Saratov JOURNAL of Medical and Scientific Research

Amosova N.A.

State Scientific Research Center n.a. A. I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency, Chief Neurologist, Deputy of Chief doctor of the medical work, Candidate of Medical Sciences

Using of virtual reality technology in acute cerebral stroke and their influense on post-stroke affective disorders

Year: 2014, volume 10 Issue: №4 Pages: 824-827
Heading: Neurology Article type: Original article
Authors: Maslyuk О.А., Smolentseva I.G., Amosova N.A., Shevchenko N.S., Milagina V.S.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim. The study of virtual reality technology in the rehabilitation of patients with cerebral stroke and influence on post stroke affective disorder. Materials and methods. The study included 88 patients with ischemic stroke: 59 men (67%) and 29 women (33%). The average age of the patients was 62,05 ± 11,74 years. In the study group included 46 patients, 44 patients in the control group. The groups were matched by age, time from the begin of disease, severity of disease, the severity of motor, affective and cognitive impairments. In addition, in the study group to the program of early rehabilitation to use individual training with virtual reality technology (BTS NIRVANA). The duration of the training was 21 days, 3 times a week for 40 minutes. Results. On the background of rehabilitation in the study group patients had a significant reduced of neurological deficit (p

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Hospital registry in special department for patients with acute cerebrovascular disease

Year: 2014, volume 10 Issue: №4 Pages: 819-823
Heading: cardiac surgery Article type: Original article
Authors: Maslyuk О.А., Smolentseva I.G., Amosova N.A., Krivonos O.V., Shevchenko N.S., Milagina V.S.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: organization and follow-up of a registry of patients with cerebrovascular disease in in special department. Materials and methods. In the period from January 2011 to December 2013 all cases of cerebrovascular disease in the special department were recorded. Each patient had an electronic case book and thematic record, developed on the basis of the materials of the National Stoke Association of "Registry of stroke." Results. 418 cases of cerebral stroke were registered. Male to female ratio was 3.7: 1. Patients with initial diagnosed cerebral stroke were 78%, secondary 22%. The average age of patients was 63. The big number of strokes was observed in men aged 56-57 years; in women aged 75-77 years. TOAST criteria for subtypes of ischemic stroke were distributed to: atherothrombotic (29,3%), cardioembolic (29,1 %), 22,4% lacunar ischemic stroke due to other established reasons (8,8%), crptogenic (10,4%). Hemorrhagic stroke was observed in 16.8% of cases. Parenchymal hemorrhage was observed in 10.7% of cases, nontraumatic subarachnoid hemorrhage (4,5%). Among the risk factors in patients with ischemic stroke identified: arterial hypertension (88,9%), coronary heart disease (43%), heart rhythm disorders (28,4%), diabetes (18,6%). The proportion of endovascular interventions performed for 3 years was 31.2%. Mortality rate was 3.74% (10 people) in 2011; 4.65% (14 people) in 2012; 2.48% (7 people) in 2013. Conclusion. Follow up the hospital stroke registry allowed to estimate the structure andcourse of cerebral stroke, found the risk factors to identify the most important factors of death.

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Organization of medical rehabilitation in Parkinson's disease in a specialized clinical diagnostic room

Year: 2013, volume 9 Issue: №4 Pages: 927-931
Heading: rehabilitative medicine Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Gubaydullina R.F.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aimed to create an organizational model of medical rehabilitation of patients with Parkinson's disease (PD). Material and methods. In medical institutions of Closed Administrative-Territorial Units of Russia (Seversk, Za-rechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk) in clinical and diagnostic rooms for providing care to patients with movement disorders there was created an organizational model of medical rehabilitation. Results. The organizational model of medical rehabilitation allowed to cover 100% of all PD patients. The main phases in the model were diagnosis and follow up care on the base of specialized clinical and diagnostic room, creating and performance of individual rehabilitation program with recreation therapist, educational sessions for patients and their relatives, evaluation effectiveness of rehabilitation measures, condition monitoring, assessment of antiparkinsonian therapy. Effectiveness of the rehabilitation in inpatient and outpatient settings was comparable. Conclusion. Creation and implementation of the organizational model of medical rehabilitation was possible only in specialized clinical and diagnostic rooms for diagnosis and treatment of movement disorders. There were introduction of the phasing and basic directions rehabilitation program for PD patients have been worked.

