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340 results of 26 texts with exact phrase : 'rehabilitation'.

1. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 1, 2005, No. 2 , , ,

Paolucci S, Silvestri G, Lubich S, et al.. Poststroke late seizures and their role in rehabilitation of inpatients.
Paolucci S, Silvestri G, Lubich S, et al.. Poststroke late seizures and their role in rehabilitation of inpatients.
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Department of Kinesitherapy and Rehabilitation,
Department of Kinesitherapy and Rehabilitation,
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Handbook of Physical Medicine and Rehabilitation.
Valbon C. Bоdily responses to immobilization. In: Krusen G, Valbon C. Handbook of Physical Medicine and Rehabilitation. WB Sаunders, Philadelphia, 1982, 963-975.
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Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
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German Society of Neuroradiology German Society for Neurological Rehabilitation
German Society of Neuroradiology German Society for Neurological Rehabilitation
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Advisory Board Member of Neurologie und Rehabilitation, Bonn
Advisory Board Member of Neurologie und Rehabilitation, Bonn
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2. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 1 , , ,

Brain Research and Rehabilitation Center “Neuron” – Kuopio, Finland
Brain Research and Rehabilitation Center “Neuron” – Kuopio, Finland
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Here I wish to give one example of how a neuroimaging study of a new stroke rehabilitation method may give hard data on the effects of rehabilitation [1].
habilitation methods have gained plenty of interest and produced promising results in selected research patients with stroke. Here I wish to give one example of how a neuroimaging study of a new stroke rehabilitation method may give hard data on the effects of rehabilitation [1].
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This two-week long intensive rehabilitation program was given to chronic stroke patients (mean time since the onset of stroke 36 months).
Hemiparesis is well known to be the most common deficit after cerebral stroke. Constraintinduced movement therapy is a new structured neurorehabilitation method that emphasizes taskrelevant repetitive training for the affected hemiparetic hand. This two-week long intensive rehabilitation program was given to chronic stroke patients (mean time since the onset of stroke 36 months). These twelve chronic stroke patients were studied with single-photon emission computerized tomography at rest before and after the two-week rehabilitation period. Increased perfusion was found in motor control related areas after the program. For analysis, data of those patients whose affected hemisphere was the left one, were mirrored. After mirroring, all lesions were in the same hemisphere and they could be realigned into the same position and analyzed. The specific areas with an increase in perfusion in the affected hemisphere were in the precentral gyrus, premotor cortex (Brodmann’s area 6 (BA6), frontal cortex, and superior frontal gyrus (BA10).
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These twelve chronic stroke patients were studied with single-photon emission computerized tomography at rest before and after the two-week rehabilitation period.
Hemiparesis is well known to be the most common deficit after cerebral stroke. Constraintinduced movement therapy is a new structured neurorehabilitation method that emphasizes taskrelevant repetitive training for the affected hemiparetic hand. This two-week long intensive rehabilitation program was given to chronic stroke patients (mean time since the onset of stroke 36 months). These twelve chronic stroke patients were studied with single-photon emission computerized tomography at rest before and after the two-week rehabilitation period. Increased perfusion was found in motor control related areas after the program. For analysis, data of those patients whose affected hemisphere was the left one, were mirrored. After mirroring, all lesions were in the same hemisphere and they could be realigned into the same position and analyzed. The specific areas with an increase in perfusion in the affected hemisphere were in the precentral gyrus, premotor cortex (Brodmann’s area 6 (BA6), frontal cortex, and superior frontal gyrus (BA10). In the nonaffected hemisphere, perfusion was increased in the superior frontal gyrus (BA6) and cingulate gyrus (BA31).
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Brain Research and Rehabilitation Center “Neuron” Kortejoki, FIN-71130 Kuopio
Brain Research and Rehabilitation Center “Neuron” Kortejoki, FIN-71130 Kuopio
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Rehabilitation Center Neuron,
Rehabilitation Center Neuron,
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Brain Research and Rehabilitation
Brain Research and Rehabilitation
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3. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 2 , , ,

Department of Kinesitherapy and Rehabilitation, National Sports Academy “V.
Department of Kinesitherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia
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Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
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4. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 1 , , ,

Department of Kinesitherapy and Rehabilitation,
Department of Kinesitherapy and Rehabilitation,
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Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
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The final outcome has been shown to be determined within a limited time window during the acute phase of brain injury if recovery is seen early after stroke onset, better outcomes may be expected six months later although motor recovery may continue over a period of years in some individuals with appropriate rehabilitation.
(3) compensatory strategy (behavioral substitution, i.e. patients learn to compensate for their deficit). At present, there are strong indications that all these mechanisms are potentially involved in the process of recovery after brain injury, however, the ability of human adult brain to reorganize itself remains more or less restricted. Irrespective of the type and the amount of applied therapy certain biological processes, characterized as “spontaneous neurological recovery”, are supposedly responsible for the final functional outcome after stroke. The final outcome has been shown to be determined within a limited time window during the acute phase of brain injury if recovery is seen early after stroke onset, better outcomes may be expected six months later although motor recovery may continue over a period of years in some individuals with appropriate rehabilitation. The present review summarizes the recent theories and hypotheses for brain reorganization of motor control after unilateral stroke.
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Selection criteria for rehabilitation services.
Wade DT. Selection criteria for rehabilitation services.
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5. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 2 , , ,

Brain Research and Rehabilitation Center “Neuron”, Kuopio, Finland
Brain Research and Rehabilitation Center “Neuron”, Kuopio, Finland
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Prof. Juhani Sivenius, MD Brain Research and Department of Neurology Rehabilitation Center “Neuron” Kuopio University Hospital 71130 Kuopio
Prof. Juhani Sivenius, MD Brain Research and Department of Neurology Rehabilitation Center “Neuron” Kuopio University Hospital 71130 Kuopio
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Neurologische rehabilitation
Neurologische rehabilitation
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6. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 2 , , ,

Rehabilitation Medicine
Rehabilitation Medicine
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7. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1 , , ,

Effects of early treatment of poststroke depression on neuropsychological rehabilitation.
Gonzales-Torrecialis JL, Mendlewicz J, Lobo A. Effects of early treatment of poststroke depression on neuropsychological rehabilitation.
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Poststroke and clinically-defined vascular depression in geriatric rehabilitation patients.
Mast BT, MacNeill SE, Lichtenberg PA. Poststroke and clinically-defined vascular depression in geriatric rehabilitation patients.
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Clinical rehabilitation
Clinical rehabilitation
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Managing depression in brain injuri rehabilitation: the use of an integrated care pathway and preliminary report of response to sertraline.
Turner – Stokes L., Hassan N., Pierce K., Clegg F. Managing depression in brain injuri rehabilitation: the use of an integrated care pathway and preliminary report of response to sertraline.
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Clinical rehabilitation
Clinical rehabilitation
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Boltkman Institute for Neurorehabilitation in Wien, proved the possibility to use the kinetic synergias for the movement rehabilitation of postictal hemipareses (1984-1988).
Austrian common project, completed together with primarius O. Rathkolb at L. Boltkman Institute for Neurorehabilitation in Wien, proved the possibility to use the kinetic synergias for the movement rehabilitation of postictal hemipareses (1984-1988).
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5th World Congress of the International Society of Physical & Rehabilitation Medicine
5th World Congress of the International Society of Physical & Rehabilitation Medicine
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8. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 1 , , ,

Regarding the rehabilitation of the patients af-
Regarding the rehabilitation of the patients af-
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Current European Stroke Organization (ESO) guidelines for management of ischemic stroke prevention, treatment and rehabilitation 2008 are also accepted in Bulgaria [24].
32, 64]. Current European Stroke Organization (ESO) guidelines for management of ischemic stroke prevention, treatment and rehabilitation 2008 are also accepted in Bulgaria [24].
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(rehabilitation stroke unit)
(rehabilitation stroke unit)
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Even within the acute phase, rehabilitation is initiated to be followed by seamless further treatment and neurorehabilitation outside the SU [11-14].
based recommendations and prespecified criteria for available resources [11-14, 27, 35, 61]. The location for such a unit in Austria follows a maximum of 90-min isochrones (transport time) to the hospital. In such a unit, a rapid diagnosis is made, confirmed by neuroimaging, followed by early treatment and minimizing residual disability. In addition, prevention, early recognition as well as treatment of complications arising from the stroke are an important domain of SUs. Even within the acute phase, rehabilitation is initiated to be followed by seamless further treatment and neurorehabilitation outside the SU [11-14]. In the SUs it is essential to watch out for: cardiac arrhythmia, dehydration/ fluid overload, electrolyte disturbances, systemic diseases, metabolic management, BP control, intracranial pressure, aspiration pneumonia, body temperature, progression of symptoms. Monitoring for complications such as, secondary haemorrhage, space-occupying oedema, seizures, infections, decubital ulcers, deep venous thrombosis, pulmonary embolism, etc. is made.
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(comprehensive care stroke unit) – takes patients that have been treated in the emergency department in the first days and starts detailed work-up, secondary prevention and rehabilitation – mean stay about 2-3 weeks;
(comprehensive care stroke unit) – takes patients that have been treated in the emergency department in the first days and starts detailed work-up, secondary prevention and rehabilitation – mean stay about 2-3 weeks;
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Rehabilitation SU –
Rehabilitation SU –
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takes the patients from the department or hospital which performs the acute treatment and focuses on rehabilitation and further management.
takes the patients from the department or hospital which performs the acute treatment and focuses on rehabilitation and further management. Mean stay there is up to several weeks [11-14, 35, 61].
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Early rehabilitation
Early rehabilitation
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Depressive symptoms and history of depression predict rehabilitation efficiency in stroke patients.
Gillen R, Tennen H, McKee TE, Gernert-Dott P, Affleck G. Depressive symptoms and history of depression predict rehabilitation efficiency in stroke patients.
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9. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 2 , , ,

Poststroke depression and its role in rehabilitation of inpatients.
Paolucci S, Antonucci G, Pratesi L, Traballesi M, Grasso MG, Lubich S. Poststroke depression and its role in rehabilitation of inpatients.
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10. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 1 , , ,

American Academy of Physical Medicine and Rehabilitation (AAPM&R) Annual Assembly
American Academy of Physical Medicine and Rehabilitation (AAPM&R) Annual Assembly
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The efficacy of fMRI follow-up of neuronal activity changes in continuous speech rehabilitation has been shown [31, 55].
The efficacy of fMRI follow-up of neuronal activity changes in continuous speech rehabilitation has been shown [31, 55].
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This direction is expected to contribute to the perfection of diagnostics and rehabilitation of speech disorders.
A new experimental direction for modeling of normal, deviant or pathological word and speech production through the creation of artificial neural networks grants novel options for evaluating theories and for solving specific tasks. This direction is expected to contribute to the perfection of diagnostics and rehabilitation of speech disorders.
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11. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 2 , , ,

Topics in stroke rehabilitation
Topics in stroke rehabilitation
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American Academy of Physical Medicine and Rehabilitation (AAPM&R) Annual Assembly
American Academy of Physical Medicine and Rehabilitation (AAPM&R) Annual Assembly
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12. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 8, 2012, No. 1 , , ,

