Примитивные рефлексы спинально-стволового уровня и их реабилитационное значение у постинсультных больных: краткое сообщение

Abstract

INTRODUCTION. Primitive reflexes of the spinal-brainstem level (defensive reflexes, support reactions, cervical and vestibular tonic reflexes) can often be observed in the first days after a stroke. In clinical neurology, they are used for topical diagnosis and serve as an indicator of the severity of damage to the central nervous system. Their rehabilitation value has not been sufficiently studied. AIM. Based on literature data, to study the features of primitive spinal-brainstem automatisms in post-stroke patients, and to evaluate the possibility of their use to optimize rehabilitation methods (kinesitherapy). RESULTS. Simple protective reflexes are suitable for awakening elementary motor activity in one of the paralyzed limbs, and complex ones are suitable for stimulating static-locomotor reactions in the arm and leg on the side of hemiparesis. Support reactions are a reliable tool for awakening both flexion movements and for restoring the support ability of paretic limbs. They should be considered when treating with positioning using positioning, splints, and orthoses. Cervical and vestibular tonic reflexes are suitable for stimulating motor activity on the side of hemiparesis, as well as for suppressing pyramidal spasticity. CONCLUSION. Thus, all studied primitive reflexes of the spinal-brainstem level have significant rehabilitation potential. Their use is most justified to facilitate flexion-extension movements in paretic limbs. The better the rehabilitologist is familiar with the characteristics of the patient’s reflex activity, the more opportunities he has for conducting a “dialogue” with paretic muscles and the more effective the rehabilitation treatment will be. KEYWORDS: protective reflex, support reaction reflex, cervical tonic reflexes, vestibular tonic reflexes, ehabilitation