Нейрометаболическая поддержка у пациентов с двигательными нарушениями при инсульте на втором этапе реабилитации

Abstract

Study Objective: To evaluate dose-dependent effects of adjunctive treatment with ethylmethylhydroxypyridine succinate within a comprehensive course of rehabilitation, in cerebral stroke patients with movement disorders in the second stage of rehabilitation. Study Design: This was a randomized study. Materials and Methods: Forty ischemic stroke patients were examined, and divided into three groups. Ethylmethylhydroxypyridine succinate was given intramuscularly to 18 patients: 250 mg/day (5 mL) in Group 1 (n = 9) and 100 mg/day (2 mL) in Group 2 (n = 9). In Group 3 (n = 22) patients did not receive this drug. All patients underwent a complete examination, including assessment of the following parameters: static and dynamic balance, as assessed by the Standing Balance Test and the Berg Balance Test; walking (Hauser Ambulation Index); and emotional (Hospital Anxiety and Depression Scale), cognitive (Montreal Cognitive Assessment), and sensory (Fugl-Meyer Assessment Scale) functions. Patients’ balance status was objectively assessed using stabilometric parameters. Study Results: Group 1 patients showed a significant increase in Berg Balance Test scores (from 44.00 [42.00; 47.00] to 46.00 [42.00; 49.00]) and a decrease in statokinesigram area (with eyes closed) (from 910.92 [36.20; 2,633.50] mm2 to 620.98 [213.40; 1,676.30] mm2 (p < 0.05). All groups exhibited trends toward improvement of static balance, quality of walking, and cognitive and sensory functions, but only the changes in the Montreal Cognitive Assessment in Group 1 were statistically significant (from 24.67 [19; 27] to 26.67 [22; 29]). Conclusion: Adjunctive ethylmethylhydroxypyridine succinate, 5 mL (250 mg/day), within a course of rehabilitation improved patients’ balance status and cognitive functions. Patients who received this medication at a dose of 2 mL (100 mg/day) and those who did not receive it showed no significant improvement during rehabilitation. Keywords: stroke, balance, neurometabolic therapy, ethylmethylhydroxypyridine succinate.