Repetitive TMS is used for treatment and rehabilitation of central pareses [1].
Repetitive TMS is used for treatment and rehabilitation of central pareses [1]. After stroke motor cortex excitability of the damage side is lowered and raised in contralateral hemisphere. TMS is applied to modulate cortical excitability and influence impaired motor function [26]. Application of high-frequency rTMS (10Hz) on motor cortex of the affected hemisphere, combined with therapeutic techniques for treatment of praxis, has resulted in a statistically significant influence on accuracy and speed of movement
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The use of rTMS in the treatment and rehabilitation of stroke patients opens future perspectives for inducing plastic changes in cerebral cortex [4].
in the affected muscle [26]. The authors underline the safety and effectiveness of the method in raising corticomotor excitability and motor skills of patients. In a small group of patients with motor aphasia and incident duration 5-11 years, the low frequency rTMS (1Hz) applied on the right gyrus Broca has led to significant improvement of symptoms (picture naming), with 2 to 8 months lasting effect [38]. Different methods are applied to stimulate the contralateral of impairment cortex leading to significant improvement in paretic leg movements. The use of rTMS in the treatment and rehabilitation of stroke patients opens future perspectives for inducing plastic changes in cerebral cortex [4].
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Together with other neuroimaging techniques, it helps for a more detailed study of these processes and tracks the results of the therapy and rehabilitation.
In recent decades it has been shown that the adult human brain has some capacity for plastic reorganization and functional recovery after injury. TMS is one of modern methods for noninvasive somatotopic cortical localization of motor functions and study of the functional reorganization of affected motor areas. Together with other neuroimaging techniques, it helps for a more detailed study of these processes and tracks the results of the therapy and rehabilitation. The future of TMS is to modify and streamline
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the process of brain reorganization and control the development of complex rehabilitation programs.
the process of brain reorganization and control the development of complex rehabilitation programs.
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They refer to the role of cognitive and behavioral disorders in the process of recovery, treatment of speech impairments and dysphagia, use of ortheses and aids in Neurorehabilitation, management of medical complications and new therapeutic approaches for stimulation of rehabilitation processes.
This summary covers the main directions of contemporary Neurorehabilitation included in the World Federation of Neurology Program of continuous postgraduate education in 2011. They refer to the role of cognitive and behavioral disorders in the process of recovery, treatment of speech impairments and dysphagia, use of ortheses and aids in Neurorehabilitation, management of medical complications and new therapeutic approaches for stimulation of rehabilitation processes.
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Cognitive disorders, behavioral and emotional changes arising directly or as a result of injury may hamper rehabilitation and brain recovery [9].
Cognitive disorders, behavioral and emotional changes arising directly or as a result of injury may hamper rehabilitation and brain recovery [9]. Impairments of concentration of attention and memory and occurrence of depression limit patient’s independence and have an adverse effect on his rehabilitation if not diagnosed and treated properly [31]. Selective inhibitors of serotonin, mirtazapine and tetracyclic antidepressants are used to treat depression in combination with psychotherapy [19]. In cases of frontal lobe syndromes beta blockers, dopamine agonists, more recent atypical antipsychotics and stimulating techniques are used [12]. In children and young people with diffuse brain injuries and increased risk of psychiatric complications and slow cognitive development, drug treatment is supported by adapted educational programs.
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Impairments of concentration of attention and memory and occurrence of depression limit patient’s independence and have an adverse effect on his rehabilitation if not diagnosed and treated properly [31].
Cognitive disorders, behavioral and emotional changes arising directly or as a result of injury may hamper rehabilitation and brain recovery [9]. Impairments of concentration of attention and memory and occurrence of depression limit patient’s independence and have an adverse effect on his rehabilitation if not diagnosed and treated properly [31]. Selective inhibitors of serotonin, mirtazapine and tetracyclic antidepressants are used to treat depression in combination with psychotherapy [19]. In cases of frontal lobe syndromes beta blockers, dopamine agonists, more recent atypical antipsychotics and stimulating techniques are used [12]. In children and young people with diffuse brain injuries and increased risk of psychiatric complications and slow cognitive development, drug treatment is supported by adapted educational programs.
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The rehabilitation team manager is a guarantor for the right solution of patient’s problems
The rehabilitation team manager is a guarantor for the right solution of patient’s problems
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Modern neuroimaging technologies allow monitoring of neurophysiologic changes and expand the knowledge about the factors affecting the rehabilitation processes [4].
combined with a therapy program. Dopaminergic and acetylcholinesterase inhibitors improve memory. Benzodiazepines and antipsychotics appear to slow recovery after traumatic brain injury and stroke. Modern neuroimaging technologies allow monitoring of neurophysiologic changes and expand the knowledge about the factors affecting the rehabilitation processes [4].
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There are some specific characteristics of the rehabilitation techniques according to the type and location of injury.
There are some specific characteristics of the rehabilitation techniques according to the type and location of injury.
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The goal of stroke rehabilitation is to ensure that each person reaches the maximal physical, functional, and psychosocial recovery possible within the limits of his impairment [30, 42].
The goal of stroke rehabilitation is to ensure that each person reaches the maximal physical, functional, and psychosocial recovery possible within the limits of his impairment [30, 42]. Most specific deficits (motor, sensory, language) recover at great degree during the first 3 to 6 months after stroke. Probably the most important recovery is the ability to restore self-care activities and mobility. Ideally, stroke rehabilitation should begin within the first 24 hours of stroke, if possible – in a stroke unit [40]. Intensive comprehensive rehabilitation is more useful than lessintense programs [2]. Daily rehabilitation procedures have a better effect than the same number of procedures performed for a longer period of time [45].
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Ideally, stroke rehabilitation should begin within the first 24 hours of stroke, if possible – in a stroke unit [40].
The goal of stroke rehabilitation is to ensure that each person reaches the maximal physical, functional, and psychosocial recovery possible within the limits of his impairment [30, 42]. Most specific deficits (motor, sensory, language) recover at great degree during the first 3 to 6 months after stroke. Probably the most important recovery is the ability to restore self-care activities and mobility. Ideally, stroke rehabilitation should begin within the first 24 hours of stroke, if possible – in a stroke unit [40]. Intensive comprehensive rehabilitation is more useful than lessintense programs [2]. Daily rehabilitation procedures have a better effect than the same number of procedures performed for a longer period of time [45]. Neuroimaging and neurophysiologic methods (functional magnetic resonance imaging and transcranial magnetic stimulation) reveal changes in the motor cortex in response to physical exercises. Recent concepts offer an intensive therapy with motor tasks associated with more functional skills. The degree of impairment of the corticospinal tract is a prognostic factor [5].
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Intensive comprehensive rehabilitation is more useful than lessintense programs [2].
The goal of stroke rehabilitation is to ensure that each person reaches the maximal physical, functional, and psychosocial recovery possible within the limits of his impairment [30, 42]. Most specific deficits (motor, sensory, language) recover at great degree during the first 3 to 6 months after stroke. Probably the most important recovery is the ability to restore self-care activities and mobility. Ideally, stroke rehabilitation should begin within the first 24 hours of stroke, if possible – in a stroke unit [40]. Intensive comprehensive rehabilitation is more useful than lessintense programs [2]. Daily rehabilitation procedures have a better effect than the same number of procedures performed for a longer period of time [45]. Neuroimaging and neurophysiologic methods (functional magnetic resonance imaging and transcranial magnetic stimulation) reveal changes in the motor cortex in response to physical exercises. Recent concepts offer an intensive therapy with motor tasks associated with more functional skills. The degree of impairment of the corticospinal tract is a prognostic factor [5]. Various aids are used: canes, walkers, ortheses, etc.
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Daily rehabilitation procedures have a better effect than the same number of procedures performed for a longer period of time [45].
The goal of stroke rehabilitation is to ensure that each person reaches the maximal physical, functional, and psychosocial recovery possible within the limits of his impairment [30, 42]. Most specific deficits (motor, sensory, language) recover at great degree during the first 3 to 6 months after stroke. Probably the most important recovery is the ability to restore self-care activities and mobility. Ideally, stroke rehabilitation should begin within the first 24 hours of stroke, if possible – in a stroke unit [40]. Intensive comprehensive rehabilitation is more useful than lessintense programs [2]. Daily rehabilitation procedures have a better effect than the same number of procedures performed for a longer period of time [45]. Neuroimaging and neurophysiologic methods (functional magnetic resonance imaging and transcranial magnetic stimulation) reveal changes in the motor cortex in response to physical exercises. Recent concepts offer an intensive therapy with motor tasks associated with more functional skills. The degree of impairment of the corticospinal tract is a prognostic factor [5]. Various aids are used: canes, walkers, ortheses, etc. The medical team responsible for patients’ condition in the course of rehabilitation watches for occurrence of potential complications and solves problems that may delay the rehabilitation process (dysphagia, incontinency, shoulder pains, spasticity, falls and post-stoke depres-
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The medical team responsible for patients’ condition in the course of rehabilitation watches for occurrence of potential complications and solves problems that may delay the rehabilitation process (dysphagia, incontinency, shoulder pains, spasticity, falls and post-stoke depres-
Daily rehabilitation procedures have a better effect than the same number of procedures performed for a longer period of time [45]. Neuroimaging and neurophysiologic methods (functional magnetic resonance imaging and transcranial magnetic stimulation) reveal changes in the motor cortex in response to physical exercises. Recent concepts offer an intensive therapy with motor tasks associated with more functional skills. The degree of impairment of the corticospinal tract is a prognostic factor [5]. Various aids are used: canes, walkers, ortheses, etc. The medical team responsible for patients’ condition in the course of rehabilitation watches for occurrence of potential complications and solves problems that may delay the rehabilitation process (dysphagia, incontinency, shoulder pains, spasticity, falls and post-stoke depres-
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Social reintegration including driving and speech rehabilitation is applied for suitable patients.
sion). An important role is played by patient’s relatives who undergo training to assist and help patient’s daily activities. The choice of a wheelchair for a patient with hemiplegia is specific – it has to be lower than a standard wheelchair. Social reintegration including driving and speech rehabilitation is applied for suitable patients. The concomitant disorders (hypertonic disease, diabetes, cardiovascular diseases) are monitored and deep vein thromboses prevented [7, 12].
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Even though the sequence of recovery after TBI follows a certain model, it is a heterogeneous disorder and rehabilitation programs must be adapted to patient’s individual needs – change of environment, training of relatives.
Treatment is directed towards reduction of complications following traumatic brain injury (TBI). The recovery prognosis correlates with the duration of posttraumatic amnesia [43]. Cognitive and behavioral changes and disorders of executive functions are common in traumatic injuries of the frontal lobe [37], which may cause mental retardation in children. Impaired social functions of patients worsen the long-term family relations. Cognitive and behavioral deficits prevent returning to school or work environment. Even though the sequence of recovery after TBI follows a certain model, it is a heterogeneous disorder and rehabilitation programs must be adapted to patient’s individual needs – change of environment, training of relatives. Pharmacotherapy plays a considerable role in long-term prognosis in traumatic and vascular brain injuries [10].
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Rehabilitation treatment and interdisciplinary approach may improve the condition of patients with progressive neurologic disorders such as multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis, muscular dystrophy and neuropathy.
Rehabilitation treatment and interdisciplinary approach may improve the condition of patients with progressive neurologic disorders such as multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis, muscular dystrophy and neuropathy. The choice of a wheelchair is crucial in progressive neurologic disorders [1].
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A systematic review of the effectiveness of treadmill training and body weight support in pediatric rehabilitation.
Damiano DL, DeJong SL. A systematic review of the effectiveness of treadmill training and body weight support in pediatric rehabilitation.
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What matters in cellular transplantation for spinal cord injury: the cells, the rehabilitation or the best mix?
Dobkin BH. What matters in cellular transplantation for spinal cord injury: the cells, the rehabilitation or the best mix?
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Effectiveness of an inpatient multidisciplinary rehabilitation program for people with Parkinson disease.
Ellis T, Katz Dl, White DK. Effectiveness of an inpatient multidisciplinary rehabilitation program for people with Parkinson disease.
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Traumatic brain injury: rehabilitation, treatment, and case management.
Gelber DA, Callahan CD. Neurologic examination of the patient with traumatic brain injury. In: Ashley MJ, editor. Traumatic brain injury: rehabilitation, treatment, and case management. 3rd ed. Boca Raton, FL, CRC Press, 2010, 3-27.
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Effectiveness of rehabilitation intervention in persons with multiple sclerosis: a randomised controlled trial.
Khan F, Pallant JF, Brand C, Kilpatrick TJ. Effectiveness of rehabilitation intervention in persons with multiple sclerosis: a randomised controlled trial.
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Cognitive and emotional consequences of TBI: intervention strategies for vocational rehabilitation.
Mateer CA, Sira CS. Cognitive and emotional consequences of TBI: intervention strategies for vocational rehabilitation.
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Aging with traumatic brain injury: cross-sectional follow-up of people receiving inpatient rehabilitation over more than 3 decades.
Sendroy-Terrill M, Whiteneck GG, Brooks CA. Aging with traumatic brain injury: cross-sectional follow-up of people receiving inpatient rehabilitation over more than 3 decades.
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Perspectives on poststroke sexual issues and rehabilitation needs.
Schmitz MA, Finkelstein M. Perspectives on poststroke sexual issues and rehabilitation needs.
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Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
Department of Kinesitherapy and Rehabilitation National Sports Academy “V. Levski”
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13. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2012, No. 2 , , ,

during rehabilitation or sports.
Even more, the position of needle electrodes for biopsy or injections of medications – e.g. botulinum toxins or local anesthetics opens new quality improvement for the treatment of patients. Using tissue velocity imaging (TVI) we are able to investigate the dynamics of movements in identified muscles. The US method provides advantage compared to EMG or MRI/CT, since the muscle motion could be better detected and quantified in terms of velocity and accelerations as well as synchronicity of muscle contraction. This will allow not only the monitoring of muscle tissue volume during processes of atrophy or after exercise, but also monitoring the effect of medicalor physiotherapies on movements e.g. during rehabilitation or sports.
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Myosonology has a good chance to be established in clinical practice and as a tool for scientific evaluation especially in rehabilitation medicine.
Myosonology has a good chance to be established in clinical practice and as a tool for scientific evaluation especially in rehabilitation medicine.
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Application of Real-Time Sonoelastography in Musculoskeletal Diseases Related to Physical Medicine and Rehabilitation.
Park GY, Kwon DR. Application of Real-Time Sonoelastography in Musculoskeletal Diseases Related to Physical Medicine and Rehabilitation.
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Rehabilitation Exercise Progression for the Gluteus Medius Muscle With Consideration for Iliopsoas Tendi-
Philippon MJ, Decker MJ, Giphart JE, Torry MR, Wahoff MS, Laprade RF. Rehabilitation Exercise Progression for the Gluteus Medius Muscle With Consideration for Iliopsoas Tendi-
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of Physical and Rehabilitation Medicine
of Physical and Rehabilitation Medicine
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14. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 1 , , ,

Prevalence and Correlates of Cognitive Impairment in Stroke Patients in a Rehabilitation Setting.
Saxena, S K. Prevalence and Correlates of Cognitive Impairment in Stroke Patients in a Rehabilitation Setting.
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Reducing the risks of cardiovascular diseases and their secondary prophylaxis (prevention of acute cardiovascular accidents and adequate rehabilitation of the patient after that) is a serious challenge for public healthcare.
987.7 per 100,000 persons, with slight preponderance of men (987.7 per 100,000 persons) over women (984.3 per 100,000 persons) [1]. The progressively increasing upward trend in cardiovascular and cerebrovascular diseases creates a serious risk for public health and increases the community expenses. Reducing the risks of cardiovascular diseases and their secondary prophylaxis (prevention of acute cardiovascular accidents and adequate rehabilitation of the patient after that) is a serious challenge for public healthcare. Coordinated effort in the framework of inpatient and outpatient care is necessary for the proper training and stimulation of patient’s improved, healthier lifestyle [10].
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A rehabilitation program for cardiac patients, both in hospital and at home, was first introduced in the United States in 1960 and was essentially aimed at regaining physical activity [16].
A rehabilitation program for cardiac patients, both in hospital and at home, was first introduced in the United States in 1960 and was essentially aimed at regaining physical activity [16]. With the advance of evidence-based medicine, patient rehabilitation has grown as a concept and now it includes risk assessment and modification of RFs through adequate communication of healthcare professionals [6]. Research shows that the complex approach – physical activity, diet and eating regimen, influences more positively the clinical presentation and the recovery process than physical exercise alone. Clinical observations on patients with myocardial infarction, who have abided by a physical activity and dietician-prescribed food regimen, indicate a deceleration in the process of atherogenesis and reduced incidence of recurrent accidents and hospitalization [15, 17]. Despite the benefits of these interventions, general practitioners do not have enough time and appropriate skills to teach patients about healthy eating, weight control and an individual workout regime [2]. It would be significantly more effective to elaborate an algorithm of rehabilitation after acute myocardial infarction and indentify the nurse’s role as a key factor in patient consultation for modification of the risk factors.
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With the advance of evidence-based medicine, patient rehabilitation has grown as a concept and now it includes risk assessment and modification of RFs through adequate communication of healthcare professionals [6].
A rehabilitation program for cardiac patients, both in hospital and at home, was first introduced in the United States in 1960 and was essentially aimed at regaining physical activity [16]. With the advance of evidence-based medicine, patient rehabilitation has grown as a concept and now it includes risk assessment and modification of RFs through adequate communication of healthcare professionals [6]. Research shows that the complex approach – physical activity, diet and eating regimen, influences more positively the clinical presentation and the recovery process than physical exercise alone. Clinical observations on patients with myocardial infarction, who have abided by a physical activity and dietician-prescribed food regimen, indicate a deceleration in the process of atherogenesis and reduced incidence of recurrent accidents and hospitalization [15, 17]. Despite the benefits of these interventions, general practitioners do not have enough time and appropriate skills to teach patients about healthy eating, weight control and an individual workout regime [2]. It would be significantly more effective to elaborate an algorithm of rehabilitation after acute myocardial infarction and indentify the nurse’s role as a key factor in patient consultation for modification of the risk factors.
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It would be significantly more effective to elaborate an algorithm of rehabilitation after acute myocardial infarction and indentify the nurse’s role as a key factor in patient consultation for modification of the risk factors.
A rehabilitation program for cardiac patients, both in hospital and at home, was first introduced in the United States in 1960 and was essentially aimed at regaining physical activity [16]. With the advance of evidence-based medicine, patient rehabilitation has grown as a concept and now it includes risk assessment and modification of RFs through adequate communication of healthcare professionals [6]. Research shows that the complex approach – physical activity, diet and eating regimen, influences more positively the clinical presentation and the recovery process than physical exercise alone. Clinical observations on patients with myocardial infarction, who have abided by a physical activity and dietician-prescribed food regimen, indicate a deceleration in the process of atherogenesis and reduced incidence of recurrent accidents and hospitalization [15, 17]. Despite the benefits of these interventions, general practitioners do not have enough time and appropriate skills to teach patients about healthy eating, weight control and an individual workout regime [2]. It would be significantly more effective to elaborate an algorithm of rehabilitation after acute myocardial infarction and indentify the nurse’s role as a key factor in patient consultation for modification of the risk factors.
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Cardiac Rehabilitation Clinical Practice Guidelines Rockville, MD Agency for Health Care Policy and Research and the National Heart, Lung and Blood Institute, 1995, AHCPR, publication N0 96-0672.
Wenger NK, Froehlicher ES, Smith LK. Cardiac Rehabilitation Clinical Practice Guidelines Rockville, MD Agency for Health Care Policy and Research and the National Heart, Lung and Blood Institute, 1995, AHCPR, publication N0 96-0672.
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– Neurologist, Head of the Clinic “Functional Diagnostics of Nervous System” at the Military Medical Academy – Sofia, Acting Head of Department “Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health” at the Faculty of Medicine of Sofia University “St.
– Neurologist, Head of the Clinic “Functional Diagnostics of Nervous System” at the Military Medical Academy – Sofia, Acting Head of Department “Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health” at the Faculty of Medicine of Sofia University “St. Kliment Ohridski” and President of the Bulgarian Society of Neurosonology and Cerebral Hemodynamics.
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– Physiotherapist, Head of Clinic “Physiotherapy and Rehabilitation” at the Military Medical Academy – Sofia, Chief Physiotherapist of the Bulgarian Army and President of Bulgarian Society of Physiotherapy.
– Physiotherapist, Head of Clinic “Physiotherapy and Rehabilitation” at the Military Medical Academy – Sofia, Chief Physiotherapist of the Bulgarian Army and President of Bulgarian Society of Physiotherapy.
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Intensive Care Unit and Neurological Rehabilitation, Segeberger Kliniken, Bad Segeberg, Germany
Intensive Care Unit and Neurological Rehabilitation, Segeberger Kliniken, Bad Segeberg, Germany
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15. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 2 , , ,