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Rehabilitation of walking disorders with a freezing in patients Parkinson disease: methods of outpatient correction

Year: 2013, volume 9 Issue: №4 Pages: 923-927
Heading: rehabilitative medicine Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Gubaydullina R.F., Karpova О.V., Chupina L. P.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aimed the effectiveness of rehabilitation approaches for patients with Parkinson disease with a freezing at an outpatient condition. Material and methods. The study included 26 patients with Parkinson disease (14 men and 12 women), average age was 54.1± 9.5 years, average disease duration — 7.8± 3.1 years, the stage of the disease by Hoehn and Yahr scale — 3, 1±0.8. The control group included 15 patients with Parkinson disease (9 men and 6 women), matched in age, duration and severity. All patients have got a stable antiparkinsonian therapy before and during the study. The experiment had been performed for 6 months. The rehabilitation program consisted of 10 sessions. In rehabilitation program there had been used a sensor treadmill and Nordic walking. Patients had been kept training the Nordic walking at home through the course of the study. The results show the effectiveness of rehabilitation for reducing the severity of a freezing, increasing the speed of walking, the increased of the length step, decreased the time for turning compared to the control group. The effect had been supported by home rehabilitation training for 3 and 6 months after the study. Besides, patients from the main group did not need the change of the antiparkinsonian therapy after the study comparing with the control group.

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Преимущества организации длительной когнитивной реабилитации при болезни Паркинсона в специализированном клинико-диагностическом кабинете

Year: 2013, volume 9 Issue: №4 Pages: 917-922
Heading: rehabilitative medicine Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Karpova O.V.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aimed: to evaluate the advantages of the long-term of cognitive rehabilitation on the evidence of cognitive and affective disorders in Parkinson disease in a specialized clinical diagnostic room. Material and methods. The study included 37 patients with Parkinson disease (PD) — the study group, who had the long-term cognitive rehabilitation on the background of a standard drug therapy, and 28 patients in the control group, who had received only standard drug therapy. Assessment of cognitive function was carried out by neurologists, who had a course of thematic advanced training in the diagnosis and treatment of patients with extrapyramidal disorders, and who are working in a specialized clinical diagnostic room for patients with movement disorders. Results. Our results show the effectiveness of the long-term cognitive rehabilitation of Parkinson disease in specialized clinical diagnostic rooms. Whether the optimal duration and frequency of trainings, the duration of the course of the rehabilitation program remains unclear.

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Epidemiological monitoring the of Parkinson's disease morbidity

Year: 2013, volume 9 Issue: №4 Pages: 873-877
Heading: Neurology Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: the analysis of epidemiological monitoring of Parkinson's disease. Material and Methods. We conducted the full-design population study in the six closed administrative-territorial unit (Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk) with an adult's population about 450000 in the period from 2009 to 2012. For collecting information was developed the register of PD. Results. 588 patients with PD were revealed and enrolled, including 302 patients, who were revealed in the first. Primary morbidity was 11.0 per 100000 population in 2009, and in 2010 and 2011 it was 25.7 and 22.7 per 100000 population respectively. By the beginning of 2012 was so-called "dredging" of patients from population (revealing of all patients, who were not revealed earlier) and was 8.5 per 100000. Total morbidity for 4 years of observation increased: so in 2009 it was 33.1 per 100000, in 2010-92.5 per 100000, in 2011-114,2 per 100000, and in 2013-118,7 per 100000, the same like international data. The Evolution of sex and age structure according to the Register's data showed: 1) peak of morbidity at age 70-74 years, with the decay over 85 years; 2) morbidity was higher in men aged 70-74 years and older. Conclusion. Implementation of the Register of PD's patients annually allowed to monitoring of the morbidity and statistically significant show the basic epidemiological evidence and undertake federal and sampling comparative studies, it is necessary for evaluation of the changes of Parkinson's disease status, which can't be done on the basis of the state statistical dates.

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Principles of dispensary observation of patients with Parkinson's disease in a specialized clinical diagnostic room

Year: 2013, volume 9 Issue: №4 Pages: 869-873
Heading: Neurology Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Chupina L.P.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: to develop and implement of the order of the dispensary observation of Parkinson's disease patients. Material and methods, the dispensary observation of Parkinson's disease patients had been performed by neurologist and diagnostic room (CDR) based on the outpatient department of health care institutions obeyed by FMBA of Russia in six Closed Administrative-Territorial Units: Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk. Neurologist examined of patients and put data to the Register's database. Register's database had 588 Parkinson's disease examined patients, 112 of them (19,1%) had stage II of the disease by Hoehn and Yahr, 231 (39,3%) patients — stage III by Hoehn and Yahr, 187 (31,8%) patients — stage IV byHoehn and Yahr, 58 (9,9%) patients — stage V by Hoehn and Yahr. The duration of the dispensary observation of Parkinson's disease patients was 4 years (2009-2012). Results. There are and implement the order of the observed and accounting of adult's group of Parkinson's disease patients were developed, who are registered in the clinical and diagnostic rooms, including the frequency of physician's visits, the list of diagnostic and treatment activities and efficiency endpoint of the dispensary observation. Conclusion. Implementation of the order of the dispensary observation according to the Register allowed to identify the main disabling PD's symptoms (depression, dementia, motor fluctuations and dyskinesia) and timely correction of therapy.

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