Assessment of the effect of methods of robotic medical rehabilitation with biofeedback on quality of life and psychoemotional status in patients after CVA with hemiparesis
Authors:   FSBSI Petrovsky National Research Centre of Surgery, Moscow, Korchazhkina Natalya Borisovna , Mikhailova Anna Andreevna ,   FSBSI Petrovsky National Research Centre of Surgery, Group of Companies «Medsi», Moscow, Koneva Elizaveta Sergeevna ,   FSAEI HE I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University), Group of Companies «Medsi», Moscow, Kotenko Konstantin Valentinovich ,   Russian Academy of Sciences, SBSI Petrovsky National Research Centre of Surgery, Moscow
Published: February 2022

Recently, to restore the functions of the affected limbs in patients who have had an ischemic stroke with movement disorders in the form of hemiparesis, non-drug methods have been actively used, including physiotherapy, physiotherapy exercises, kinesiotherapy and, especially, robotic biomechanics. The paper presents data on the effectiveness of using gait training on the BFB equipment with video gait reconstruction and biofeedback (BFB) in the late recovery period of medical rehabilitation. Material and methods. The study included 80 patients who underwent ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone by the type of spasticity. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics: control group — 40 patients who received standard drug therapy and medical rehabilitation and the main group — 40 patients receiving standard drug therapy and medical rehabilitation (exercise therapy, medical massage, mechanotherapy) who were prescribed gait training with video reconstruction on a biofeedback system (BFB) «C-Mill». Subjective indicators of cognitive impairment (Montreal Cognitive Assessment), psychoemotional defects (Hospital Anxiety and Depression Scale) and quality of life (EQ-5D questionnaire) were assessed. Results. As a result of the studies, it has been proved that the inclusion of a gait stereotype with video reconstruction on a biofeedback system (BFB) «C-Mill» in the rehabilitation training program contributes to a significantly more pronounced improvement of cognitive functions and the quality of life, as well as to a decrease in the degree of psychoemotional disorders in patients after ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone by the type of spasticity. This is confirmed by the increase in the total indicator of the MoCA scale to 26,5±0,5 points, which corresponds to the reference values. In the patients of the control group, less pronounced results were obtained; the total indicator of the MoCA scale was 25,0±1,0 points, which is lower than normal; similar dynamics was observed when studying the data of the Hospital Anxiety and Depression Scale (HADS) and the EQ-5D questionnaire, which indicated the quality of life improvement. Conclusion. The inclusion of gait training on a biofeedback system (BFB) «C-Mill» by the method of «imposing» in medical rehabilitation of patients after ischemic stroke with motor impairments in the form of hemiparesis with increased muscle tone contributes to a significant improvement in cognitive functions, a decrease in the level of anxiety and depression and improved quality of life.