We tested whether this method could be applicated to measure the forearm muscle motions in order to monitor rehabilitation therapies and pharmacological effects.
By means of ultrasound (US) methods structural and functional properties of the muscle tissue could be detected in patients in real time and non-invasively. Using tissue velocity imaging (TVI) we are able to investigate the dynamics of movements in identified muscles. We tested whether this method could be applicated to measure the forearm muscle motions in order to monitor rehabilitation therapies and pharmacological effects.
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After 2 weeks rehabilitation exercises these parameters improved in a wide range (up to normal) on both sides.
of 4.5 cm/s, respectively (mean values). In stroke patients, a significant reduction of these parameters are found on the lesion side (1.1 cm/s; 1.2 cm/s; 1.2/s). A significant decrease was also found on the contralateral healthy side (2.5 cm/s; 2.6 cm/s; 2.5/s) which is also significant different to healthy controls. After 2 weeks rehabilitation exercises these parameters improved in a wide range (up to normal) on both sides. L-Dopa (n=3 patients) improved substantially the parameters within 1 week.
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in stroke rehabilitation.
This US technique is a simple and bedside method which allows to analyze and quantify the movement kinetic of identified muscles. This allow to monitor disease progression and treatment effects and may be thereby an appropriate tool for clinical application e.g. in stroke rehabilitation.
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Department of Kinesitherapy and Rehabilitation, National Sports Academy Vassil Levski – Sofia, Bulgaria
Department of Kinesitherapy and Rehabilitation, National Sports Academy Vassil Levski – Sofia, Bulgaria
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Patients from EG after 10-day daily physical therapy continued with adapted program for home rehabilitation and requirements for it.
We used two exercise methods: specialized physical therapy methodology (SPTM) applied in the experimental group (EG) and usual physical therapy methodology applied in the control group (CG). SPTM was developed by us based on principles of motor control, motor learning and contemporary guidance to neurodevelopmental treatment (NDT). Patients from EG after 10-day daily physical therapy continued with adapted program for home rehabilitation and requirements for it.
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16. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 1 , , ,

World Congress of the lnternational Society of Physical and Rehabilitation Medicine
World Congress of the lnternational Society of Physical and Rehabilitation Medicine
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17. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 2 , , ,

