High effectiveness of cognitive rehabilitation in the late recovery period after revascularization

Background: Systemic thrombolytic therapy (STLT) with alteplase is the method of choice in all patients with acute ischemic stroke (IS) within the first 4.5 hours after the symptom onset. There is a noticeable difference between men and women in the clinical characteristics and results of stroke treatment; however, results of studies have been contradictory.
 Aim: To evaluate the efficacy of STLT with alteplase in women compared to men, depending on the presence of some risk factors for stroke.
 Materials and methods: This open-label prospective observational non-interventional cohort study of STLT in IS included 209 patients (102 women, the main group, and 107 men, or the comparison group) aged 32 to 86 years. All patients received STLT with alteplase within 4.5 hours from the onset of IS symptoms. The primary endpoint of the study was 28-day survival, and the secondary endpoint was the achievement of mobility independence (0 to 2 points by the modified Rankin Scale (mRS)).
 Results: The demographic and clinical patient characteristics of both groups were comparable, but women were on average 5 years older than men (p = 0.003). The index IS was not the first one in 31.4% of women and 23.4% of men (p 0.05). There were no significant differences in the severity of stroke and the timing of STLT. Men had a high mortality rate in the acute period of IS, but the difference was non-significant. PST-STLT hemorrhagic transformation was more common in men, with the difference being non-significant (2 0.743, p = 0.389). Women were more likely to have type 2 diabetes mellitus (DM2) (37.3% and 20.6%, respectively, 2 7.111, p = 0.008). In women, there was a trend towards better symptom regression by about 1 point (p = 0.129). The women with DM2 had a 13% higher survival than men (p = 0.038). The numbers of patients achieving independence (02 points on the mRS scale) by Day 28 was not different (56 women and 52 men). No between-groups differences were found in the numbers of patients with arterial hypertension and atrial fibrillation. Only 13 women (12.75%) and 21 men (20%) had a normal body mass index, while 56.3% of women and 46.7% of men had obesity 2 or 3 grades, with the gender differences being non-significant.
 Conclusion: In women, who have received STLT in the acute period of IS, the death rates and the functional outcomes were non-inferior to those in men, despite their older age, hyperglycemia in the acute period and past history of DM2. The risk factors for stroke in women, compared to men, could be the potential cause of more frequent IS recurrence (every third case in women and every fourth in men was recurrent). Despite a number of negative factors (age, obesity, metabolic syndrome, hyperglycemia, DM2, atrial fibrillation), there was a trend towards better outcomes of STLT in women.

INTRODUCTION. Emotional and personality disorders that occur in patients after a stroke have a negative impact on the rehabilitation process, reducing its effectiveness, disrupting the motivation for treatment and quality of life. Today, comprehensive rehabilitation programs for patients in the late recovery period after acute cerebrovascular accident, aimed at psychological correction of emotional disorders, are becoming relevant. AIM. To study the effectiveness of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy on the emotional state of patients in the late recovery period after an ischaemic stroke. MATERIALS AND METHODS. The study included 40 patients after an acute cerebrovascular accident (ACVA) in the late recovery period (from 6 months to 2 years after ACVA) aged between 45 and 75 years, average age 61.6 [53.95; 68.1]. The patients were randomized into two groups. The main group included patients (n = 20 people, of which 7 men, 13 women, age — 62.09 [53.5; 68.6] years), who underwent a complex basic rehabilitation program, including audiovisual stimulation and psychotherapy techniques; the control group included patients (n = 20, including 6 men, 14 women, age — 61.1 [54.4; 67.5] years) who underwent a basic rehabilitation program. For psychological diagnostics, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program were used to study the current emotional state. The statistical significance of differences before and after the treatment was determined using the nonparametric Wilcoxon test. To assess the statistical comparability of the two groups, the Mann-Whitney test was used (p 0.05). RESULTS. The use of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy in the psychological correction of emotional disorders in patients in the late recovery period after an ischemic stroke allows us to achieve a statistically significant effect in reducing state and trait anxiety, the level of chronic fatigue, as well as increasing the subjective comfort and quality of life (p 0.05). DISCUSSION. The study showed that patients in the late recovery period after a stroke before treatment experienced high levels of anxiety and depression and experienced a severe psycho-emotional stress. As a result of audiovisual stimulation and psychotherapy techniques, indicators of the negative emotional state of patients in the late recovery period after an ischemic stroke significantly decreased, mood improved, activity and tolerance to psychological stress increased. CONCLUSION. A comprehensive rehabilitation of patients in the late recovery period after a stroke, aimed at psychological correction of emotional disorders, significantly improved the emotional background, increased tolerance to psychological stress, and also contributed to increased motivation for restorative treatment and rehabilitation.

