medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-12-36-38medsovet-2561Research ArticleНЕВРОЛОГИЯNEUROLOGYПрактические аспекты реабилитации при постинсультных расстройствах равновесияPractical aspects of balance and vestibular rehabilitation after strokeЗамерградМ. В.ZamergradM. V.

д.м.н., профессор

ХатьковаС. Е.KhatkovaS. E.

д.м.н.

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Postgraduate Education of the Ministry of Health of RussiaRussian FederationФГАУ «Лечебно-реабилитационный центр Минздрава России»РоссияMedical Rehabilitation Center of the Ministry of Health of RussiaRussian Federation2018240720180123638Copyright © Замерград М.В., Хатькова С.Е., 20182018Замерград М.В., Хатькова С.Е.Zamergrad M.V., Khatkova S.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2561

Расстройства равновесия часто встречаются у пациентов, перенесших инсульт. Причины неустойчивости разнообразны. В одних случаях походка нарушается из-за спастических парезов, в других – вследствие расстройства проприоцептивной чувствительности и мозжечковых нарушений. Ведение пациентов с расстройствами равновесия в постинсультном периоде складывается из тщательной оценки функциональных возможностей, риска падений и причины неустойчивости, а также подбора физической реабилитации и медикаментозной терапии. Среди методов физической реабилитации эффективными могут быть как обычные упражнения, ориентированные на тренировку устойчивости и физической выносливости, так и занятия на специальных тренажерах с биологической обратной связью. Медикаментозная терапия включает базовые средства для вторичной профилактики инсульта и симптоматические средства, способные скорректировать различные нарушения, обусловленные патогенетическими механизмами церебрального инсульта (ботулинотерапия, Вазобрал).

Balance and vestibular disorders are often detected in patients who have suffered a stroke. Instability may be caused by various reasons. In some cases, impairment of gait is caused by spastic paresis, in others by proprioceptive sensitivity and cerebellar disorders. Management of patients with balance disorders in the post-stroke period is composed of a detailed assessment of functional capabilities, the risk of falls and the cause of instability, as well as the adjustment of physical rehabilitation and drug therapy. The effective methods of physical rehabilitation include general exercises to strengthen stability and physical endurance, and special simulators with biological feedback. The drug therapy includes basic pharmacotherapy for the secondary prevention of stroke and symptomatic agents that can manage various disorders due to pathogenetic mechanisms of cerebral stroke (botulinum therapy, Vasobral).

 

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The authors declare that there are no conflicts of interest present.