Tasks for Post-Stroke Upper Extremity Rehabilitation
Tasks for Post-Stroke Upper Extremity Rehabilitation
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For the EAN Regional Teaching Course we have registered delegates from the fields of Neurology, Physical Medicine, Rehabilitation, Physiotherapy, students and graduates in training from 10 countries Bulgaria, Republic of Macedonia, Serbia, Russia, Moldova, Ukraine, Albania, Romania, Bosnia and Herzegovina, and Egypt.
For the EAN Regional Teaching Course we have registered delegates from the fields of Neurology, Physical Medicine, Rehabilitation, Physiotherapy, students and graduates in training from 10 countries Bulgaria, Republic of Macedonia, Serbia, Russia, Moldova, Ukraine, Albania, Romania, Bosnia and Herzegovina, and Egypt.
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with Movement Practice using Real Objects and Simulated Tasks for Post-Stroke Upper Extremity Rehabilitation.
with Movement Practice using Real Objects and Simulated Tasks for Post-Stroke Upper Extremity Rehabilitation.
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Attention Lounge – a New Concept of Neuropsychological Rehabilitation.
Attention Lounge – a New Concept of Neuropsychological Rehabilitation.
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Neurological Rehabilitation using FES – Potential Underlying Mechanisms.
Neurological Rehabilitation using FES – Potential Underlying Mechanisms.
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Cross-disciplinary research into the development, application and user perspectives of novel technologies (Functional Electrical Stimulation, Non-Invasive Brain Stimulation, Rehabilitation Robotics, Constraint induced Movement Therapy, and Movement Sensors) for upper limb and trunk neurorehabilitation.
Cross-disciplinary research into the development, application and user perspectives of novel technologies (Functional Electrical Stimulation, Non-Invasive Brain Stimulation, Rehabilitation Robotics, Constraint induced Movement Therapy, and Movement Sensors) for upper limb and trunk neurorehabilitation.
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Established global researcher and clinician network; led virtual European team on complex EU grant; organised outreach workshops; presented with Best Paper at the International Conference of Rehabilitation Robotics (ICORR) in Japan 09; ethics committee member; reviewer for: journals, (Rehabilitation Research and Development, Neurorehabilitation and Neural Repair, Presence and Physiotherapy); grants (BBSRC) and MS Society grant review panel; IEEE conferences; MRC Training Fellowship Applications; and contributed to the UK Intercollegiate Working Party for Stroke RCP Guidelines 2012.
Established global researcher and clinician network; led virtual European team on complex EU grant; organised outreach workshops; presented with Best Paper at the International Conference of Rehabilitation Robotics (ICORR) in Japan 09; ethics committee member; reviewer for: journals, (Rehabilitation Research and Development, Neurorehabilitation and Neural Repair, Presence and Physiotherapy); grants (BBSRC) and MS Society grant review panel; IEEE conferences; MRC Training Fellowship Applications; and contributed to the UK Intercollegiate Working Party for Stroke RCP Guidelines 2012. Steering Committee member for ICORR & International Industry Society for advanced rehabilitation technologies (IISART). EU Cost Action on Rehabilitation Robotics Fellow.
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Steering Committee member for ICORR & International Industry Society for advanced rehabilitation technologies (IISART).
Established global researcher and clinician network; led virtual European team on complex EU grant; organised outreach workshops; presented with Best Paper at the International Conference of Rehabilitation Robotics (ICORR) in Japan 09; ethics committee member; reviewer for: journals, (Rehabilitation Research and Development, Neurorehabilitation and Neural Repair, Presence and Physiotherapy); grants (BBSRC) and MS Society grant review panel; IEEE conferences; MRC Training Fellowship Applications; and contributed to the UK Intercollegiate Working Party for Stroke RCP Guidelines 2012. Steering Committee member for ICORR & International Industry Society for advanced rehabilitation technologies (IISART). EU Cost Action on Rehabilitation Robotics Fellow.
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EU Cost Action on Rehabilitation Robotics Fellow.
Established global researcher and clinician network; led virtual European team on complex EU grant; organised outreach workshops; presented with Best Paper at the International Conference of Rehabilitation Robotics (ICORR) in Japan 09; ethics committee member; reviewer for: journals, (Rehabilitation Research and Development, Neurorehabilitation and Neural Repair, Presence and Physiotherapy); grants (BBSRC) and MS Society grant review panel; IEEE conferences; MRC Training Fellowship Applications; and contributed to the UK Intercollegiate Working Party for Stroke RCP Guidelines 2012. Steering Committee member for ICORR & International Industry Society for advanced rehabilitation technologies (IISART). EU Cost Action on Rehabilitation Robotics Fellow.
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Dr. Tarkka received her PhD at the University of Jyväskylä 1986, did many years of neuroscience research in USA and Germany and then served as Director of Research at the Brain Research and Rehabilitation Center Neuron, Kuopio.
Dr. Tarkka received her PhD at the University of Jyväskylä 1986, did many years of neuroscience research in USA and Germany and then served as Director of Research at the Brain Research and Rehabilitation Center Neuron, Kuopio. She is Adjunct Professor in Cognitive Neuroscience and Researcher in the Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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He proved, first using rhesus monkeys, then on humans, that tying up of healthy half of the body in case of hemiplegia, “forces” the damaged part of the brain to faster rehabilitation [8, 9, 10].
that healthy regions of the brain can take over the functions of injured parts of the brain. This was the basis of his treatment for people who suffered vestibular damage. He patented an appliance which when connected to one’s tongue, stimulates receptors by vibrations in a frequency and amplitude in correlation with pixel analysis from the surroundings [5, 6, 7]. Edward Taub supported research and developed first real and applicable treatments for patients. He proved, first using rhesus monkeys, then on humans, that tying up of healthy half of the body in case of hemiplegia, “forces” the damaged part of the brain to faster rehabilitation [8, 9, 10]. Michael Merzenich is yet another neuroscientist who left his mark in the field of neuroplasticity. He designed software for in order to help people with learning difficulties [11, 12].
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Movement rehabilitation: when we learn complex movements, the brain firstly recognizes basic motoric movements, and divides them and stores them into a given model which is then remembered.
Movement rehabilitation: when we learn complex movements, the brain firstly recognizes basic motoric movements, and divides them and stores them into a given model which is then remembered. The same network of neurons will activate every time we observe, think, or make a certain movement, or hear sounds which remind us of that movement. If we focus on repetitive movements, it is important to understand the purpose of the movement. For example, for a patient practicing hand pronation, the movement itself is not the purpose; the purpose is for him to be able to open the door again. This way we can stimulate other neuronal circuits which can lead to execution of this
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Neurological rehabilitation must focus on expediency of the movement.
final goal. Neurological rehabilitation must focus on expediency of the movement. This makes familiarizing with patient’s habits before stroke very important. Most complex movements that we perform, we were first observing during childhood. It is helpful to repeat these movements during rehabilitation process. Ventral premotor cortex and base of parietal lobe are cortical areas belonging to mirror neuron system [18]. These areas have shown to be great neuroanatomical target areas for rehabilitation exercises.
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It is helpful to repeat these movements during rehabilitation process.
final goal. Neurological rehabilitation must focus on expediency of the movement. This makes familiarizing with patient’s habits before stroke very important. Most complex movements that we perform, we were first observing during childhood. It is helpful to repeat these movements during rehabilitation process. Ventral premotor cortex and base of parietal lobe are cortical areas belonging to mirror neuron system [18]. These areas have shown to be great neuroanatomical target areas for rehabilitation exercises. The goal is to reach their activation through any connected healthy part of the cortical network. The mirror neuron system will activate differently in every person, depending on individual’s level of practice of specific movement. For example, if a patient played a guitar and danced tango prior to stroke, the observation of these activities itself will strongly activate his mirror neurons, which leads to stimulation of larger network area and reconnection of large number of synapses.
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These areas have shown to be great neuroanatomical target areas for rehabilitation exercises.
Neurological rehabilitation must focus on expediency of the movement. This makes familiarizing with patient’s habits before stroke very important. Most complex movements that we perform, we were first observing during childhood. It is helpful to repeat these movements during rehabilitation process. Ventral premotor cortex and base of parietal lobe are cortical areas belonging to mirror neuron system [18]. These areas have shown to be great neuroanatomical target areas for rehabilitation exercises. The goal is to reach their activation through any connected healthy part of the cortical network. The mirror neuron system will activate differently in every person, depending on individual’s level of practice of specific movement. For example, if a patient played a guitar and danced tango prior to stroke, the observation of these activities itself will strongly activate his mirror neurons, which leads to stimulation of larger network area and reconnection of large number of synapses.
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It can be useful for predicting stroke risk [4], and after stroke it might help in assessing changes in motor organization with rehabilitation.
Looking at the performance of cerebral autoregulation in acute stroke can be very helpful if this allows adjusting the blood pressure, and investigations are ongoing on this topic [7, 14]. This adaptation can potentially reduce the risk of further ischemia when BP decreases or help preventing edema and hemorrhage when BP increases. The analysis of the cerebral evoked flow to cortical activation is important to evaluate the performance of the neurovascular coupling unit, both for neuronal and endothelial dysfunction, and also allows localizing some cortical functions, as in the laterality studies [10]. It can be useful for predicting stroke risk [4], and after stroke it might help in assessing changes in motor organization with rehabilitation. Functional brain imaging may assist in the selection of rehabilitation methods that best foster recovery [24].
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Functional brain imaging may assist in the selection of rehabilitation methods that best foster recovery [24].
Looking at the performance of cerebral autoregulation in acute stroke can be very helpful if this allows adjusting the blood pressure, and investigations are ongoing on this topic [7, 14]. This adaptation can potentially reduce the risk of further ischemia when BP decreases or help preventing edema and hemorrhage when BP increases. The analysis of the cerebral evoked flow to cortical activation is important to evaluate the performance of the neurovascular coupling unit, both for neuronal and endothelial dysfunction, and also allows localizing some cortical functions, as in the laterality studies [10]. It can be useful for predicting stroke risk [4], and after stroke it might help in assessing changes in motor organization with rehabilitation. Functional brain imaging may assist in the selection of rehabilitation methods that best foster recovery [24].
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Despite great advances in acute stroke therapy – mainly by thrombolysis which had generated the acute stroke management (stroke units) – most of the patients remained disabled and need rehabilitation.
Stroke is the leading cause of disability, and about 65% of stroke survivors experience longterm functional limitations. Despite great advances in acute stroke therapy – mainly by thrombolysis which had generated the acute stroke management (stroke units) – most of the patients remained disabled and need rehabilitation. Due to the international classification of functioning (ICF), the aim of the rehabilitation therapy is focused not only on functional recovery (which is often limited) but also to the reintegration of the patients in their former social life and work.
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Due to the international classification of functioning (ICF), the aim of the rehabilitation therapy is focused not only on functional recovery (which is often limited) but also to the reintegration of the patients in their former social life and work.
Stroke is the leading cause of disability, and about 65% of stroke survivors experience longterm functional limitations. Despite great advances in acute stroke therapy – mainly by thrombolysis which had generated the acute stroke management (stroke units) – most of the patients remained disabled and need rehabilitation. Due to the international classification of functioning (ICF), the aim of the rehabilitation therapy is focused not only on functional recovery (which is often limited) but also to the reintegration of the patients in their former social life and work.
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Each system has their own temporal development during the rehabilitation process (e.g.
After stroke, nearly all patients are affected in a complex manner: motoric dysfunctions, restriction of upper extremity functionality, broad ranges of neuropsychological deficits, communication and swallowing problems, post-stroke depression etc. Each system has their own temporal development during the rehabilitation process (e.g. degeneration of the pyramidal tract, recovery, neuroendocrinological adaption). Thus, it is not simple to focus therapeutic management only on one aspect of the dysfunction. At least, the risk for complications such as aspiration, cardiovascular problems, diabetic control, fall with fractures, frozen shoulder and others are very high.
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New insights in the effect of stroke lesions and therapeutic methods have changed traditional clinical rehabilitation and more evidence based therapies are provided.
New insights in the effect of stroke lesions and therapeutic methods have changed traditional clinical rehabilitation and more evidence based therapies are provided. The rehabilitation process is divided in regeneration, neuroplasticity and adaption. Learning and repetitive exercises are the most important aspect for the rehabilitation success. In addition, neuronal aggregates adjacent to a lesion in the brain areas may take over the function previously played by the damaged neurons. Such reorganization modifies the interhemispheric networking in organization of the cortices. This reorganization may be responsible for clinical recovery of motor performances and sensorimotor integration after a stroke.
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The rehabilitation process is divided in regeneration, neuroplasticity and adaption.
New insights in the effect of stroke lesions and therapeutic methods have changed traditional clinical rehabilitation and more evidence based therapies are provided. The rehabilitation process is divided in regeneration, neuroplasticity and adaption. Learning and repetitive exercises are the most important aspect for the rehabilitation success. In addition, neuronal aggregates adjacent to a lesion in the brain areas may take over the function previously played by the damaged neurons. Such reorganization modifies the interhemispheric networking in organization of the cortices. This reorganization may be responsible for clinical recovery of motor performances and sensorimotor integration after a stroke.
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Learning and repetitive exercises are the most important aspect for the rehabilitation success.
New insights in the effect of stroke lesions and therapeutic methods have changed traditional clinical rehabilitation and more evidence based therapies are provided. The rehabilitation process is divided in regeneration, neuroplasticity and adaption. Learning and repetitive exercises are the most important aspect for the rehabilitation success. In addition, neuronal aggregates adjacent to a lesion in the brain areas may take over the function previously played by the damaged neurons. Such reorganization modifies the interhemispheric networking in organization of the cortices. This reorganization may be responsible for clinical recovery of motor performances and sensorimotor integration after a stroke.
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Current methods in stroke clinical rehabilitation
Current methods in stroke clinical rehabilitation
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There is evidence to incorporate cardiorespiratory training involving walking within post-stroke rehabilitation program to improve speed, tolerance, and independence during walking.
The most used traditional therapeutic approaches are founded by Bobath which has failed in clinical trials to be more effective in comparison with unspecific approaches. Thus, the target agreements with patients in relation to ICF are improvement of physical fitness, balance and gait. Walking training improves walking capacity and self-care in different stages of stroke, but the training frequency should be high. However, the effects of training on death, dependence, and disability after stroke are unclear. There is evidence to incorporate cardiorespiratory training involving walking within post-stroke rehabilitation program to improve speed, tolerance, and independence during walking. For the treatment of pain coordination with physical and pharmacological therapies are recommended.
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The current review reveals that repetitive magnetic stimulation (rTMS) with or without conventional rehabilitation has positive effects on post-stroke aphasia.
One of the most devastating consequences of stroke is aphasia. Communication problems after stroke can severely impair the patient's quality of life and make even simple everyday tasks challenging. One challenge is to predict the language outcome for stroke patients with aphasia. The new therapeutic approaches are based on non invasive focal electrical stimulation. The current review reveals that repetitive magnetic stimulation (rTMS) with or without conventional rehabilitation has positive effects on post-stroke aphasia.
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It is mandatory to check all stroke patients for basic cognitive function before rehabilitation.
It is mandatory to check all stroke patients for basic cognitive function before rehabilitation. Memory or attentional deficits limit all rehabilitation processes. Thus the individual rehabilitation therapy design had to respect the neuropsychological test results.
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Memory or attentional deficits limit all rehabilitation processes.
It is mandatory to check all stroke patients for basic cognitive function before rehabilitation. Memory or attentional deficits limit all rehabilitation processes. Thus the individual rehabilitation therapy design had to respect the neuropsychological test results.
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Thus the individual rehabilitation therapy design had to respect the neuropsychological test results.
It is mandatory to check all stroke patients for basic cognitive function before rehabilitation. Memory or attentional deficits limit all rehabilitation processes. Thus the individual rehabilitation therapy design had to respect the neuropsychological test results.
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Here, re-entrainment of the 24 hour rhythm may improve also the cognitive performance and thereby the rehabilitation effect.
Patients with attention deficits often suffered on circadian rhythmic disorders with inversion of day-night. Here, re-entrainment of the 24 hour rhythm may improve also the cognitive performance and thereby the rehabilitation effect. We have developed a specific therapy package (Attention lounge) including intense light application for the regaining of circadian rhythmic activity.
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Repetitive transcranial magnetic stimulation (rTMS) was introduced as a therapeutic tool for improving the efficacy of rehabilitation for recovery after stroke.
In recent years, efforts have focused on investigating the neurophysiological changes that occur in the brain after stroke, and on developing novel strategies such as additional brain stimulation to enhance sensorimotor and cognitive recovery. Repetitive transcranial magnetic stimulation (rTMS) was introduced as a therapeutic tool for improving the efficacy of rehabilitation for recovery after stroke. The current hypothesis is that disturbances of interhemispheric activities after stroke result in a pathological hyperactivity of the intact hemisphere. The rationale of using rTMS as a complementary therapy is mainly to decrease the cortical excitability in regions that are presumed to hinder optimal recovery by lowfrequency rTMS delivered to the unaffected hemi-
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International guidelines of neurological and rehabilitation societies recommend this treatment (level A).
One of the best studied effects on pharmacology improvement after stroke is the application of Botulinum toxin against the spasticity in the upper and recently shown also in the lower extremities. Also it is not so clear at which time during development of spasticity (very early, early, late) the application is most effective. International guidelines of neurological and rehabilitation societies recommend this treatment (level A). A very high portion of patients developed post stroke depression and several studies had demonstrat-
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Patients with cognitive dysfunction also present massive circadian rhythmic disorders which are negative for the rehabilitation.
ed a positive effect of SSRI on the depression but also on the regaining of functionality. Motoric function is very often slowed down on both sides and the basal ganglia may be involved. Some clinical studies had demonstrated a positive effect of L-Dopa on the motoric and neuropsychological performance even in chronic lesions. Beyond that aspect and due to the high impact of cognitive performance, some discussion is held about the adjunct therapy by “neuroenhancer”. Patients with cognitive dysfunction also present massive circadian rhythmic disorders which are negative for the rehabilitation. Some experimental and clinical data give a hint for the involvement of neuro endocrinological disturbances. This would be very interesting because it would open more specific and known pharmacological treatment (melatonin, cortison, etc). To my mind to find the right “cocktail” will be one of the challenges for neurorehabilitation in the future.
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Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review.
Basteris A, Nijenhuis SM, Stienen AH, Buurke JH, Prange GB, Amirabdollahian F. Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review.
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S. Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity.
S. Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity.
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Rehabilitation Therapies After Botulinum Toxin-A Injection to Manage Limb Spasticity: A Systematic Review.
Kinnear BZ, Lannin NA, Cusick A, Harvey LA, Rawicki B. Rehabilitation Therapies After Botulinum Toxin-A Injection to Manage Limb Spasticity: A Systematic Review.
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Role of repetitive transcranial magnetic stimulation in stroke rehabilitation.
Pinter MM, Brainin M. Role of repetitive transcranial magnetic stimulation in stroke rehabilitation.
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motor evoked potentials, rehabilitation, stroke, transcranial magnetic stimulation
motor evoked potentials, rehabilitation, stroke, transcranial magnetic stimulation
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Comparison of the gait-oriented rehabilitation (GOR) and conventional treatment (CT) groups at start.
Patient, lesion and physical functioning characteristics. Comparison of the gait-oriented rehabilitation (GOR) and conventional treatment (CT) groups at start.
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Motor outcomes at three weeks and at six months according to the existing versus non-existing MEP response after stimulation of lesioned hemisphere at the beginning of study in patients with acute stroke who received gaitoriented rehabilitation, GOR, N=17.
Motor outcomes at three weeks and at six months according to the existing versus non-existing MEP response after stimulation of lesioned hemisphere at the beginning of study in patients with acute stroke who received gaitoriented rehabilitation, GOR, N=17.
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The intervention group received intensive gait-oriented rehabilitation for 3 weeks whereas the patients in the control group followed the conventional treatment path.
The follow-up of the recovery process of stroke patients from the very acute stage onwards was performed using a multimodal approach including lesion characterization with MRI and neurophysiologic and physical functioning evaluations. The intervention group received intensive gait-oriented rehabilitation for 3 weeks whereas the patients in the control group followed the conventional treatment path. The focus of this study was on assessing the motor tract physiology after stroke. The conduction properties of the unimpaired descending motor pathways to the affected side muscles during the
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Gait-oriented rehabilitation resulted in better motor tract function which was evidenced in more and higher amplitude MEPs and better physical functioning at follow-up compared to the corresponding values in those who had received conventional treatment.
early stage of stroke predicted better physical functioning. Gait-oriented rehabilitation resulted in better motor tract function which was evidenced in more and higher amplitude MEPs and better physical functioning at follow-up compared to the corresponding values in those who had received conventional treatment. Neither anatomical locations of the lesions nor cortical involvement vs. primary involvement of the subcortical motor tracts showed any statistically significant correlations with the MTs, MEP latencies and amplitudes or SPs. Only the lesion size influenced the MT values of the TA muscle. This is in line with the evidence that functional recovery is more likely related to changes in distributed neuronal networks rather than functions or lesions in individual regions.
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Our results of gait rehabilitation and TA MEPs confirm their conclusion that TMS is useful in both moderately affected and in more impaired patients as a physiological assay of treatment-induced plasticity and functional gains.
increased after less extensive treatment. Our results of gait rehabilitation and TA MEPs confirm their conclusion that TMS is useful in both moderately affected and in more impaired patients as a physiological assay of treatment-induced plasticity and functional gains. There is evidence that neural reorganization can be enhanced by gait-oriented rehabilitation. These results support previous clinical studies of MEPs of the lower limb in predicting motor recovery and ambulation and correlations between MEPs and gait recovery after stroke [9].
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There is evidence that neural reorganization can be enhanced by gait-oriented rehabilitation.
increased after less extensive treatment. Our results of gait rehabilitation and TA MEPs confirm their conclusion that TMS is useful in both moderately affected and in more impaired patients as a physiological assay of treatment-induced plasticity and functional gains. There is evidence that neural reorganization can be enhanced by gait-oriented rehabilitation. These results support previous clinical studies of MEPs of the lower limb in predicting motor recovery and ambulation and correlations between MEPs and gait recovery after stroke [9].
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Financial support for this work was provided by Brain Research and Rehabilitation Center Neuron and Kuopio University Hospital, Kuopio, Finland.
nen, PhD, and physiotherapists Pirjo Huuskonen and Dorota Musialowicz for their help. Financial support for this work was provided by Brain Research and Rehabilitation Center Neuron and Kuopio University Hospital, Kuopio, Finland.
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Immediate and long-term changes in corticomotor output in response to rehabilitation: correlation with functional improvements in chronic stroke.
Koski L, Mernar TJ, Dobkin BH. Immediate and long-term changes in corticomotor output in response to rehabilitation: correlation with functional improvements in chronic stroke.
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Upper Extremity Rehabilitation
Upper Extremity Rehabilitation
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electrical stimulation, iterative learning control, rehabilitation, stroke, upper extremity
electrical stimulation, iterative learning control, rehabilitation, stroke, upper extremity
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Task specific training and Electrical stimulation (ES) are techniques used in rehabilitation of the upper extremity post stroke.
Task specific training and Electrical stimulation (ES) are techniques used in rehabilitation of the upper extremity post stroke. This study describes the feasibility of using a rehabilitation system that combines personalised, precisely controlled levels of ES to the anterior deltoid, triceps and finger and wrist extensors during goal-oriented activity utilising real objects from daily life.
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This study describes the feasibility of using a rehabilitation system that combines personalised, precisely controlled levels of ES to the anterior deltoid, triceps and finger and wrist extensors during goal-oriented activity utilising real objects from daily life.
Task specific training and Electrical stimulation (ES) are techniques used in rehabilitation of the upper extremity post stroke. This study describes the feasibility of using a rehabilitation system that combines personalised, precisely controlled levels of ES to the anterior deltoid, triceps and finger and wrist extensors during goal-oriented activity utilising real objects from daily life.
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This presents a major challenge to healthcare providers, and is driving the development of rehabilitation technology which can deliver this specific and intense rehabilitation without using additional resources.
intensive, highly repetitive task-oriented and taskspecific training in all phases post stroke [7]. This presents a major challenge to healthcare providers, and is driving the development of rehabilitation technology which can deliver this specific and intense rehabilitation without using additional resources. Technologies such as electromechanical and robot-assisted arm training have been demonstrated to improve activities of daily living and arm function (but not muscle strength) [8]. However few evidence based technologies are routinely used in clinical practice in the UK. Identified barriers which need to be overcome to facilitate translation include usability, knowledge, education, awareness and access to ATs as well as cost [9]. One of the technologies which shows promise in meeting some of these barriers is Electrical Stimulation (ES) which has a growing evidence base [10], demonstrating improvements in range of movement, strength and spasticity.
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To be useful in longer term self-management, technologies need to promote adherence through stimulating and motivating rehabilitation.
The system directly trains goal-oriented activities and is able to provide greater assistance than in previous research by including an electrode array to support functional hand and wrist gestures. This is expected to lead to further reduction in upper limb motor impairments, as reflected by evidence that effects resulting from training are mostly restricted to the actually trained functions and activities [10]. To be useful in longer term self-management, technologies need to promote adherence through stimulating and motivating rehabilitation. The use of a touch table provides such an environment, and, when combined with inexpensive non-contact sensors (Kinect and Primesense), represent a significant step in the development of technology that is suitable for translation into the home environment.
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The rehabilitation system has been designed to facilitate recovery of UE motor control and function in chronic stroke participants.
The aim of this study is to test the feasibility of using the multi-channel ES system to precisely control ES applied to multiple muscle groups in the UE in combination with real and virtual tasks to facilitate functional motor recovery post-stroke. The rehabilitation system has been designed to facilitate recovery of UE motor control and function in chronic stroke participants.
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vii) current participation in another study involving physical rehabilitation of the arm.
vii) current participation in another study involving physical rehabilitation of the arm. Following ethical approval, to date, a total of 4 participants have been recruited to the trial.
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The rehabilitation system
The rehabilitation system
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This type of system will become increasingly important in the drive to deliver cost-effective improvements in stroke rehabilitation and to fulfil national clinical guidelines which include recommendations for patients to have every opportunity to practise within their capacity.
The results of this feasibility study are relevant to all studies in which non-contact movement measurement is required. This type of system will become increasingly important in the drive to deliver cost-effective improvements in stroke rehabilitation and to fulfil national clinical guidelines which include recommendations for patients to have every opportunity to practise within their capacity.
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Additionally, feedback is known to be an important factor in rehabilitation, and this type of system
The far reach task challenged all joints, but was the only task to require index finger extension to complete the task; repetitive practice resulted in the most significant improvement in index finger extension. The highlight switch task challenged participants repeatedly in terms of their shoulder flexion, and this is where the changes in movement occurred. In clinical practice,outcome measurements would generally be recorded in line with the WHO International Classification of Functioning, Disability and Health [16]. However clinical outcomes generally do not measure incremental changes in movements, but solely provide a pre-post perspective. It can be oberved from the graphs that although the trend is in an overall direction, the day to day fluctuations could mean that a prepost measurement could present a misleading picture of what the participant is achieving. Additionally, feedback is known to be an important factor in rehabilitation, and this type of system
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Reconsidering the motor recovery plateau in stroke rehabilitation.
Page SJ, Gater DR, Bach YRP. Reconsidering the motor recovery plateau in stroke rehabilitation.
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Translation of evidencebased Assistive Technologies into stroke rehabilitation: users' perceptions of the barriers and opportunities.
Hughes A-M, Burridge J, Demain S, Ellis-Hill C, Meagher C, Tedesco-Triccas L, Turk R, Swain I. Translation of evidencebased Assistive Technologies into stroke rehabilitation: users' perceptions of the barriers and opportunities.
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Journal of NeuroEngineering and Rehabilitation
Journal of NeuroEngineering and Rehabilitation
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The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study.
Meadmore K, Exell T, Hallewell E, Hughes A-M, Freeman C, Kutlu M, Benson V, Rogers E, Burridge J. The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study.
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Journal of NeuroEngineering and Rehabilitation
Journal of NeuroEngineering and Rehabilitation
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Computational models of upper limb movement during functional reaching tasks for application in electrical stimulation based stroke rehabilitation.
Freeman CT, Exell T, Meadmore K, Hallewell E, Hughes AM, Burridge J. Computational models of upper limb movement during functional reaching tasks for application in electrical stimulation based stroke rehabilitation. Technically Assisted Rehabilitation 2013.
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Technically Assisted Rehabilitation 2013.
Freeman CT, Exell T, Meadmore K, Hallewell E, Hughes AM, Burridge J. Computational models of upper limb movement during functional reaching tasks for application in electrical stimulation based stroke rehabilitation. Technically Assisted Rehabilitation 2013.
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Phase-lead iterative learning control algorithms for functional electrical stimulation-based stroke rehabilitation.
Freeman CT, Tong D, Meadmore K, Cai Z, Rogers E, Hughes AM, Burridge JH. Phase-lead iterative learning control algorithms for functional electrical stimulation-based stroke rehabilitation. Proceedings of the Institution of Mechanical Engineers Part I
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At presence it is accepted that stroke patients have an optimal time window for fast recovery within the rehabilitation.
The restoration of gait after stroke is a primary and long-term goal of neurorehabilitation. This article focuses on the update scientific theories for the influence of neurorehabilitation on restoration of hemiparetic gait due to unilateral supratentorial stroke. At presence it is accepted that stroke patients have an optimal time window for fast recovery within the rehabilitation. A significant motor improvement can be achieved in the first 6 months after stoke following by a plateau, although some functional recovery may be observed many years after stroke. Gait restoration in chronic hemiparesis is mainly associated with the use of optimal behavior strategies for compensation the existed motor deficit where the non-affected, clinically healthy side is more involved. Recent concepts emphasize on optimal stimulation of brain plasticity using relevant task-oriented and high-intensity training in better motivated and moving patients who have preserved cognition and receive family support.
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The final outcome has been shown to be determined within a limited time window during the acute phase of brain injury – if recovery is seen early after stroke onset, better outcomes may be expected six months later although motor recovery may continue over a period of years in some individuals with appropriate rehabilitation [17].
At present there are strong indications that all these mechanisms are potentially involved in the recovery process after brain injury, however the ability of human adult brain to reorganize itself remains more or less restricted. Irrespective of the type and the amount of applied therapy certain biological processes, characterized as the “spontaneous neurological recovery”, are supposedly responsible for the functional outcome after stroke. The final outcome has been shown to be determined within a limited time window during the acute phase of brain injury – if recovery is seen early after stroke onset, better outcomes may be expected six months later although motor recovery may continue over a period of years in some individuals with appropriate rehabilitation [17].
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Rehabilitation programs focus on gait training at sub-acute and chronic stroke patients where the rehabilitation outcome is strongly associated with cognitive function (attention, motor adaptation, learning and ability for re-learning), the degree of motivation and the engagement of the patient and his/her family [6].
Restoration of motor functions after stroke is a complex process involving spontaneous recovery and appropriate therapeutic interventions. Its primary goals are stroke patients to be able to walk independently and to manage to perform daily activities. Rehabilitation programs focus on gait training at sub-acute and chronic stroke patients where the rehabilitation outcome is strongly associated with cognitive function (attention, motor adaptation, learning and ability for re-learning), the degree of motivation and the engagement of the patient and his/her family [6].
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The approaches used in gait rehabilitation after stroke include neurophysiological and motor learning techniques, robotic devices, Functional Electrical Stimulation (FES), and braincomputer interface (BCIs).
The approaches used in gait rehabilitation after stroke include neurophysiological and motor learning techniques, robotic devices, Functional Electrical Stimulation (FES), and braincomputer interface (BCIs). The majority of methodologies applied are
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There are general agreement that the combination of different rehabilitation strategies seems to be more effective than overground gait training alone [6].
(based on the state of the brain after stroke). There are general agreement that the combination of different rehabilitation strategies seems to be more effective than overground gait training alone [6]. However, the neurophysiological and motor learning techniques are not specifically focused on the gait rehabilitation. Compared to conventional therapy the use of robotic devices (including systems for BWSTT and FES) seems to be more effective for stroke gait recovery [6], but needs further evaluation.
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However, the neurophysiological and motor learning techniques are not specifically focused on the gait rehabilitation.
(based on the state of the brain after stroke). There are general agreement that the combination of different rehabilitation strategies seems to be more effective than overground gait training alone [6]. However, the neurophysiological and motor learning techniques are not specifically focused on the gait rehabilitation. Compared to conventional therapy the use of robotic devices (including systems for BWSTT and FES) seems to be more effective for stroke gait recovery [6], but needs further evaluation.
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The footprint peak times of hemipateric patients before and after rehabilitation [43].
The footprint peak times of hemipateric patients before and after rehabilitation [43].
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ter rehabilitation.
ter rehabilitation. Most of the studies report for improved preferred walking speed as a result of rehabilitation with variations between the subtypes of stroke. As general, patients with better functional outcome (higher gait velocity, higher Barthel Index and more symmetry in swing and stance duration) at the start of rehabilitation obtained higher gait capability at the end of rehabilitation. However, it has been observed that in chronic post-stroke hemiparesis the 3-weeks intensive neurorehabilitation is effective to improve the kinetic gait performance but appears insufficient to change the central programming of gait footfall patterns [43, 45].
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Most of the studies report for improved preferred walking speed as a result of rehabilitation with variations between the subtypes of stroke.
ter rehabilitation. Most of the studies report for improved preferred walking speed as a result of rehabilitation with variations between the subtypes of stroke. As general, patients with better functional outcome (higher gait velocity, higher Barthel Index and more symmetry in swing and stance duration) at the start of rehabilitation obtained higher gait capability at the end of rehabilitation. However, it has been observed that in chronic post-stroke hemiparesis the 3-weeks intensive neurorehabilitation is effective to improve the kinetic gait performance but appears insufficient to change the central programming of gait footfall patterns [43, 45].
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As general, patients with better functional outcome (higher gait velocity, higher Barthel Index and more symmetry in swing and stance duration) at the start of rehabilitation obtained higher gait capability at the end of rehabilitation.
ter rehabilitation. Most of the studies report for improved preferred walking speed as a result of rehabilitation with variations between the subtypes of stroke. As general, patients with better functional outcome (higher gait velocity, higher Barthel Index and more symmetry in swing and stance duration) at the start of rehabilitation obtained higher gait capability at the end of rehabilitation. However, it has been observed that in chronic post-stroke hemiparesis the 3-weeks intensive neurorehabilitation is effective to improve the kinetic gait performance but appears insufficient to change the central programming of gait footfall patterns [43, 45].
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Gait Rehabilitation Techniques
Gait Rehabilitation Techniques
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Modern gait rehabilitation is based on physical therapy interventions with robotic approaches and aims to improve functional ambulation after stroke.
Modern gait rehabilitation is based on physical therapy interventions with robotic approaches and aims to improve functional ambulation after stroke. According to the Cochrane review the classic neurological gait rehabilitation techniques can be classified in two main categories: neurophysiological and motor learning [6, 25].
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According to the Cochrane review the classic neurological gait rehabilitation techniques can be classified in two main categories: neurophysiological and motor learning [6, 25].
Modern gait rehabilitation is based on physical therapy interventions with robotic approaches and aims to improve functional ambulation after stroke. According to the Cochrane review the classic neurological gait rehabilitation techniques can be classified in two main categories: neurophysiological and motor learning [6, 25].
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Commonly used in gait rehabilitation are:
They are based on the theories that the physiotherapist supports the correct patient’s movement patterns, acting as problem solver and decision maker with the patient being a relatively passive recipient [43]. Commonly used in gait rehabilitation are:
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The rehabilitation starts with tactile recognition of different stimuli and evolves trough passive exploitation and manipulation of muscles and joints to active manipulation.
– it is a sensory motor technique developed originally for controlling spasticity in arms and subsequently – for improving gait. The rehabilitation starts with tactile recognition of different stimuli and evolves trough passive exploitation and manipulation of muscles and joints to active manipulation. It needs a certain degree of cognitive preservation to allow patient’s cooperation [31].
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The rehabilitation protocol is initially focussed on movement that cannot be performed, followed by functional tasks and generalization of the training into activities of daily living [9].
– it is based on the hypothesis that neurological patients learn in the same way as healthy subjects and through appropriate sensory inputs it is possible to modulate motor responses to a task. The rehabilitation protocol is initially focussed on movement that cannot be performed, followed by functional tasks and generalization of the training into activities of daily living [9].
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– the rehabilitation protocols are focused on coping with disability in daily life of the patients by teaching them to use appropriate strategies [18].
– the rehabilitation protocols are focused on coping with disability in daily life of the patients by teaching them to use appropriate strategies [18].
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According to the only available Cochrane review on gait rehabilitation techniques there is insufficient evidence to determine if any rehabilitation approach is more effective in promoting functional recovery of lower limbs after stroke.
According to the only available Cochrane review on gait rehabilitation techniques there is insufficient evidence to determine if any rehabilitation approach is more effective in promoting functional recovery of lower limbs after stroke. Some studies reveal that patients receiving conventional functional treatment regimens need less time to achieve their functional goals compared to specific neurological approaches, such as Bobath [11]. There is strong evidence that patients benefit from task-oriented and high-intensity training to improve gait and gait-related activities after stroke supporting the view that functional recovery is driven mainly by adaptive strategies that compensate for impaired body functions [27].
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There is no systematic review addressed to the efficacy of gait training methods in stroke rehabilitation.
There is no systematic review addressed to the efficacy of gait training methods in stroke rehabilitation. For acute stage of stroke there is a consensus that ground gait training helps for recovery of patients who cannot walk independently [5], but the opinion of gait training in chronic patients with permanent mobility deficits is contraversal – from negative to small, time-limited benefits mainly for walking speed [38]. Better results are considered in combination of ground gait training with treadmill or high-technology approaches (body weight support treadmill training, robotic devices, ect) [14, 26].
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They provide safe, intensive and task-oriented rehabilitation to people with mild to severe motor impairments after neurologic injury [15].
Gait robotic devices (treadmill with body weight support, gait trainer and electromechanical exoskeletons) are related mainly to motor re-learning programs and promote learning depended on the self-selected usage and self initiated movements. They provide safe, intensive and task-oriented rehabilitation to people with mild to severe motor impairments after neurologic injury [15]. Their main advantages are associated with ability to increase the intensity of therapy under on-line control of kinetic and kinematic variables of walking, ability for repetition and increased training motivation through the use of interactive feedback along with reduction of the amount of required physical assistance that reduces the health care costs [6]. The positive effect of retraining gait with robotic devices on recovery of ambulation has been confirmed by several studies. However, according to recent Cochrane review robotic gait rehabilitation increases the walking independently mainly in patients with subacute stroke but not in patients with chronic stroke [25].
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However, according to recent Cochrane review robotic gait rehabilitation increases the walking independently mainly in patients with subacute stroke but not in patients with chronic stroke [25].
Gait robotic devices (treadmill with body weight support, gait trainer and electromechanical exoskeletons) are related mainly to motor re-learning programs and promote learning depended on the self-selected usage and self initiated movements. They provide safe, intensive and task-oriented rehabilitation to people with mild to severe motor impairments after neurologic injury [15]. Their main advantages are associated with ability to increase the intensity of therapy under on-line control of kinetic and kinematic variables of walking, ability for repetition and increased training motivation through the use of interactive feedback along with reduction of the amount of required physical assistance that reduces the health care costs [6]. The positive effect of retraining gait with robotic devices on recovery of ambulation has been confirmed by several studies. However, according to recent Cochrane review robotic gait rehabilitation increases the walking independently mainly in patients with subacute stroke but not in patients with chronic stroke [25].
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Functional Electrical Stimulation (FES) has been used in rehabilitation of chronic hemiplegia since
Functional Electrical Stimulation (FES) has been used in rehabilitation of chronic hemiplegia since
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Knowledge for predictors of gait recovery after stroke can contribute to more appropriate selection of the rehabilitation strategy when different techniques in gait training are considered.
Knowledge for predictors of gait recovery after stroke can contribute to more appropriate selection of the rehabilitation strategy when different techniques in gait training are considered. Most of the studies confirm the significant association of recovery with younger age, better functional outcome (higher preferred gait velocity, Barthel Index and more gait symmetry at the start of rehabilitation), severity of stroke and brain ability for neuroplasticity (location and extent of damange, activation of secondary and contralateral areas, individual genetic abilities for brain reorganization) and better motivated and moving patients [6, 21, 32].
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Most of the studies confirm the significant association of recovery with younger age, better functional outcome (higher preferred gait velocity, Barthel Index and more gait symmetry at the start of rehabilitation), severity of stroke and brain ability for neuroplasticity (location and extent of damange, activation of secondary and contralateral areas, individual genetic abilities for brain reorganization) and better motivated and moving patients [6, 21, 32].
Knowledge for predictors of gait recovery after stroke can contribute to more appropriate selection of the rehabilitation strategy when different techniques in gait training are considered. Most of the studies confirm the significant association of recovery with younger age, better functional outcome (higher preferred gait velocity, Barthel Index and more gait symmetry at the start of rehabilitation), severity of stroke and brain ability for neuroplasticity (location and extent of damange, activation of secondary and contralateral areas, individual genetic abilities for brain reorganization) and better motivated and moving patients [6, 21, 32].
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Disability & Rehabilitation
Disability & Rehabilitation
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Veterans affairs/ department of defense clinical practice guideline for the management of adult stroke rehabilitation care: executive summary.
Bates B, Choi JY, Duncan PW, Glasberg JJ, Graham GD, Katz RC, Lamberty K, Reker D, Zorowitz R. Veterans affairs/ department of defense clinical practice guideline for the management of adult stroke rehabilitation care: executive summary.
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Rehabilitation of gait after stroke: a review towards a topdown approach.
Belda-Lois J-M, del Horno SM, Bermejo-Bosch IB, Moreno JC, Pons JL, Farina D, Iosa M, Molinari M, Tamburella F, Ramos A, Caria A, Solis-Escalante T, Brunner C, Rea M. Rehabilitation of gait after stroke: a review towards a topdown approach.
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Dickstein R, Hocherman S, Pillar T, Shaham R: Stroke rehabilitation.
Dickstein R, Hocherman S, Pillar T, Shaham R: Stroke rehabilitation.
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IEEE Transactions on Neural Systems and Rehabilitation Engineering
IEEE Transactions on Neural Systems and Rehabilitation Engineering
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Effect of duration of upperand lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait.
Kwakkel G, Wagenaar RC. Effect of duration of upperand lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait.
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Journal of Rehabilitation Medicine
Journal of Rehabilitation Medicine
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Gait characteristics after gait-oriented rehabilitation in chronic stroke.
nen K, Sivenius J, Tarkka I. Gait characteristics after gait-oriented rehabilitation in chronic stroke.
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18. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 1 , , ,

