): 182-3.</mixed-citation><mixed-citation xml:lang="en">De Weerdt W, Feys H. Assessment of physiotherapy for patients with stroke. Lancet, 2002, 359(9302): 182-3.</mixed-citation></citation-alternatives></ref><ref id="cit40"><label>40</label><citation-alternatives><mixed-citation xml:lang="ru">The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. www.karger.com/Article/ FullText/131083 (accessed 27 November 2016).</mixed-citation><mixed-citation xml:lang="en">The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. www.karger.com/Article/ FullText/131083 (accessed 27 November 2016).</mixed-citation></citation-alternatives></ref><ref id="cit41"><label>41</label><citation-alternatives><mixed-citation xml:lang="ru">National Institute for Health and Care Excellence. Stroke rehabilitation in adults. www.nice.org.uk/guidance/cg162 (accessed 27 November 2016).</mixed-citation><mixed-citation xml:lang="en">National Institute for Health and Care Excellence. Stroke rehabilitation in adults. www.nice.org.uk/guidance/cg162 (accessed 27 November 2016).</mixed-citation></citation-alternatives></ref><ref id="cit42"><label>42</label><citation-alternatives><mixed-citation xml:lang="ru">Scottish Intercollegiate Guidelines Network. SIGN Guideline 118. Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning. www.sign.ac.uk/pdf/sign118.pdf (accessed 1 September 2013).</mixed-citation><mixed-citation xml:lang="en">Scottish Intercollegiate Guidelines Network. SIGN Guideline 118. Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning. www.sign.ac.uk/pdf/sign118.pdf (accessed 1 September 2013).</mixed-citation></citation-alternatives></ref><ref id="cit43"><label>43</label><citation-alternatives><mixed-citation xml:lang="ru">Welmer AK, Holmqvist LW, Sommerfeld DK. Limited fine hand use after stroke and its association with other disabilities. J Rehabil Med, 2008, 40(8): 603-8.</mixed-citation><mixed-citation xml:lang="en">Welmer AK, Holmqvist LW, Sommerfeld DK. Limited fine hand use after stroke and its association with other disabilities. J Rehabil Med, 2008, 40(8): 603-8.</mixed-citation></citation-alternatives></ref><ref id="cit44"><label>44</label><citation-alternatives><mixed-citation xml:lang="ru">Carey LM, Matyas TA. Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting. J Rehabil Med, 2011,43(3): 257-63.</mixed-citation><mixed-citation xml:lang="en">Carey LM, Matyas TA. Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting. J Rehabil Med, 2011,43(3): 257-63.</mixed-citation></citation-alternatives></ref><ref id="cit45"><label>45</label><citation-alternatives><mixed-citation xml:lang="ru">Ekstrand E, Rylander L, Lexell J., Brogårdh C. Perceived ability to perform daily hand activities after stroke and associated factors: a cross-sectional study. BMC Neurol, 2016, 16(1): 208-217.</mixed-citation><mixed-citation xml:lang="en">Ekstrand E, Rylander L, Lexell J., Brogårdh C. Perceived ability to perform daily hand activities after stroke and associated factors: a cross-sectional study. BMC Neurol, 2016, 16(1): 208-217.</mixed-citation></citation-alternatives></ref><ref id="cit46"><label>46</label><citation-alternatives><mixed-citation xml:lang="ru">Remple MS, Bruneau RM, VandenBerg PM, Goertzen C, Kleim JA. Sensitivity of cortical movement representations to motor experience: evidence that skill learning but not strength training induces cortical reorganization. Behav Brain Res, 2001, 123(2): 133-41.</mixed-citation><mixed-citation xml:lang="en">Remple MS, Bruneau RM, VandenBerg PM, Goertzen C, Kleim JA. Sensitivity of cortical movement representations to motor experience: evidence that skill learning but not strength training induces cortical reorganization. Behav Brain Res, 2001, 123(2): 133-41.