Vol 23, No 4 (2024)

Restoring gait and balance functions after stroke constitutes a major problem in modern neurology. Post-stroke static and locomotor impairments are the most common disabling consequences that are critical for patients’ quality of life and basic functional independence.

This analytical review attempts to comprehensively examine and assess the biomechanical aspects affecting the gait in patients with post-stroke static and locomotor impairments.

The review outlines the multifaceted nature of such impairments, including muscle weakness, changes in neuromotor coordination, proprioception and stability, as well as compensatory mechanisms developing in patients.

A particular focus is on biomechanical parameters, including kinematics and kinetics of movements, to provide a deeper understanding of the nature of impairments in order to develop more effective treatment strategies. The analysis highlights the importance of a personalized rehabilitation approach to be based on specific impairments of each patient.

This review is intended to enhance the understanding of the biomechanical aspects of gait impairments for further research and development of innovative approaches in rehabilitation. The data presented are of great importance for the development and elaboration of personalized medical rehabilitation plans for post-stroke patients and may contribute to improving their functional independence and quality of life.

BACKGROUND: Patients with multiple sclerosis who have multifocal lesions of the central nervous system may present various complaints, including loss of balance. Some postural control disorders are detected already at an early stage of the disease. Solving this problem is critical, as it directly causes falls with subsequent injuries and deteriorating quality of life. The Balance Evaluation Systems Test offers benefits over other postural control assessment tests. It enables more personalized therapy, especially in the context of decreased tolerance to physical exercise in patients.

AIM: To implement the Balance Evaluation Systems Test for a detailed assessment of postural control, identifying the markers to be used for the development of individual physical rehabilitation programs, as well as to assess the effectiveness of this approach.

MATERIALS AND METHODS: This single-center, prospective, continuous, controlled, randomized study involved 38 patients from the pediatric neuropsychiatric department of a Russian children’s clinical hospital (mean age: 13–16 years). All of them had a confirmed diagnosis of relapsing-remitting multiple sclerosis. The patients were examined in the pediatric medical rehabilitation department using the Balance Evaluation Systems Test at the beginning and at the end of a therapeutic exercise course conducted on a daily basis for 10 days. The patients were randomized into two groups, 19 persons each. The control group was offered standard balance exercises; in the experimental group, exercises were selected individually for each patient, considering the identified postural control defects.

RESULTS: The treatment resulted in statistically significant changes for patients both in the control and experimental groups (p <0.001). However, when comparing the results after the exercise course between the groups, the experimental group demonstrated more significant changes in postural control (p <0.001).

CONCLUSION: Therefore, the Balance Evaluation Systems Test helps develop a personalized physical rehabilitation program showing more effective results. This provides patients with an opportunity to improve their functional status and reduce the risk of falls and injuries, while delaying the progression of disability and improving the quality of life.

BACKGROUND: A large number of currently available studies focus on the effects accompanying the whole-body cryostimulation impact. Information about the capabilities of the method differs significantly since the presented results are based on the use of different types of equipment. Therefore, the limits of effective parameters of the whole-body cryostimulation impact should be determined.

AIM: Сompare existing technological solutions in terms of efficiency and safety, and to substantiate the known practical advantages of single-chamber cryostimulation devices.

MATERIALS AND METHODS: The reasons for the differences in the achieved therapeutic effects and lists of indications are elucidated through comparing the published data on whole-body cryostimulation applications in medical practice based on the use of single- and multi-chamber whole-body cryostimulation devices.

RESULTS: The analysis of available information has shown that various authors use the term “whole-body cryostimulation” (WBC) for two different technologies of physiotherapeutic impact on the patient’s body. They differ both in terms of organization (group and individual procedures) and technological parameters of the cryostimulation process (temperature of the cryogenic gas environment and duration of the patient’s stay in the low-temperature cabin). These differences are the reason why the changes in the skin surface temperature in multi-chamber cabins are much smaller than in single-chamber ones, which primarily accounts for the low physiotherapeutic efficiency of procedures in multi-chamber units.

CONCLUSION: The analysis shows the reasons for the inconsistent assessments of the whole-body cryostimulation efficiency in different research papers. The main reason for these discrepancies is that the same term refers to two procedures that are physically different. This brings confusion into the scientific data and undermines the credibility of the whole-body cryostimulation method. Further use of cryotherapy in clinical practice requires distinguishing between group cryostimulation and individual cryostimulation.