With regard to the rehabilitation of patients after their discharge from health facilities, information about their degree of disability, early and late survival after thrombolysis and the process of re-socialization is missing.
With regard to the rehabilitation of patients after their discharge from health facilities, information about their degree of disability, early and late survival after thrombolysis and the process of re-socialization is missing.
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Ann-Marie Hughes (UK) described Combining electrical stimulation mediated by iterative learning control with movement practice using real objects and simulated tasks for post-stroke upper extremity rehabilitation.
Professor Mario Siebler (Germany) really kept the attention of the audience presenting the topic “Advances in neurorehabilitation after stroke”. Prof. Ina Tarkka (Finland) spoke about Brain imaging in neurorehabilitation and Prof. Ann-Marie Hughes (UK) described Combining electrical stimulation mediated by iterative learning control with movement practice using real objects and simulated tasks for post-stroke upper extremity rehabilitation. The lecture session was concluded by Professor Ekaterina Titianova (Bulgaria) who spoke about Hemiparetic gait in stroke neurorehabilitation. The workshops in the afternoon were also very productive and raised many discussions.
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World Congress of the International Society of Physical and Rehabilitation Medicine
World Congress of the International Society of Physical and Rehabilitation Medicine
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19. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 2 , , ,

The Society supports the participation of young neurologists, students in medicine, medical rehabilitation and occupational therapy and physiotherapy students in training courses and scientific forums organized by BSNCH.
National Sports Academy. The Society supports the participation of young neurologists, students in medicine, medical rehabilitation and occupational therapy and physiotherapy students in training courses and scientific forums organized by BSNCH. The goal is to form an interest for scientific activities by preparing presentations, scientific posters and reviews. Two awards were received by participants in this activity – first prize for the best poster of the 16th World Neu-
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The textbook in general neurology is designed towards a wide audience with interests in neuroscience – students, physicians and specializing doctors in neurology and in physical and rehabilitation medicine, physiotherapists and healthcare professionals.
The textbook in general neurology is designed towards a wide audience with interests in neuroscience – students, physicians and specializing doctors in neurology and in physical and rehabilitation medicine, physiotherapists and healthcare professionals. It can be used by neurosurgeons, dentists, general practitioners, psychologists, psychiatrists and other specialists with interests in the field of neuroscience. Through its unique appearance and content the textbook fills a significant gap in the modern education literature as a contemporary practical guide on nervous system diseases.
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After a rehabilitation program, on the 7
After the procedure the patient was treated in ICU where another 10 mg Actylise were infused over the next 3 hours. Since the neurological condition was improving, he was extubated 12 hours later. On the first day, the patient regained consciousness, was able to speak and had no deficit in the right limbs. On control CT there were no new signs of ischemic stroke. CT angiography showed complete basilar artery recanalization in the distal part, a moderate residual stenosis in the middle and aplasia of the left posterior communication artery. After a rehabilitation program, on the 7
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Faculty for Special Education and Rehabilitation, University
Faculty for Special Education and Rehabilitation, University
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Department of Physiotherapy and Rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria
Department of Physiotherapy and Rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria
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Department of Physiotherapy and Rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria
Department of Physiotherapy and Rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria
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National Sports Academy “Vassil Levski”, Department of Kinesitherapy and Rehabilitation,
National Sports Academy “Vassil Levski”, Department of Kinesitherapy and Rehabilitation,
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Department of physiotherapy and rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria,
Department of physiotherapy and rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria,
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World Congress of the International Society of Physical and Rehabilitation Medicine (ISPRM)
World Congress of the International Society of Physical and Rehabilitation Medicine (ISPRM)
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20. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 1 , , ,