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

Introduction. The relevance of neuroprotective therapy in patients with cerebral stroke (CS) is due to its high prevalence, as well as the need for the maximum possible restoration of damaged structures and functions of the central nervous system (CNS).Аim. Тo evaluate the clinical efficacy and nicotinoyl gamma-aminobutyric acid tolerance in the complex rehabilitation of patients in the late recovery and chronic periods of ischemic stroke (IS) in outpatient stage.Materials and methods. 110 patients in the late recovery period (LRP) and the residual period of IS, 57 women and 43 men, average age 58.0 ± 9.74 years, were observed. The duration of the stroke was on average 214 ± 28 days in PVP-patients and 428 ± 47 days for the residual period. All patients included in the study received a standard medical rehabilitation program. Two main groups included 30 patients in LRP and the residual period of IS, who treated with nicotinoyl gammaaminobutyric. Two control groups included 30 patients in LRP and 20 patients in the residual period of IS, who recievedonly the standard medical rehabilitation program.Results. The complex of rehabilitation with the inclusion of nicotinoyl gamma-aminobutyric acid (picamilon) significantly improved the indicators of neurodynamic (p < 0.05) and regulatory functions (p < 0.05) in the main subgroups on the MoCA scale, emotional status (p > 0.05 on the Beck scale), general well-being, activity, mood (WAM scale) and basic functional activity (the average Bartel index at the end of the study was 82.6 ± 3.5 in the main groups, p < 0.05). The clinical effect was observed after a month of the therapy and persisted until the end of the study.Conclusion. The inclusion of neuroprotective therapy in the complex rehabilitation leads to earlier neuropsychological and social adaptation of the patient, regression of fatigue, which is probably associated with an increase in neuroplastic and regulatory brain processes.

Was to determine the proportion of patients with ischemic stroke (IS) who achieved functional independence by the end of the hospitalization, among those who underwent systemic thrombolytic therapy (STT) with two different alteplase preparations (Actilyse and Revelisa). An open, prospective observational non-interventional cohort study of the results of STT in patients with IS was carried out. The study included 195 patients, 123 men and 72 women aged 32 to 86 years, who received STT in the acute period of IS. Of these, 120 patients received Actilyse, 75 - Revelisa. Patients who achieved independence in movement (0-2 points on the modified Rankin scale (MRS)) among those who received STT with Actilyse and Revelisa, the value of the χ2 criterion was 0.014 (p=0.905), which showed that there was no statistical significance of the difference in the frequency of recovery of functional disorders on the MRS scale, in patients receiving STT with two different alteplase preparations. After STT with alteplase preparations, patients with IS experienced a significant improvement, which was expressed in a statistically significant decrease in the severity of neurological deficit and a decrease in the degree of disability. When comparing the results of STT with two different alteplase preparations, no statistically significant differences were found in terms of mortality, survival, and independence during the acute period of IS.

Some aspects of late and delayed post-stroke rehabilitation of patients with cognitive impairment and various manifestations of brain neuroplasticity are considered. Particular attention is paid to comprehensive rehabilitation programs for post-stroke patients with cognitive impairment, based on the choice of the optimal modes of physiotherapeutic, drug effects and the duration of the course of therapeutic treatment. Similar programs that can be implemented both in a sanatorium and on an outpatient basis, are effective for patients of working age, including in the late recovery period after ischemic stroke. These programs will lead to the restoration of cognitive and motor functions, the normalization of the psychoemotional state of patients.

Introduction. Modern methods of recanalization — systemic thrombolytic therapy (STT) and mechanical thrombectomy (MT) — allow restoring blood fl ow in the brain tissue in ischemic stroke (IS).Purpose of the study: to analyze the effectiveness of IS reperfusion therapy methods used in the Regional Stroke Center (RSC) of the Tomsk Regional Clinical Hospital from 2017 to 2022.Material and methods. A retrospective evaluation of 666 analyzed cases of specific therapy for IS was performed: 505 cases of STT (67 [59.0; 75.0] years), 126 cases of MT (69 [60.5; 77.5] years), 35 cases a combination of STT followed by MT (69 [63.0; 76.7] years).Results. The severity of neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS) before the intervention was greater in the MT and STT + MT groups (18 [14.0; 25.0] and 18 [14.5; 20.0] points) relative to patients who received STT (11 [8.0; 16.0] and 4 [2.0; 10.0]). Mortality in the MTE group was (64/127, 50.8%) and was higher compared to patients who received STT (104/505, 20.6%, p < 0.001). In the group of patients who underwent combined intervention with STT + MT (9/27, 25.7%), there was a trend towards lower mortality (p = 0.050) compared with isolated MT.Conclusion. A trend towards fewer deaths was found when using a combined intervention in the treatment of IS compared with isolated MT, which may indicate a higher effi ciency of bridging-therapy.