</mixed-citation></citation-alternatives></ref><ref id="cit47"><label>47</label><citation-alternatives><mixed-citation xml:lang="ru">Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T. et al. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil, 2009, 90(10): 1692-8.</mixed-citation><mixed-citation xml:lang="en">Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T. et al. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil, 2009, 90(10): 1692-8.</mixed-citation></citation-alternatives></ref><ref id="cit48"><label>48</label><citation-alternatives><mixed-citation xml:lang="ru">Lang CE, DeJong SL, Beebe JA. Recovery of thumb and finger extension and its relation to grasp performance after stroke. J Neurophysiol, 2009, 102(1): 451-9.</mixed-citation><mixed-citation xml:lang="en">Lang CE, DeJong SL, Beebe JA. Recovery of thumb and finger extension and its relation to grasp performance after stroke. J Neurophysiol, 2009, 102(1): 451-9.</mixed-citation></citation-alternatives></ref><ref id="cit49"><label>49</label><citation-alternatives><mixed-citation xml:lang="ru">Schweighofer N, Han CE, Wolf SL, Arbib MA, Winstein CJ. A functional threshold for longterm use of hand and arm function can be determined: predictions from a computational model and supporting data from the Extremity Constraint-Induced Therapy Evaluation (EXCITE) Trial. Phys Ther, 2009, 9(12): 1327-36.</mixed-citation><mixed-citation xml:lang="en">Schweighofer N, Han CE, Wolf SL, Arbib MA, Winstein CJ. A functional threshold for longterm use of hand and arm function can be determined: predictions from a computational model and supporting data from the Extremity Constraint-Induced Therapy Evaluation (EXCITE) Trial. Phys Ther, 2009, 9(12): 1327-36.</mixed-citation></citation-alternatives></ref><ref id="cit50"><label>50</label><citation-alternatives><mixed-citation xml:lang="ru">Winstein CJ, Wolf SL, Dromerick AW, Lane CJ, Nelsen MA, Lewthwaite R. et al. Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Investigative Team. Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke: The ICARE Rando mized Clinical Trial. JAMA, 2016, 315(6): 571-81.</mixed-citation><mixed-citation xml:lang="en">Winstein CJ, Wolf SL, Dromerick AW, Lane CJ, Nelsen MA, Lewthwaite R. et al. Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Investigative Team. Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke: The ICARE Rando mized Clinical Trial. JAMA, 2016, 315(6): 571-81.</mixed-citation></citation-alternatives></ref><ref id="cit51"><label>51</label><citation-alternatives><mixed-citation xml:lang="ru">Lin KC, Chen YA, Chen CL, Wu CY, Change YF. The effects of bilateral arm training on motor control and functional performance in chronic stroke: a randomized controlled study. Neurorehabil Neural Repair, 2010, 24: 42-51.</mixed-citation><mixed-citation xml:lang="en">Lin KC, Chen YA, Chen CL, Wu CY, Change YF. The effects of bilateral arm training on motor control and functional performance in chronic stroke: a randomized controlled study. Neurorehabil Neural Repair, 2010, 24: 42-51.</mixed-citation></citation-alternatives></ref><ref id="cit52"><label>52</label><citation-alternatives><mixed-citation xml:lang="ru">Kwakkel G, Kolten BJ, Krebs HI. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil. Neural Repair, 2008, 22: 111-21.</mixed-citation><mixed-citation xml:lang="en">Kwakkel G, Kolten BJ, Krebs HI. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil. Neural Repair, 2008, 22: 111-21.