Students in “Medicine”, “Nursing”, “Kinesitherapy, Medical Rehabilitation and Ergotherapy” from various medical universities in the country and the National Sports Academy “Vasil Levski” joined the sessions.
Over 300 delegates from Bulgaria, Austria, Georgia, Macedonia, Serbia, Russia, Switzerland, China and Cyprus took part in the First National Neurosonology and Cerebral Hemodynamics Congress with international participation, organized by the Bulgarian Society of Neurosonology and Cerebral Hemodynamics (BSNCH). The forum was held on October 2-4, 2015 in Marinella Hotel, Sofia. Students in “Medicine”, “Nursing”, “Kinesitherapy, Medical Rehabilitation and Ergotherapy” from various medical universities in the country and the National Sports Academy “Vasil Levski” joined the sessions.
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The Bulgarian Society of Neurosonology and Cerebral Hemodynamics supports the participation of young neurologists, doctorants, medical students, medical rehabilitation and occupational therapy and physiotherapy students in its training courses and scientific forums.
The Bulgarian Society of Neurosonology and Cerebral Hemodynamics supports the participation of young neurologists, doctorants, medical students, medical rehabilitation and occupational therapy and physiotherapy students in its training courses and scientific forums. In poster sessions of the First Neurosonology Congress, medical students from the Medical Faculty of Sofia University “St. Kl. Ohridski” and the Medical University – Sofia received 3 poster awards for innovations in Medicine (G. Adam et al.), a clinical neurological case report (T. Vladimirov et al.) and a poster design (P. Iliev, M.
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Guest speaker at the event was academician Ekaterina Titianova, MD – Head of the “Clinic of Functional Diagnostics of Nervous System” and Head of the Department “Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health” of the Medical Faculty of Sofia University “St.
On the first day over 80 doctors and pharmacists from the region attended the forum. Dr. Maria Radiykova – Chief Doctor of the local hospital, opened the seminar. Guest speaker at the event was academician Ekaterina Titianova, MD – Head of the “Clinic of Functional Diagnostics of Nervous System” and Head of the Department “Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health” of the Medical Faculty of Sofia University “St. Kliment Ohridski”. She presented the various neuropathy forms in diabetes mellitus, the reasons for their occurrence and some new treatment approaches, including strict glycemic control using insulin pumps, pathogenetic treatment with benfotiamine and alpha-lipoic acid, symptomatic treatment of neuropathic pain, foot hygiene, combined with appropriate exercise regimen. It was emphasized that as genetic dis-
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Daniela Lyubenova, a specialist in kinesitherapy and Vice-dean of the National Sports Academy “Vasil Levski” – Sofia presented the basic principles of physical rehabilitation and demonstrated a specialized program for individual home rehabilitation adapted for use by patients with diabetes mellitus.
, 2015 at the House of Science and Technology in the city a specialized training of patients with diabetes mellitus and diabetic neuropathy was held. Assoc. Prof. Daniela Lyubenova, a specialist in kinesitherapy and Vice-dean of the National Sports Academy “Vasil Levski” – Sofia presented the basic principles of physical rehabilitation and demonstrated a specialized program for individual home rehabilitation adapted for use by patients with diabetes mellitus. Participants in the event were given the
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21. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 2 , , ,

All patients should have access to rehabilitation programs and to be properly motivated.
Neurorehabilitation is an effective part of a comprehensive treatment of patients with acute and chronic neurological diseases and is essential for those who have experienced stroke. All patients should have access to rehabilitation programs and to be properly motivated. Neurological rehabilitation is a cost-effective and efficient intervention in patients with impaired static and dynamic balance and expressed sensomotor deficits in gait after a cerebrovascular accident.
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Neurological rehabilitation is a cost-effective and efficient intervention in patients with impaired static and dynamic balance and expressed sensomotor deficits in gait after a cerebrovascular accident.
Neurorehabilitation is an effective part of a comprehensive treatment of patients with acute and chronic neurological diseases and is essential for those who have experienced stroke. All patients should have access to rehabilitation programs and to be properly motivated. Neurological rehabilitation is a cost-effective and efficient intervention in patients with impaired static and dynamic balance and expressed sensomotor deficits in gait after a cerebrovascular accident.
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lt includes a preface, introduction, 5 sections, conclusion and adapted program for home rehabilitation to restore hemiparetic gait after stroke.
The monograph consists of 144 pages and is very well structured. lt includes a preface, introduction, 5 sections, conclusion and adapted program for home rehabilitation to restore hemiparetic gait after stroke. Bibliography is comprehensive and up to date and includes authors on Cyrillic and Latin of recent years. ln the book are discussed all scientific aspects of gait disorders after stroke and are presented practical research methods for favorably influence the clinical and functional status of patients. The monograph is a result of many years of academic and practical work of Acad. Prof. Е. Titianova and Assoc.
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lt is the first attempt in our country to be systematized and presented the therapeutic approaches of neurorehabilitation, and to analyze, summarize and describe modern foreign and own methods of kinesitherapy in rehabilitation of patients with stroke and impaired balance and gait.
ln the book are discussed all scientific aspects of gait disorders after stroke and are presented practical research methods for favorably influence the clinical and functional status of patients. The monograph is a result of many years of academic and practical work of Acad. Prof. Е. Titianova and Assoc. Prof. D. Lyubenova. lt is the first attempt in our country to be systematized and presented the therapeutic approaches of neurorehabilitation, and to analyze, summarize and describe modern foreign and own methods of kinesitherapy in rehabilitation of patients with stroke and impaired balance and gait.
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The monograph emphasizes important and insufficiently studied and developed in Bulgaria problem concerning rehabilitation in patients with abnormal gait after stroke.
The monograph emphasizes important and insufficiently studied and developed in Bulgaria problem concerning rehabilitation in patients with abnormal gait after stroke. lt provides synthesized information about the role of kinesitherapy in the treatment of patients with stroke and is designed to acquaint the readers with neurophysiological mechanisms underpinning the appropriateness of kinesitherapeutic application.
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Specialists in Neurology, Physical Medicine, Rehabilitation, Kinesitherapy, medical graduates, residents, nurses and students from 9 countries: Austria, Bosnia and Herzegovina, Bulgaria, Germany, Israel, Macedonia, Serbia, Sudan and Croatia have signed up for participation in the Congress.
Specialists in Neurology, Physical Medicine, Rehabilitation, Kinesitherapy, medical graduates, residents, nurses and students from 9 countries: Austria, Bosnia and Herzegovina, Bulgaria, Germany, Israel, Macedonia, Serbia, Sudan and Croatia have signed up for participation in the Congress. On behalf of the Organizing Committee I wish you a fruitful work.
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P9 Rehabilitation and psychological approach to patients with Cerebrovascular disease.
P9 Rehabilitation and psychological approach to patients with Cerebrovascular disease.
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P12 The effectiveness of Bobath Concept in Stroke Rehabilitation.
P12 The effectiveness of Bobath Concept in Stroke Rehabilitation.
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At present our knowledge about them is minimal, but is used for in-depth study of children with autism, cerebral rehabilitation, and explanation of various higher cortical functions such as memory, learning, speech, and empathy.
Mirror neurons are not yet a completely understood field of the brain and have not revealed all their possible applications. At present our knowledge about them is minimal, but is used for in-depth study of children with autism, cerebral rehabilitation, and explanation of various higher cortical functions such as memory, learning, speech, and empathy. Some authors accept them as a new, so called "social nervous system". Further investigations are needed to elucidate their real role in human life.
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REHABILITATION AND PSYCHOLOGICAL APPROACH TO PATIENTS WITH CEREBROVASCULAR DISEASE
REHABILITATION AND PSYCHOLOGICAL APPROACH TO PATIENTS WITH CEREBROVASCULAR DISEASE
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Department of Physical Medicine and Rehabilitation, University Hospital “Losenets” – Sofia, Bulgaria
Department of Physical Medicine and Rehabilitation, University Hospital “Losenets” – Sofia, Bulgaria
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The method included rehabilitation activities, speech therapy and psychotherapy.
: The subject under study was a man aged 66, with ischemic stroke in the left middle cerebral artery lapse 23 days. The method included rehabilitation activities, speech therapy and psychotherapy. Barthel Index tests were used for assessing the patient’s independence in everyday life. The self-assessment HADS scale was used to determine his levels of depression and anxiety, while the Von Zerssen adjective mood scale was used to determine the types of conditions.
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After administration of the rehabilitation program, the overall assessment by Bartel changes from 50 units to 85 units.
The clinical examination of the patient establishes a right-sided hemiparesis that is more severe for the hand, and sensorimotor aphasia, depression and anxiety. After administration of the rehabilitation program, the overall assessment by Bartel changes from 50 units to 85 units. After the ten psychological sessions, the study establishes a decrease of the high levels of depression by 19% to 11% and of the levels of anxiety by 17% to 14%. The daily speech rehabilitation ameliorates the speech disturbances in breathing and speech rate.
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The daily speech rehabilitation ameliorates the speech disturbances in breathing and speech rate.
The clinical examination of the patient establishes a right-sided hemiparesis that is more severe for the hand, and sensorimotor aphasia, depression and anxiety. After administration of the rehabilitation program, the overall assessment by Bartel changes from 50 units to 85 units. After the ten psychological sessions, the study establishes a decrease of the high levels of depression by 19% to 11% and of the levels of anxiety by 17% to 14%. The daily speech rehabilitation ameliorates the speech disturbances in breathing and speech rate.
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Clinic of Physical and Rehabilitation Medicine, Univerity
Clinic of Physical and Rehabilitation Medicine, Univerity
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Prof. Karakanev started the treatment of soldiers with speech disorders, as Head of the Rehabilitation Ward at the Military Hospital in Belovo.
Prof. Karakanev started the treatment of soldiers with speech disorders, as Head of the Rehabilitation Ward at the Military Hospital in Belovo. As a result of his scientific contributions he consistently received the following academic titles – PhD, associate professor and professor. He was Head of the Neurological Clinic at the Military Medical Academy, Sofia and Chief Neurologist of the Bulgarian Army. He had over 140 scientific works, participated in local and foreign congresses. Prof. Karakanev entered very thoroughly in investigation and treatment of cranial
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22. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 1 , , ,

Evidence-based stroke rehabilitation: an expanded guidance document from the European stroke organisation (ESO) guidelines for management of ischaemic stroke and transient ischaemic attack 2008.
Quinn TJ, Paolucci S, Sunnerhagen KS et al. Evidence-based stroke rehabilitation: an expanded guidance document from the European stroke organisation (ESO) guidelines for management of ischaemic stroke and transient ischaemic attack 2008.
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Over 160 delegates from Austria, Bosnia and Herzegovina, Bulgaria, Germany, Israel, Macedonia, Serbia, Sudan and Croatia, medical, nursing, physical therapy, medical rehabilitation and occupational therapy students from various Bulgarian medical universities and the National Sports Academy “V.
The Second National Congress of the Bulgarian Society of Neurosonology and Cerebral Hemodynamics with international participation was held in the halls of the Bulgarian Red Cross in Sofia from September 30 to October 2, 2016. The event was under the auspices of the Neurosonology Research Group of the World Federation of Neurology, European Society of Neurosonology and Cerebral Hemodynamics, Medical Faculty of Sofia University “St. Kl. Ohridski”, Military Medical Academy, Bulgarian Academy of Sciences and Arts, Bulgarian Society of Neurology, Bulgarian Medical Association and Bulgarian Red Cross. Over 160 delegates from Austria, Bosnia and Herzegovina, Bulgaria, Germany, Israel, Macedonia, Serbia, Sudan and Croatia, medical, nursing, physical therapy, medical rehabilitation and occupational therapy students from various Bulgarian medical universities and the National Sports Academy “V. Levski” were registered for participation. The forum was dedicated to the developments in diagnosis and treatment of cerebrovascular diseases with a focus on differentiated stroke treatment (thrombolysis and thrombectomy). The event was accredited with 12 points by
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23. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 2 , , ,

