Combined rehabilitation of patients after acute cerebrovascular accident in the early recovery period: the role of osteopathic correction

Introduction . Acute cerebrovascular accident (ACA) circulatory disorders are the cause of persistent motor disorders in the form of impaired static-dynamic functions and psychoemotional disorders, which significantly affect the quality of life of patients. Disability due to stroke ranks 1st among all causes of disability in Russia and is an important medical and social problem requiring a comprehensive rehabilitation approach. The biofeedback method (biofeedback therapy), as one of the modern methods of hardware rehabilitation, demonstrates its effectiveness in research on restoring lost functions in patients who have undergone ACA. One of the methods of neurorehabilitation of patients with ACA is osteopathic correction (structural, visceral, cranial), which improves the regulation of static and dynamic postural balance. The aim of the study : to study the effectiveness of osteopathic correction on the formation of a motor stereotype in the rehabilitation of patients with ACA in the early recovery period. Materials and methods . The study was conducted at the Biomechanics Laboratory of the Moscow Scientific and Practical Center for Medical Rehabilitation, Rehabilitation and Sports Medicine from November 2019 to March 2021. A randomized controlled prospective study involved 155 patients with stroke aged 40 to 75 years who underwent rehabilitation for 10 days in hospital. The patients were divided into two groups by simple randomization. Patients of both groups received standard preventive therapy for stroke (antiplatelet, lipidlowering, hypotensive therapy), as well as 10 sessions of physical therapy and Bio-feedback therapy. The main group underwent osteopathic correction after the first and fifth sessions of Bio-feedback therapy, while the control group underwent standard treatment without osteopathic correction. All patients underwent stabilometry, osteopathic examination, and a 10-meter walking time. Results . The inclusion of osteopathic correction in the course of biofeedback therapy in patients in the early recovery period improves the function of postural control according to stabilometry ( p <0,05) compared with standard treatment. Somatic dysfunctions at the global and regional levels were revealed in both groups. Among global-level somatic dysfunctions, rhythmogenic cranial impairment was identifi ed, which was also the dominant somatic dysfunctions in these patients. Conclusion . Osteopathic correction in patients with ACA in the early recovery period improves the static-dynamic characteristics of the motor stereotype.