</mixed-citation></citation-alternatives></ref><ref id="cit53"><label>53</label><citation-alternatives><mixed-citation xml:lang="ru">Mehrholz J, Plats T, Kugler J, Pohl M. Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke. Cochrane Database Syst Rev, 2008, 4: CD006876.</mixed-citation><mixed-citation xml:lang="en">Mehrholz J, Plats T, Kugler J, Pohl M. Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke. Cochrane Database Syst Rev, 2008, 4: CD006876.</mixed-citation></citation-alternatives></ref><ref id="cit54"><label>54</label><citation-alternatives><mixed-citation xml:lang="ru">Luft AR, Hafer-Macko C, Schallert T. Physiological basis of rehabilitation therapeutics in stroke. Stroke recovery and rehabilitation. Edited by Stein J, Harvey RL, Macko RF, Winstein CJ, Zorowitz RD. New York, USA: Demos Medical Publishing, 2009: 145-152.</mixed-citation><mixed-citation xml:lang="en">Luft AR, Hafer-Macko C, Schallert T. Physiological basis of rehabilitation therapeutics in stroke. Stroke recovery and rehabilitation. Edited by Stein J, Harvey RL, Macko RF, Winstein CJ, Zorowitz RD. New York, USA: Demos Medical Publishing, 2009: 145-152.</mixed-citation></citation-alternatives></ref><ref id="cit55"><label>55</label><citation-alternatives><mixed-citation xml:lang="ru">Crisostomo EA, Duncan PW, Propst M et al. Evidence that amphetamine with physical therapy promotes recovery of motor function in stroke patients. Ann Neurol, 1988, 23(1): 94-97.</mixed-citation><mixed-citation xml:lang="en">Crisostomo EA, Duncan PW, Propst M et al. Evidence that amphetamine with physical therapy promotes recovery of motor function in stroke patients. Ann Neurol, 1988, 23(1): 94-97.</mixed-citation></citation-alternatives></ref><ref id="cit56"><label>56</label><citation-alternatives><mixed-citation xml:lang="ru">Gladstone DJ, Danells CJ, Armesto A, McIlroy WE, Staines WR, Graham SJ et al. Physiotherapy coupled with dextroamphetamine for rehabilitation after hemiparetic stroke: A randomized, double-blind, placebo-controlled trial. Stroke, 2006, 37(1): 179-185.</mixed-citation><mixed-citation xml:lang="en">Gladstone DJ, Danells CJ, Armesto A, McIlroy WE, Staines WR, Graham SJ et al. Physiotherapy coupled with dextroamphetamine for rehabilitation after hemiparetic stroke: A randomized, double-blind, placebo-controlled trial. Stroke, 2006, 37(1): 179-185.</mixed-citation></citation-alternatives></ref><ref id="cit57"><label>57</label><citation-alternatives><mixed-citation xml:lang="ru">Breitenstein C, Floel A, Korsukewitz C, Wailke S, Bushuven S, Knecht S. A shift of paradigm: from noradrenergic to dopaminergic modulation of learning? J Neurol Sci, 2006, 248(1–2): 42-47.</mixed-citation><mixed-citation xml:lang="en">Breitenstein C, Floel A, Korsukewitz C, Wailke S, Bushuven S, Knecht S. A shift of paradigm: from noradrenergic to dopaminergic modulation of learning? J Neurol Sci, 2006, 248(1–2): 42-47.</mixed-citation></citation-alternatives></ref><ref id="cit58"><label>58</label><citation-alternatives><mixed-citation xml:lang="ru">Plewnia C, Bartels M, Cohen L, Gerloff C. Noradrenergic modulation of human cortex excitability by the presynaptic alpha(2)-antagonist yohimbine. Neurosci Lett, 2001, 307(1): 41-44.</mixed-citation><mixed-citation xml:lang="en">Plewnia C, Bartels M, Cohen L, Gerloff C. Noradrenergic modulation of human cortex excitability by the presynaptic alpha(2)-antagonist yohimbine. Neurosci Lett, 2001, 307(1): 41-44.