BACKGROUND: For the purpose of early and late medical rehabilitation in recent decades, non-drug methods of physiotherapy have been actively used to restore patients who have had an ischemic stroke. AIMS: substantiation of the inclusion of multimodal physiotherapeutic effects from the Alpha LED Ohu Light_Spa apparatus and low-frequency electrostatic massage from the Khivamat apparatus for the correction of cognitive impairment in patients who have suffered an ischemic stroke, with motor disorders in the form of hemiparesis, increased muscle tone by the type of spasticity in the late recovery period. MATERIALS AND METHODS: The study included 120 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the form of spasticity in the late recovery period. Patients of group 3 (40 people) were prescribed standard drug therapy and medical rehabilitation, patients of group 1 (40 people in addition to standard therapy and rehabilitation, multimodal physiotherapeutic effects were used from the Alpha LED Oxy Light-Spa device and patients of group 2 (40 people) a low-frequency electrostatic massage from the Khivamat apparatus was added to the standard complex. RESULTS: At all control points after the course of treatment, after 6 and 12 months, in addition to general clinical studies, we assessed indicators of cognitive functions (according to the Montreal Cognitive Assessment Scale) and psycho-emotional state according to the HADS scale. In dynamics, it was revealed that in groups 1 and 2, where the developed rehabilitation programs were carried out, there was a significant improvement in cognitive functions (attention, memory, fluency, generalization, etc.), to a greater extent in group 1, while in patients who, against the background of drug therapy, underwent standard medical rehabilitation, only a positive trend was noted. CONCLUSION: The inclusion in the medical rehabilitation of patients who have suffered an ischemic stroke, to a greater extent, multimodal physiotherapeutic effects and to a somewhat lesser extent, low-frequency electrostatic massage contributes to a significant improvement in cognitive functions and a reduction in anxiety and depression.

BACKGROUND: A crucial pathogenetic link in the development of stroke is the deterioration of endothelial function, which is a pathological condition characterized by an imbalance between endothelium-dependent relaxing and constricting factors. An example of an endothelium-dependent relaxing factor is nitric oxide, a substance synthesized by the body’s cells that has a vasodilating, antithrombogenic, anti-inflammatory, and antiproliferative effect. Studies have shown the neuroprotective function of inhaled nitric oxide after ischemia; however, determining the minimum effective dose of inhaled nitric oxide in patients who have suffered an acute cerebrovascular accident remains challenging. AIM: To analyze the protective effect of exogenous nitric oxide using the TIANOX device on the vascular endothelium in patients who have had an ischemic stroke in the early and late recovery period during medical rehabilitation. MATERIALS AND METHODS: The study involved 21 patients (10 people in the main group, 56.9±8.9 years old, 11 people in the control group, 57.2±8.8 years old) in the early or late recovery period after an ischemic stroke. Patients in the main group underwent an individual medical rehabilitation program and a course of 8–10 inhalations of a gas mixture with nitric oxide at 20 ppm for 20 minutes. Those in the control group underwent an individual rehabilitation course without nitric oxide therapy. Flow-dependent vasodilation of the brachial artery was evaluated to assess endothelial function. RESULTS: In the main group, a statistically insignificant (p 0.05) increase was found in the diameter of the brachial artery (3.68±0.64 mm), whereas in the control group, this indicator at rest during repeated diagnostics was less than the initial one (3.09±0.87 mm). During repeated diagnostics, the average endothelial shear velocity in patients of the control group increased from 141.53±52.62 to 159.3±82 versus from 143.17±43.53 to 143.48±46.37 in the main group; however, the results were not statistically significant (p=0.753). CONCLUSION: The increase in the diameter of the brachial artery during flow-dependent vasodilation in patients in the main group may indicate a prosthetic effect of the exogenous form of nitric oxide when using the Tianox device on the vascular endothelium, owing to the possibility of depositing nitric oxide in the body. To confirm the obtained data, a larger sample size of patients is critical in order to further divide the groups of patients into early and late recovery periods after ischemic stroke.