More than 150 specialists, residents and students in Neurology, Physical Medicine, Rehabilitation, and Kinesiotherapy from Albania, Austria, Bosnia and Herzegovina, Bulgaria, Croatia, Georgia, Germany, Greece, Israel, Italy, Latvia, Macedonia, Montenegro, Poland, Portugal, Romania, Serbia, etc.
More than 150 specialists, residents and students in Neurology, Physical Medicine, Rehabilitation, and Kinesiotherapy from Albania, Austria, Bosnia and Herzegovina, Bulgaria, Croatia, Georgia, Germany, Greece, Israel, Italy, Latvia, Macedonia, Montenegro, Poland, Portugal, Romania, Serbia, etc. have been registered for this event. Along with the training, all delegates will have the opportunity to enjoy the history and the beauty of Sofia – one of the oldest capitals in Europe.
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At present she is Professor of Neurology, Head of the Clinic of Functional Diagnostics of Nervous System at the Military Medical Academy, Sofia, member of the Faculty Council and Head of the Department of Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health at the Medical Faculty of St Kliment Ohridski Sofia University.
At present she is Professor of Neurology, Head of the Clinic of Functional Diagnostics of Nervous System at the Military Medical Academy, Sofia, member of the Faculty Council and Head of the Department of Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health at the Medical Faculty of St Kliment Ohridski Sofia University. Since 2013 she has been Academician of the Bulgarian Academy of Sciences and Arts and since 2015 – Academician of the Serbian Royal Academy. She is an expert at the Ministry of Health, the National Agency for Assessment and Accreditation at the Council of Ministers, and the National Health Insurance Fund of the Republic of Bulgaria. She is also an expert of the European Commission of the European Union.
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Head of Department “Kinesiotherapy and Rehabilitation” and Vice Dean of the “Vasil Levski” National Sports Academy.
Prof. Daniela Lubenova, PhD is a Professor of Kinesiotherapy. Head of Department “Kinesiotherapy and Rehabilitation” and Vice Dean of the “Vasil Levski” National Sports Academy. Head of the Master's programs “Kinesiotherapy” and “Physical therapy and rehabilitation” in National Sports Academy. She is expert at the National Agency for Assessment and Accreditation at the Council of Ministers.
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Head of the Master's programs “Kinesiotherapy” and “Physical therapy and rehabilitation” in National Sports Academy.
Prof. Daniela Lubenova, PhD is a Professor of Kinesiotherapy. Head of Department “Kinesiotherapy and Rehabilitation” and Vice Dean of the “Vasil Levski” National Sports Academy. Head of the Master's programs “Kinesiotherapy” and “Physical therapy and rehabilitation” in National Sports Academy. She is expert at the National Agency for Assessment and Accreditation at the Council of Ministers.
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Her research fields are focused on neurorehabilitation, proprioceptive neuromuscular facilitation, methodology Perfeti, kinesioteyping, methods of Bobath, cardiological and pulmonary rehabilitation.
She has specialized in Kinesiotherapy at prestigious universities in Hungary, Finland, England and Norway. Her research fields are focused on neurorehabilitation, proprioceptive neuromuscular facilitation, methodology Perfeti, kinesioteyping, methods of Bobath, cardiological and pulmonary rehabilitation.
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Rehabilitator in clinic “Physiotherapy and rehabilitation”, III City United Hospital – Sofia (1988–1995); assistant at the Department “Kinesiotherapy and Rehabilitation”, “Vasil Levski” National Sports Academy – Sofia (1995–2009); Associate professor at the Department “Kinesiotherapy and Rehabilitation”, “Vasil Levski” National Sports Academy – Sofia (2009–2016); Professor at the Department “Kinesiotherapy and Rehabilitation”, “Vasil Levski” National Sports Academy – Sofia (since 2016).
Rehabilitator in clinic “Physiotherapy and rehabilitation”, III City United Hospital – Sofia (1988–1995); assistant at the Department “Kinesiotherapy and Rehabilitation”, “Vasil Levski” National Sports Academy – Sofia (1995–2009); Associate professor at the Department “Kinesiotherapy and Rehabilitation”, “Vasil Levski” National Sports Academy – Sofia (2009–2016); Professor at the Department “Kinesiotherapy and Rehabilitation”, “Vasil Levski” National Sports Academy – Sofia (since 2016).
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Kinesiotherapy in neurological and psychiatric diseases, kinesiotherapy in internal medicine, kinesiotherapy in geriatrics for students in the specialty “Kinesiotherapy”, Bachelor's degree in “Vasil Levski” National Sports Academy – Sofia; Neurorehabilitation for students in the specialization to the Master's program “Kinesiotherapy” and “Physical therapy and rehabilitation”.
Kinesiotherapy in neurological and psychiatric diseases, kinesiotherapy in internal medicine, kinesiotherapy in geriatrics for students in the specialty “Kinesiotherapy”, Bachelor's degree in “Vasil Levski” National Sports Academy – Sofia; Neurorehabilitation for students in the specialization to the Master's program “Kinesiotherapy” and “Physical therapy and rehabilitation”.
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kinesiotherapy, neurorehabilitation, gait, stroke, diabetic neuropathy, cardiologic and pulmonary rehabilitation, ets.
kinesiotherapy, neurorehabilitation, gait, stroke, diabetic neuropathy, cardiologic and pulmonary rehabilitation, ets.
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Literature shows that experience and behavior activate brain plasticity mechanisms and remodel neuronal circuitry in the brain Exercise and behavioral enrichment paradigms, such as environmental enrichment, rehabilitation training and learning, affect common endpoints in the brain, including regulation of growth factors, neurogenesis and structural changes.
Literature shows that experience and behavior activate brain plasticity mechanisms and remodel neuronal circuitry in the brain Exercise and behavioral enrichment paradigms, such as environmental enrichment, rehabilitation training and learning, affect common endpoints in the brain, including regulation of growth factors, neurogenesis and structural changes. Similarities between these effects and exercise support the idea of existing common mechanisms regulating plasticity [19].
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It may be due to belated complications from the stroke or from infections, metabolic disorders, lung thromboembolism in bedridden patients, etc., the lack of establishments for professional post-stroke recovery, where the rehabilitation started at the clinic can continue and timely measures be taken if case of changes in the basic vital signs.
There is no exact information about the reasons leading to such significant rise in the mortality during the monitored three-month period. It may be due to belated complications from the stroke or from infections, metabolic disorders, lung thromboembolism in bedridden patients, etc., the lack of establishments for professional post-stroke recovery, where the rehabilitation started at the clinic can continue and timely measures be taken if case of changes in the basic vital signs. The absence of sufficient information and preparation of patients’ relatives to take care of them can also be the reason for this rise in mortality.
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The rehabilitation of stroke patients can be improved by incorporation of music listening in the therapy; the studies show that music stimulation increases blood flow in patients suffering from acute ischemic stroke and therefore enhances the post-stroke recovery [2].
The basis of The Mozart Effect lies at the superorganization of the cerebral cortex that may resonate with the superior architecture of Mozart’s music [9]. Other type of music, described as “brain music” that uses frequency, amplitude and duration of musical sound similar to Chopin music is able to move the brain from an anxious to a more relaxed state and has positive effect on insomnia and fatigue (www.dhs.gov). The use of music as a cure showed its success in depressive patients after stroke. Sarkamo and colleagues conducted a study involving after stroke patients with mood disorders; one group selected for listening to self-elected music one hour daily, one listening to language on audio books and control group without listening material. After two months in the group of the music listeners a significantly lower depression rate was registered, as well as lower irritability, inertia and fewer confusion states [22]. The rehabilitation of stroke patients can be improved by incorporation of music listening in the therapy; the studies show that music stimulation increases blood flow in patients suffering from acute ischemic stroke and therefore enhances the post-stroke recovery [2]. Music is beneficial not only if listened to, but also if created, especially due to the lack of boundaries such as speech, language, psychological state or motor skills. The prospective study performed on hobby singers has shown the changes of physiologic markers of happiness during singing; the serotonin, norepinephrine and
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Neuroplasticity of the brain is crucial for rehabilitation of the patients after brain injury and it can be prompted by activity, but also by imaging of activity, due to activation of mirror neuron system.
– endorphin levels were significantly higher after than before singing and stress hormone epinephrine was reduced by singing [5]. Neuroplasticity of the brain is crucial for rehabilitation of the patients after brain injury and it can be prompted by activity, but also by imaging of activity, due to activation of mirror neuron system. In the experiment of PascalLeone and co-workers one group of subjects played the piano and the other one had to just imagine that they were playing piano, with their hands being still on the table. Transmagnetic stimulation presented that the active part of the
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Music can be used as a background during physical therapy in rehabilitation centers, in hospitals as well as at home.
Music can be used as a background during physical therapy in rehabilitation centers, in hospitals as well as at home. More active approach, with plying un instrument, singing (especially for patients with speech disorders such as aphasia) or more complex activity like watching a video with dancing is even more successful. Art therapy is a complex intervention capable of addressing the diverse disabilities of stroke survivors. Case studies and a few interview studies show that stroke survivors improve use of the affected limb or learn adaptational techniques through participating in art therapy. Art therapy facilitates focused attention, social interaction, communication, and emotional expression. As formal research evidence is rather limited, few explicit guidelines emerge for achieving best practice with stroke survivors.
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Mixed-method research might provide the foundation for art therapy to become a better recognized component within stroke rehabilitation programs [20].
More active approach, with plying un instrument, singing (especially for patients with speech disorders such as aphasia) or more complex activity like watching a video with dancing is even more successful. Art therapy is a complex intervention capable of addressing the diverse disabilities of stroke survivors. Case studies and a few interview studies show that stroke survivors improve use of the affected limb or learn adaptational techniques through participating in art therapy. Art therapy facilitates focused attention, social interaction, communication, and emotional expression. As formal research evidence is rather limited, few explicit guidelines emerge for achieving best practice with stroke survivors. Mixed-method research might provide the foundation for art therapy to become a better recognized component within stroke rehabilitation programs [20].
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peripheral nervous system, rehabilitation, ultrasound
peripheral nervous system, rehabilitation, ultrasound
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Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, “Sapienza” University – Rome, Italy
Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, “Sapienza” University – Rome, Italy
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Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University – Rome, Italy.
Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University – Rome, Italy.
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peripheral nervous system, rehabilitation, ultrasound
peripheral nervous system, rehabilitation, ultrasound
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Testing the effect of drugs, rehabilitation approaches, training, etc.;
Testing the effect of drugs, rehabilitation approaches, training, etc.;
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The application of myosonology in every day neurorehabilitation is still very restricted to: (a) estimation of muscle volume, degree of muscle atrophy and muscle fibre contractility before, during and after rehabilitation; (b) monitoring the muscle fiber kinetics during active or passive movements or EMG stimulation; (c) ultrasound navigation of needle positioning for botulinum injections; (d) testing the peripheral muscle pump efficacy due to orthostatic training; (e) evaluating the impact of other co-factors (surrounding tissue, contractures, etc) for peripheral nerve and muscle recovery; (f) clinical or experimental research for post-stroke
The application of myosonology in every day neurorehabilitation is still very restricted to: (a) estimation of muscle volume, degree of muscle atrophy and muscle fibre contractility before, during and after rehabilitation; (b) monitoring the muscle fiber kinetics during active or passive movements or EMG stimulation; (c) ultrasound navigation of needle positioning for botulinum injections; (d) testing the peripheral muscle pump efficacy due to orthostatic training; (e) evaluating the impact of other co-factors (surrounding tissue, contractures, etc) for peripheral nerve and muscle recovery; (f) clinical or experimental research for post-stroke
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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For practice we have developed a substantial and augmented specialized physical therapy, suitable for application in clinical conditions, which is adapted for home usage as a home based self-directed learning didactic tools for rehabilitation.
For practice we have developed a substantial and augmented specialized physical therapy, suitable for application in clinical conditions, which is adapted for home usage as a home based self-directed learning didactic tools for rehabilitation. The program is easy to perform for a long time and increases the activities of daily living in patients with DN [3, 4].
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A report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation.
England J, Gronseth G, Franklin G, Miller R, Asbury A. Distal symmetrical polyneuropathy: A definition for clinical research. A report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation.
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Neuromuscular rehabilitation and electrodiagnosis.
Kowalske K. Neuromuscular rehabilitation and electrodiagnosis. Generalized Peripheral Neuropathy.
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Department of Physiotherapy and Rehabilitation
Department of Physiotherapy and Rehabilitation
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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Department “Physiotherapy and Rehabilitation”, Faculty of kinesitherapy, tourism and sports animation, National Sports Academy “V.
Department “Physiotherapy and Rehabilitation”, Faculty of kinesitherapy, tourism and sports animation, National Sports Academy “V. Levski” – Sofia, Bulgaria
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The changes in the motor activity are monitored twice after discharging from hospital in domestic rehabilitation conditions.
more breaks between the exercises, without getting a level of exhaustion. Correct positioning in the bed and in sitting position, passive/active exercises, analytical exercises for upper and lower extremities, breathing exercises, balance and coordination exercises to sitting and standing, massage treatments are applied. The Berg balance scale and tests for transfer (from occipital laying position to left/right laying position, or to standing position) are used to assess the effects of this therapy. The test Five Times Sit -ToStand (FTSST) for evaluating the abilities of transfer is used. The changes in the motor activity are monitored twice after discharging from hospital in domestic rehabilitation conditions.
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The biggest benefit is reached by combined complex medication therapy and multidisciplinary rehabilitation, in order to lower the clinical symptoms of the disease and the functional deficits, and improvement of the functional performances.
The efficiency of the directed and structured exercises is proved by the improvement of the functionality, aerobic capacity for exercising and muscle strength. The biggest benefit is reached by combined complex medication therapy and multidisciplinary rehabilitation, in order to lower the clinical symptoms of the disease and the functional deficits, and improvement of the functional performances. When properly directed and dosed, neurorehabilitation can prevent secondary health issues, such as obesity, coronary heart disease and osteoporosis.
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V.
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski” – Sofia, Bulgaria,
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24. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 1 , , ,