</mixed-citation></citation-alternatives></ref><ref id="cit59"><label>59</label><citation-alternatives><mixed-citation xml:lang="ru">Plewnia C, Hoppe J, Cohen LG, Gerloff C. Improved motor skill acquisition after selective stimulation of central norepinephrine. Neurology, 2004, 62(11): 2124-2126.</mixed-citation><mixed-citation xml:lang="en">Plewnia C, Hoppe J, Cohen LG, Gerloff C. Improved motor skill acquisition after selective stimulation of central norepinephrine. Neurology, 2004, 62(11): 2124-2126.</mixed-citation></citation-alternatives></ref><ref id="cit60"><label>60</label><citation-alternatives><mixed-citation xml:lang="ru">Chollet F, Tardy J, Albucher JF, Thalamas C, Berard E, Lamy C et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. Lancet Neurol, 2011, 10(2): 123-30.</mixed-citation><mixed-citation xml:lang="en">Chollet F, Tardy J, Albucher JF, Thalamas C, Berard E, Lamy C et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. Lancet Neurol, 2011, 10(2): 123-30.</mixed-citation></citation-alternatives></ref><ref id="cit61"><label>61</label><citation-alternatives><mixed-citation xml:lang="ru">https: //medi.ru/instrukciya/vazobral_1821/.</mixed-citation><mixed-citation xml:lang="en">https: //medi.ru/instrukciya/vazobral_1821/.</mixed-citation></citation-alternatives></ref><ref id="cit62"><label>62</label><citation-alternatives><mixed-citation xml:lang="ru">Cahn R, Borzeix MG, Legeai J. The effects of dihydroergocryptine on the neurological and enzyme disorders induced by cerebral ischemia in rats. Resuscitation, 1989, 18(1): 37-48.</mixed-citation><mixed-citation xml:lang="en">Cahn R, Borzeix MG, Legeai J. The effects of dihydroergocryptine on the neurological and enzyme disorders induced by cerebral ischemia in rats. Resuscitation, 1989, 18(1): 37-48.</mixed-citation></citation-alternatives></ref><ref id="cit63"><label>63</label><citation-alternatives><mixed-citation xml:lang="ru">Батышева Т.Т., Костенко Е.В., Ганжула П.А., Журавлева Е.Ю., Лисинкер Л.Н., Хозова А.А. и др. Комплексная программа вторичной профилактики инсульта: место комбинированного препарата Вазобрал. Consilium medicum, 2007, 2(2): 93-96.</mixed-citation><mixed-citation xml:lang="en">Batysheva TT, Kostenko EV, Ganzhula PA, Zhuravleva EYu, Lisinker LN, Khozova AA. The comprehensive program for secondary prevention of stroke: efficacy of the combination drug vazobral. Consilium medicum, 2007, 2 (2): 93-96.</mixed-citation></citation-alternatives></ref><ref id="cit64"><label>64</label><citation-alternatives><mixed-citation xml:lang="ru">Гудкова В.В., Стаховская Л.В., Кирильченко Т.Д., Ковражкина Е.А., Чекнева Н.С., Квасова О.В. и др. Ранняя реабилитация после перенесенного инсульта. Consilium medicum, 2007, 8(8): 692-696.</mixed-citation><mixed-citation xml:lang="en">Gudkova VV, Stakhovskaya LV, Kirilchenko TD, Kovrazhkina EA, Chekneva NS, Kvasova OV. Early rehabilitation after stroke. Consilium medicum, 2007, 8 (8): 692-696.</mixed-citation></citation-alternatives></ref><ref id="cit65"><label>65</label><citation-alternatives><mixed-citation xml:lang="ru">Левин О.С., Баранцевич Е.Р., Бельская Г.Н., Васенина Е.Е., Копишинская С.В., Лукашевич И.Г. и др. Эффективность комбинированного препарата вазобрал при дисциркуляторной энцефалопатии. Журнал неврологии и психиатрии им. С.С. Корсакова, 2014, 10: 25-29.</mixed-citation><mixed-citation xml:lang="en">Levin OS, Barantsevich ER, Belskaya GN, Vasenina EE, Kopishinskaya SV, Lukashevich IG, et al. The efficacy of the combination drug vasobral for the treatment of dyscirculatory encephalopathy. Zhurnal Nevrologii i Psikhiatrii Im S. S. Korsakova, 2014, 10: 25-29</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