40–70% of patients after a stroke, including a mild one, may experience cognitive impairment. Brain-derived neurotrophic factor (BDNF) plays a significant role in the pathogenesis and rehabilitation of ischemic stroke and also affects the patients' recovery prognosis. An association between cognitive impairment in the poststroke period and lower peripheral BDNF levels is known, but the prognostic significance of serum BDNF levels and clinical characteristics for the risk of developing cognitive impairment in the acute period remains uncertain. We conducted a prospective cohort study of patients in the acute phase of ischemic stroke. Clinical examination, assessment of neurological status, neuropsychological testing, and laboratory analyzes were performed on patients at 1 and 14 days after ischemic stroke. The state of cognitive functions was assessed by the Mini-Mental State Examination scale. Quantification of BDNF in blood serum was performed by solid-phaseenzyme-linked immunosorbent assay (ELISA). We found that within 14 days after an acute ischemic stroke, we found a decrease in the clinical severity of patients compared to 1 day of the onset of the disease before the start of treatment and a significant decrease in the level of BDNF in the blood serum of patients with ischemic stroke both on the first and on the 14th day. However, during the 2 weeks of the acute period, no significant changes were detected, despite the general improvement of the clinical condition. In our study, cognitive impairment was found in almost half of the patients on the first day of ischemic stroke, and there was no significant reduction in this prevalence over 2 weeks. We found that a low level of BDNF and a thrombotic subtype of ischemic stroke can be risk factors for cognitive impairment in the acute period, which can be useful in planning treatment and rehabilitation measures.

The aim of this study was to define electroencephalographic predictors of unfavorable functional outcome of spontaneous supratentorial intracerebral hemorrhage (SSICH) in the acute period.Materials and methods. Prospective, cohort and comparative study was conducted in 114 patients (mean age 67.4 ± 0.8 years) in the acute period of SSICH. Electroencephalography (EEG) was conducted on the 1st–2nd day of the disease. The values of relative band spectral powers of delta rhythm (0.5–4.0 Hz), theta (4–8 Hz), alpha (8–13 Hz), beta (13–35 Hz), theta1 (4–6 Hz), theta2 (6–8 Hz), alpha1 (8–10 Hz), alpha2 (10–13 Hz), beta1 (13–25 Hz) and beta2 (25–35 Hz) were determined in the affected and intact hemispheres. The fronto-occipital rhythm gradient and the severity of interhemispheric rhythm asymmetry were calculated. The functional outcome of the disease in the acute period was assessed on day 21 based on the modified Rankin Scale (mRS), and the value of mRS score >3 was considered as an unfavorable functional outcome.Results. Unfavorable functional outcome of the SSICH in the acute period was registered in 53 (46.5 %) patients. Independent association with the risk of unfavorable functional outcome of SSICH in the acute period was proved for the following indexes of the spectral analysis of EEG pattern in the first 2 days from the onset of the disease: the relative delta band spectral power in the affected hemisphere (OR (95 % CI) = 1.18 (1.11–1.25), P ˂ 0.0001) and the fronto-occipital rhythm gradient of beta band in the affected hemisphere (OR (95 % CI) = 0.0007 (0.0001–0.0293), P = 0.0001). These predictors were integrated in the mathematical model for the determination of an individual risk of unfavorable functional outcome of SSICH in the acute period (AUC (95 % CI) = 0.94 (0.88–0.98), P ˂ 0.0001; forecast accuracy = 87.7 %).Conclusions. Bilateral shift of EEG spectral power pattern of rhythms towards slow-wave activity of the hemisphere with the formation of interhemispheric asymmetry of delta band rhythms in the frontal areas, bilateral reduction in zonal differences of alpha band rhythms, the inversion of the fronto-occipital rhythm gradient of beta band in the affected hemisphere and the reduction in zonal differences of beta band rhythms due to beta2 band in the intact hemisphere with the formation of multidirectional interhemispheric asymmetry in the frontal and occipital parts of the brain in the first 2 days upon the onset of SSICH are considered as EEG criteria for unfavorable functional outcome of the disease in the acute period.

November 2020 Stroke Highlights.

