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The use of TES therapy in the complex treatment of post-stroke motor disorders

Volkov A. K.
Military Medical Academy named after S.M. Kirov,
Saint-Petersburg

Introduction. As is known, post-stroke movement disorders (paralysis and paresis) are one of the most severe consequences of diseases of the vascular system, which lead to disability and, often, immobilization of a person.

Modern restorative medicine has a large arsenal of medications and non-medications aimed at combating these complications, but practice shows that the number of such patients does not decrease.

For the first time, we applied the method of TES therapy for the treatment of patients with impaired motor functions after ischemic or hemorrhagic strokes on the background of hypertension.

Materials and methods. TES therapy was used in cases of insufficient effectiveness of previously conducted treatment. Treatment was carried out in 21 patients aged 50 to 81 years with different periods after stroke – 3 months (1 patient) and from 2 to 8 years (20 patients). Of these, there were 15 men and 6 women. The defeat of the right hemisphere was noted in 11 cases, the left – in 10. Violation of motor functions was expressed in the form of hemiparesis (17 cases) and hemiplegia (4 cases).

TES therapy procedures were performed in outpatient or at home conditions daily or after 1-2 days, taking into account the dynamics of positive effects. The duration of the TES therapy session, as a rule, ranged from 20 to 40 minutes, the current strength from 0.2 to 1.5 mA with unipolar pulses. During the first session, the minimum current strength (0.2–0.5 mA) was used to determine the threshold of the patient’s sensations and to identify the degree and speed of his adaptation to electrical exposure.

The second and subsequent procedures were carried out taking into account the patient’s condition. The course of treatment consisted of 10-25 procedures, and its duration depended on the results achieved. TES therapy was combined with electromyostimulation of sick and healthy limbs and physical therapy according to an individual plan.

Results. Evaluation of treatment results was carried out by the clinical method based on subjective and objective data. In 19 cases (90.5%), there was an increase in the volume of movements, a decrease in spasticity in the muscles, a decrease in the level of hyperreflexia, and a decrease in sensitivity disorders. Three patients with hemiplegia had active movements in the affected limbs and the ability to move independently.

In one observation, a patient with hemiparesis had a complete restoration of lost functions and working capacity. In all cases, there was an improvement in the general condition, an increase in mental and physical activity, and a decrease in pain. There was motivation for recovery, the quality of life improved.

Findings. The method of TES therapy helps to reduce the degree of motor disorders in patients after a stroke, regardless of the patient’s age and the duration of the disease. Electromyostimulation of limb muscles enhances the therapeutic effects of TES therapy.

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