Stroke heads the list of all causes of disability in middle-aged and elderly people. In recent years, there have been about 30% of morbid events among able-bodied persons (less than 65 years of age). The major post-stroke incapacitating disorders are motor and speech defects, cognitive and psychoemotional disorders, and pelvic organ dysfunctions. The patients’ quality of life largely depends on the degree of recovery of lost functions. In turn, the degree of their recovery depends on the start, proportioning, and continuity of initiated rehabilitation measures and on whether the patient has cognitive, speech, and psychoemotional problems and pelvic organ dysfunctions. Unfortunately, after discharge from a specialized unit, only a small number of post-stroke patients are admitted to specialized rehabilitation centers. The responsibility of caring for these patients rests with their relatives and outpatient physicians. The main tasks in the early and late recovery periods following stroke are, in addition to the prevention of recurrent stroke, the implementation of rehabilitation programs to correct motor and speech disorders and cognitive impairments, the stabilization of emotions, and the provision of proper and qualitative general care for patients with severe motor defects and pelvic organ dysfunctions. The paper considers the main principles of patient management in the early and late post-stroke recovery periods. The authors give rehabilitation recommendations and main errors in routine practice (their relatives and junior medical staff have no speech contact with patients having speech disorders; psychoemotional disorders are underestimated and uncorrected; proper general care for patients with pelvic organ dysfunctions is absent).

Aim. To reveal the peculiarities of microcirculatory disorders in persons in early and late recovery periods of ischemic stroke using the method of laser Doppler flowmetry. Materials and methods. We examined 58 patients aged 43 to 75 years, diagnosed with ischemic stroke with motor deficiency. The functional state of microcirculation was studied in dynamics-in the early and late recovery periods of ischemic stroke by laser Doppler flowmetry (LDF). Results. All patients with ischemic stroke along with central hemodynamic disorder had peripheral microcirculatory disorders both on paretic and on healthy limbs correlated with the degree of paresis. Disorders of the сentral hemodynamics were revealed in the form of stenosing and non-stenosing atherosclerosis vessels of the carotid basin, hypertensive angiopathy. Violations of peripheral hemodynamics were established in all patients in both early and late recovery periods of ischemic stroke, coarser on the side of the paresis. More often, more severe forms of microcirculation disorders were observed in the paretic extremity both in the early and late recovery periods, accompanied by signs of a sharp decrease in blood flow, an increase in vascular tone with the phenomena of blood stagnation. In the presence of positive dynamics on the part of the motor sphere, patients in the late recovery period showed positive changes in the parameters of the microcirculation, both on the side of the paresis and on the healthy limbs. Conclusion. The established features of microcirculation disorders make it possible to recommend to patients with ischemic stroke both in the early and late recovery periods active use of drugs that improve arterial blood flow, remove vascular spasm, disaggregants, peripheral vasodilators, vegetative correctors, massage, physiotherapy, reflexology, physiotherapy involving Sick, and healthy limbs, which contributes to the improvement of rehabilitation potential in this category of patients At different stages of recovery.

BACKGROUND: All over the world, scientific research is being actively conducted aimed at the prevention, treatment and rehabilitation of patients with cerebrovascular pathology, but acute cerebrovascular accidents still remain an acute medical and social problem in the world. Post-stroke complications include pain in the upper limb, which affects the performance of simple movements, reduces the level of daily life activity and, as a result, the quality of life of patients.
 AIM: to evaluate the effectiveness of the influence of various complexes of medical rehabilitation on the intensity of the pain syndrome in dynamics and quality of life in patients with acute cerebrovascular accident in the late recovery period of medical rehabilitation.
 MATERIALS AND METHODS: The paper presents data on the effectiveness of the influence of various methods of medical rehabilitation in the late recovery period in 120 patients with ischemic stroke in the late recovery period on pain intensity (according to the digital pain rating scale, NRS, and the Verbal Descriptive Pain Assessment Scale), activity of daily life (according to according to the Barthel index) and quality of life (according to the EQ-5D questionnaire). All patients were divided into 3 groups comparable in terms of clinical and functional characteristics: according to the clinical and functional characteristics of the group: group 1 ― 40 patients who received standard drug therapy and medical rehabilitation (exercise therapy, medical massage, mechanotherapy), group 2 (40 patients) who, in addition to the standard treatment complex, were prescribed massage with a pulsed low-frequency electrostatic field from the Khivamat apparatus and broadband modulation currents, group 3 (40 patients), who, against the background of standard therapy and medical rehabilitation, were included in physiotherapy methods from the Alpha apparatus LED Oxy Light-Spa.
 RESULTS: The data obtained indicate the advantage of including in the standard complex of medical rehabilitation and treatment of patients who have had ischemic stroke with movement disorders in the form of hemiparesis of a pulsed low-frequency electrostatic field and broadband modulation currents. This was confirmed by the improvement in the index of activity of daily life.
 CONCLUSIONS: In the course of the work, it was proved that the inclusion of a pulsed low-frequency electrostatic field and broadband modulation currents in a standard medical rehabilitation complex contributes to a significant reduction in pain syndrome, and also positively affects the assessment of the quality of life of patients after a course of treatment.