Rehabilitation of Cerebrovascular Complications after Heart Surgery
Rehabilitation of Cerebrovascular Complications after Heart Surgery
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It has been shown that the combination of imaginary simulation of actions and/or watching video recordings of certain movements in parallel with rehabilitation of the affected limb significantly accelerates functional recovery.
One of the main methods is imaginary exercises (Motor Imagery) [13]. The patient is instructed to imagine how he performs a movement, whether he can do it or not, or to see the execution of the movement by another individual. It has been shown that the combination of imaginary simulation of actions and/or watching video recordings of certain movements in parallel with rehabilitation of the affected limb significantly accelerates functional recovery. Motor imagery is also applied to healthy individuals to improve their skills in various fields
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The combination of visual information, proprioceptive stimuli and pre-frontal cortex motion commands makes mirror therapy a complex rehabilitation method.
between the two limbs (one healthy and one with motor deficit). The patient is instructed to move both limbs in an identical manner (Fig. 1). Thus, in the place of the affected limb, the patient sees the mirror image of the unaffected. Through the visual illusion created, mirror neurons are activated. The combination of visual information, proprioceptive stimuli and pre-frontal cortex motion commands makes mirror therapy a complex rehabilitation method. The effect of this therapy is reported to be greater in women [26], which is associated with a more developed mirror system [7].
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The use of techniques such as Facial Imitation Therapy (FIT) and Synergistic Activity Therapy (SAT) has a beneficial effect on the postoperative rehabilitation of these patients.
The concept of mirror neurons is also used in the treatment of Moebius syndrome. It is characterized by congenital dysfunction of the facial and abducens nerves and causes facial paralysis and impaired ocular abduction. The use of techniques such as Facial Imitation Therapy (FIT) and Synergistic Activity Therapy (SAT) has a beneficial effect on the postoperative rehabilitation of these patients. Their ability to smile, make facial expression and speak improves significantly [11].
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Action observation and motor imagery for rehabilitation in Parkinson's disease: A systematic review and an integrative hypothesis.
Caligiore D, Mustile M, Spalletta G, Baldassarre G. Action observation and motor imagery for rehabilitation in Parkinson's disease: A systematic review and an integrative hypothesis.
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Carvalho D.The mirror neuron system in post-stroke rehabilitation.
Carvalho D.The mirror neuron system in post-stroke rehabilitation.
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Mirror neuron system based therapy for aphasia rehabilitation.
Chen W, Ye Q. Mirror neuron system based therapy for aphasia rehabilitation.
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Virtual Reality In Stroke Rehabilitation: Review Of The Emerging Research.
Gallichio, Joann and Patricia Kluding. Virtual Reality In Stroke Rehabilitation: Review Of The Emerging Research.
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Virtual Reality And Cognitive Rehabilitation.
Klinger E. Virtual Reality And Cognitive Rehabilitation.
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Annals of Physical and Rehabilitation Medicine
Annals of Physical and Rehabilitation Medicine
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Rehabilitation of Cerebrovascular Complications after Heart Surgery
Rehabilitation of Cerebrovascular Complications after Heart Surgery
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Department of Physical Medicine and Rehabilitation, Lozenetz University Hospital – Sofia, Bulgaria
Department of Physical Medicine and Rehabilitation, Lozenetz University Hospital – Sofia, Bulgaria
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cardiac surgery, cardio rehabilitation, neurorehabilitation, stroke
cardiac surgery, cardio rehabilitation, neurorehabilitation, stroke
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The period of recovery requires complex rehabilitation, which includes the means of neurorehabilitation, cardio rehabilitation and general care in the early postoperative period.
Cerebrovascular complications are observed at low frequency after cardiac surgery, despite the advance in surgical techniques. The most serious of them is stroke. The period of recovery requires complex rehabilitation, which includes the means of neurorehabilitation, cardio rehabilitation and general care in the early postoperative period. The preparation of the rehabilitation program requires an accurate assessment of the functional capacity of the patient and the rehabilitation potential. Success is achieved by complying with the fundamental principles of Physical Medicine and Rehabilitation for individual approach, gradual increase of the load and complexity.
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The preparation of the rehabilitation program requires an accurate assessment of the functional capacity of the patient and the rehabilitation potential.
Cerebrovascular complications are observed at low frequency after cardiac surgery, despite the advance in surgical techniques. The most serious of them is stroke. The period of recovery requires complex rehabilitation, which includes the means of neurorehabilitation, cardio rehabilitation and general care in the early postoperative period. The preparation of the rehabilitation program requires an accurate assessment of the functional capacity of the patient and the rehabilitation potential. Success is achieved by complying with the fundamental principles of Physical Medicine and Rehabilitation for individual approach, gradual increase of the load and complexity.
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Success is achieved by complying with the fundamental principles of Physical Medicine and Rehabilitation for individual approach, gradual increase of the load and complexity.
Cerebrovascular complications are observed at low frequency after cardiac surgery, despite the advance in surgical techniques. The most serious of them is stroke. The period of recovery requires complex rehabilitation, which includes the means of neurorehabilitation, cardio rehabilitation and general care in the early postoperative period. The preparation of the rehabilitation program requires an accurate assessment of the functional capacity of the patient and the rehabilitation potential. Success is achieved by complying with the fundamental principles of Physical Medicine and Rehabilitation for individual approach, gradual increase of the load and complexity.
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In this review, we will focus on the relationship between stroke and cardiac surgery and the need for rehabilitation.
In this review, we will focus on the relationship between stroke and cardiac surgery and the need for rehabilitation.
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The recovery of these patients requires a multidisciplinary approach and represents a serious challenge to specialists of physical and rehabilitation medicine.
The recovery of these patients requires a multidisciplinary approach and represents a serious challenge to specialists of physical and rehabilitation medicine. Rehabilitation is a compilation of the means of cardiac rehabilitation, neurorehabilitation, and those used in the early postoperative period.
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Rehabilitation is a compilation of the means of cardiac rehabilitation, neurorehabilitation, and those used in the early postoperative period.
The recovery of these patients requires a multidisciplinary approach and represents a serious challenge to specialists of physical and rehabilitation medicine. Rehabilitation is a compilation of the means of cardiac rehabilitation, neurorehabilitation, and those used in the early postoperative period.
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Cardiac rehabilitation
Cardiac rehabilitation
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Rehabilitation of Cerebrovascular Complications after Heart Surgery
Rehabilitation of Cerebrovascular Complications after Heart Surgery
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trials, emphasizing the importance of specialized rehabilitation, have been used to create up-todate guidelines for its use.
trials, emphasizing the importance of specialized rehabilitation, have been used to create up-todate guidelines for its use. Patients usually have impaired physical capacity and physical activity several years before surgery, which in combination with bed rest after surgery determines the need for timely rehabilitation. It has been established that rehabilitation doesn’t harm the patient in the postoperative period and has positive physical and psychological effects [10, 14].
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Patients usually have impaired physical capacity and physical activity several years before surgery, which in combination with bed rest after surgery determines the need for timely rehabilitation.
trials, emphasizing the importance of specialized rehabilitation, have been used to create up-todate guidelines for its use. Patients usually have impaired physical capacity and physical activity several years before surgery, which in combination with bed rest after surgery determines the need for timely rehabilitation. It has been established that rehabilitation doesn’t harm the patient in the postoperative period and has positive physical and psychological effects [10, 14].
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It has been established that rehabilitation doesn’t harm the patient in the postoperative period and has positive physical and psychological effects [10, 14].
trials, emphasizing the importance of specialized rehabilitation, have been used to create up-todate guidelines for its use. Patients usually have impaired physical capacity and physical activity several years before surgery, which in combination with bed rest after surgery determines the need for timely rehabilitation. It has been established that rehabilitation doesn’t harm the patient in the postoperative period and has positive physical and psychological effects [10, 14].
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When creating a rehabilitation program to restore the neurological deficit, the level of impaired myocardial function and the features of the postoperative period must be taken into account.
for neurological complications after cardiac surgery ranges from prevention of possible complications to recovery of the limb motor function, recovery of the ability to walk and return to daily activities [11]. The ability of the human brain to reorganize, albeit limited, is known, and is associated with the plasticity of the brain [6]. When creating a rehabilitation program to restore the neurological deficit, the level of impaired myocardial function and the features of the postoperative period must be taken into account.
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In general, another goal of rehabilitation is prophylaxis and treatment of cognitive impairments, depression, and anxiety, associated with lower functional physical capacity, fatigue, and reduced quality of life [7, 10, 11].
In general, another goal of rehabilitation is prophylaxis and treatment of cognitive impairments, depression, and anxiety, associated with lower functional physical capacity, fatigue, and reduced quality of life [7, 10, 11]. Тhe basic principles of early initiation, individualization, gradual increase of the load, and complexity of the rehabilitation method must be observed.
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Тhe basic principles of early initiation, individualization, gradual increase of the load, and complexity of the rehabilitation method must be observed.
In general, another goal of rehabilitation is prophylaxis and treatment of cognitive impairments, depression, and anxiety, associated with lower functional physical capacity, fatigue, and reduced quality of life [7, 10, 11]. Тhe basic principles of early initiation, individualization, gradual increase of the load, and complexity of the rehabilitation method must be observed.
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Assessment of the functional physical capacity and determining the rehabilitation potential
Assessment of the functional physical capacity and determining the rehabilitation potential
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Before initiating the rehabilitation, a good functional evaluation of the patient’s baseline condition and rehabilitation potential should be done.
Before initiating the rehabilitation, a good functional evaluation of the patient’s baseline condition and rehabilitation potential should be done. In the clinical functional examination, the functional, muscular, cardiovascular and respiratory capacities are evaluated at the same time. Considering the complex disorganization of the motor control after stroke and the major elements of motor disorders, the tracked indicators are the globality of movement, the presence of pathological synkinesis, spasticity, and proprioceptive hyperreflexia. Functional rating scales are used for evaluation in the beginning and after completing the rehabilitation. In patients with hemiparesis, the convenient and fast evaluation of Brunnstrom is used for determining the functional stages. The functional disability of patients is assessed by the 6-point Rankin scale, and everyday abilities – by the Barthel index [6].
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Functional rating scales are used for evaluation in the beginning and after completing the rehabilitation.
Before initiating the rehabilitation, a good functional evaluation of the patient’s baseline condition and rehabilitation potential should be done. In the clinical functional examination, the functional, muscular, cardiovascular and respiratory capacities are evaluated at the same time. Considering the complex disorganization of the motor control after stroke and the major elements of motor disorders, the tracked indicators are the globality of movement, the presence of pathological synkinesis, spasticity, and proprioceptive hyperreflexia. Functional rating scales are used for evaluation in the beginning and after completing the rehabilitation. In patients with hemiparesis, the convenient and fast evaluation of Brunnstrom is used for determining the functional stages. The functional disability of patients is assessed by the 6-point Rankin scale, and everyday abilities – by the Barthel index [6]. In the presence of spasticity, the Ashworth scale is used. Coordination in terms of statics and balance is also tested, while locomotion is assessed with а locomotor
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Rehabilitation of stroke patients after cardiac surgery.
Rehabilitation of stroke patients after cardiac surgery.
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To prevent respiratory complications (atelectasis, retention of fluids, infections, pleural effusions, paralysis of the phrenic nerve, etc.), passive and active respiratory rehabilitation is performed.
It is established that in patients with a median sternotomy or thoracotomy gas exchange and the mechanics of breathing are impaired, the respiratory volume and capacity (vital, inspiratory, functional residual) change, while the mucociliary activity and cough reflex are reduced. To prevent respiratory complications (atelectasis, retention of fluids, infections, pleural effusions, paralysis of the phrenic nerve, etc.), passive and active respiratory rehabilitation is performed. Techniques for coughing, postural drainage, vibration massage, unblocking of the diaphragm, positive pressure at the end of exhalation, and saccadic breathing are used [3, 13].
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is lack of exercise and lack of adequate and timely rehabilitation [13].
is lack of exercise and lack of adequate and timely rehabilitation [13]. Prevention is accomplished through passive ideomotor exercises to maintain normal joint amplitudes and improve the volume of movement. For prophylaxis and treatment of
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Rehabilitation of Cerebrovascular Complications after Heart Surgery
Rehabilitation of Cerebrovascular Complications after Heart Surgery
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Speech rehabilitation should be started as soon as possible, depending on the patient's condition.
Disturbances in perception, cognitive and communication functions are observed often. Speech rehabilitation should be started as soon as possible, depending on the patient's condition.
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In this phase, the rehabilitation program aims to impact the postoperative neurological complications.
In this phase, the rehabilitation program aims to impact the postoperative neurological complications. It works mainly on the motor deficit. Patients are taught to walk and maintain posture [5].
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In addition, rehabilitation treatment has positive effects on cognitive and emotional impairments.
In addition, rehabilitation treatment has positive effects on cognitive and emotional impairments. The use of orthotic and assistive devices – canes, walkers, and braces, provides acceptable autonomy in everyday life. Occupational therapy occupies an important place in the treatment and is defined as a set of techniques and therapies used for prevention, recovery and maintenance of physical, mental and social state, helping the performance of daily activities, essential for the health and welfare of patients [13].
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They increase the time for hospitalization and rehabilitation, and hence the costs of treatment.
Neurological complications after cardiac surgery are associated with increased morbidity and mortality. They increase the time for hospitalization and rehabilitation, and hence the costs of treatment. The quality of life of patients and their families is reduced. Besides identifying high risk patients, improving cardiac surgery techniques and providing adequate cerebral protection, complex and specialized rehabilitation for prophylaxis and treatment of neurological complications after cardiac surgery is needed.
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Besides identifying high risk patients, improving cardiac surgery techniques and providing adequate cerebral protection, complex and specialized rehabilitation for prophylaxis and treatment of neurological complications after cardiac surgery is needed.
Neurological complications after cardiac surgery are associated with increased morbidity and mortality. They increase the time for hospitalization and rehabilitation, and hence the costs of treatment. The quality of life of patients and their families is reduced. Besides identifying high risk patients, improving cardiac surgery techniques and providing adequate cerebral protection, complex and specialized rehabilitation for prophylaxis and treatment of neurological complications after cardiac surgery is needed.
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Rehabilitation of Cerebrovascular Complications after Heart Surgery
Rehabilitation of Cerebrovascular Complications after Heart Surgery
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This rehabilitation requires a multidisciplinary approach, and precise assessment of the patient’s functional status.
This rehabilitation requires a multidisciplinary approach, and precise assessment of the patient’s functional status. The basic principles of Physical Medicine and Rehabilitation in these patients includes individual approach, gradual increase of the load, and complexity. For achieving optimal results, the resources of cardiac rehabilitation, neurorehabilitation, and postoperative rehabilitation are combined.
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The basic principles of Physical Medicine and Rehabilitation in these patients includes individual approach, gradual increase of the load, and complexity.
This rehabilitation requires a multidisciplinary approach, and precise assessment of the patient’s functional status. The basic principles of Physical Medicine and Rehabilitation in these patients includes individual approach, gradual increase of the load, and complexity. For achieving optimal results, the resources of cardiac rehabilitation, neurorehabilitation, and postoperative rehabilitation are combined.
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For achieving optimal results, the resources of cardiac rehabilitation, neurorehabilitation, and postoperative rehabilitation are combined.
This rehabilitation requires a multidisciplinary approach, and precise assessment of the patient’s functional status. The basic principles of Physical Medicine and Rehabilitation in these patients includes individual approach, gradual increase of the load, and complexity. For achieving optimal results, the resources of cardiac rehabilitation, neurorehabilitation, and postoperative rehabilitation are combined.
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based cardiac rehabilitation for coronary heart disease.
based cardiac rehabilitation for coronary heart disease.
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Cardiac rehabilitation past, present and future: an overview.
Mampuya WM. Cardiac rehabilitation past, present and future: an overview.
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Neurological Complications in Aortic Valve Surgery and Rehabilitation Treatment Used. In
Sanz-Ayan M, Diaz D, Martinez-Salio A, Garzon F, Urbaneja C, Valdivia J, & Forteza A. Neurological Complications in Aortic Valve Surgery and Rehabilitation Treatment Used. In
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Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeart VR): study protocol for a randomised clinical trial.
Sibilitz K, Berg S, Hansen T, Risom S, Rasmussen T, Hassager C, Thygesen L. Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeart VR): study protocol for a randomised clinical trial.
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Department of Physical Medicine and Rehabilitation Lozenets University Hospital – Sofia
Department of Physical Medicine and Rehabilitation Lozenets University Hospital – Sofia
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In the group of patients with carotid dissection, one patient received thrombolytic therapy; she ameliorated, but afterward worsened, and during rehabilitation got deep vein thrombosis and pulmonary embolism.
In the group of patients with carotid dissection, one patient received thrombolytic therapy; she ameliorated, but afterward worsened, and during rehabilitation got deep vein thrombosis and pulmonary embolism.
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The EAN course succeeded to bring 307 specialists (228 Bulgarian and 79 foreigners), residents and students in Neurology, Physical Medicine, Rehabilitation, and Kinesitherapy from 18 countries (Albania, Austria, Bosnia and Herzegovina, Bulgaria, Croatia, Germany, Greece, India, Italy, Latvia, Macedonia, Portugal, Romania, Russia, Serbia, Switzerland, Turkey,
The EAN course succeeded to bring 307 specialists (228 Bulgarian and 79 foreigners), residents and students in Neurology, Physical Medicine, Rehabilitation, and Kinesitherapy from 18 countries (Albania, Austria, Bosnia and Herzegovina, Bulgaria, Croatia, Germany, Greece, India, Italy, Latvia, Macedonia, Portugal, Romania, Russia, Serbia, Switzerland, Turkey,
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25. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 2 , , ,

We formed a specific risk patient group with low MMSE results at the first days after stroke onset, for early cognitive rehabilitation and evaluation of medical outcome risk.
day are due to the severe clinical picture and not to initial symptom worsening. Some cognitive improvement is found only for patients examined at the first stroke day. The MMSE test performed at day 2 and 3 after IS is a good predictor for cognitive dysfunction at the first 3 months after the incident. Low MMSE is a risk factor for low quality of life and poor functional recovery [24, 38, 40] and independent factor for clinical worsening, death and late dementia [1]. We formed a specific risk patient group with low MMSE results at the first days after stroke onset, for early cognitive rehabilitation and evaluation of medical outcome risk. Patients with low MMSE results and
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As usual, more than 150 specialists, residents and students in Neurology, Angiology, Neurosurgery, Physical Medicine and Rehabilitation, and Kinesiotherapy from Austria, Bulgaria, Croatia, Finland, Germany, Hungary, Latvia and Republic of Macedonia have been registered for this event.
As usual, more than 150 specialists, residents and students in Neurology, Angiology, Neurosurgery, Physical Medicine and Rehabilitation, and Kinesiotherapy from Austria, Bulgaria, Croatia, Finland, Germany, Hungary, Latvia and Republic of Macedonia have been registered for this event.
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Update Stroke Rehabilitation.
Update Stroke Rehabilitation.
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UPDATE STROKE REHABILITATION
UPDATE STROKE REHABILITATION
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Department of Neurology and Neurological Rehabilitation, Essen-Kettwig – Germany
Department of Neurology and Neurological Rehabilitation, Essen-Kettwig – Germany
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Therefore, recovery of gait function is one important goal of rehabilitation for independent living.
Despite great improvement of acute stroke therapy, multimodale neuronal dysfunction leads to longtime disability. Neuropsychological disorders and gait impairment are one of the most important problems after stroke and are associated with reduced qualitiy of life. Therefore, recovery of gait function is one important goal of rehabilitation for independent living. Physical therapeutic interventions are focused on high repetitive task training and supporting robotic systems are more and more involved. The rehabilitation had to include physical, pharmaceutical and orthotic applications over a long period (up to years afer stroke onset) to optimize the recovery. But it is not clear, which combination, dosage and time period are most effective. Gait analysis mаy help to understand better the kinetic problems in stroke patients. In this presentation the state of the art in stroke rehabilitation will be presented.
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The rehabilitation had to include physical, pharmaceutical and orthotic applications over a long period (up to years afer stroke onset) to optimize the recovery.
Despite great improvement of acute stroke therapy, multimodale neuronal dysfunction leads to longtime disability. Neuropsychological disorders and gait impairment are one of the most important problems after stroke and are associated with reduced qualitiy of life. Therefore, recovery of gait function is one important goal of rehabilitation for independent living. Physical therapeutic interventions are focused on high repetitive task training and supporting robotic systems are more and more involved. The rehabilitation had to include physical, pharmaceutical and orthotic applications over a long period (up to years afer stroke onset) to optimize the recovery. But it is not clear, which combination, dosage and time period are most effective. Gait analysis mаy help to understand better the kinetic problems in stroke patients. In this presentation the state of the art in stroke rehabilitation will be presented. Future perspectives are discussed looking on results of actual gait analysis including a new developed clinical score system (Rehab X score). The impact on interlimb
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In this presentation the state of the art in stroke rehabilitation will be presented.
Therefore, recovery of gait function is one important goal of rehabilitation for independent living. Physical therapeutic interventions are focused on high repetitive task training and supporting robotic systems are more and more involved. The rehabilitation had to include physical, pharmaceutical and orthotic applications over a long period (up to years afer stroke onset) to optimize the recovery. But it is not clear, which combination, dosage and time period are most effective. Gait analysis mаy help to understand better the kinetic problems in stroke patients. In this presentation the state of the art in stroke rehabilitation will be presented. Future perspectives are discussed looking on results of actual gait analysis including a new developed clinical score system (Rehab X score). The impact on interlimb
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gait, rehabilitation, stroke
gait, rehabilitation, stroke
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Impaired somatic sensation is known to be a significant predictor for poor rehabilitation outcome in cerebrovascular stroke patients.
Impaired somatic sensation is known to be a significant predictor for poor rehabilitation outcome in cerebrovascular stroke patients. A number of neurorehabilitation treatment strategies have been aimed to stimulate mechanisms of sensory cortical plasticity with results showing improvements in sensorimotor deficits following treatments. In attempts to understand cortical sensory plasticity in humans my research group has investigated automatic sensory processing of non-nociceptive and
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Department of Cardiology and Rehabilitation MediClin – Essen,
Department of Cardiology and Rehabilitation MediClin – Essen,
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We investigated 25 consecutive patients a few month after implantation of a LVAD in our rehabilitation department.
We investigated 25 consecutive patients a few month after implantation of a LVAD in our rehabilitation department. By means of transcranial ultrasound sonography (TCD, 2 MHz probe, head fixation) of the middle cerebral artery (MCA), the cerebral blood flow velocity (CBFV) was recorded and the mean CBFV was calculated. Patients were first recorded in supine positon and then brought into standing position. We measured the mean CBFV after standing up and registered any symptoms ranging from dizziness to even postural control failures.
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The Effects of Vestibular Rehabilitation on the Sway Path
The Effects of Vestibular Rehabilitation on the Sway Path
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THE EFFECTS OF VESTIBULAR REHABILITATION ON THE SWAY PATH IN FRONTALAND SAGITTAL PLANE IN PATIENTS WITH PERIPHERAL-ONLYAND COMBINED CENTRALAND PERIPHERALVESTIBULOPATHY
THE EFFECTS OF VESTIBULAR REHABILITATION ON THE SWAY PATH IN FRONTALAND SAGITTAL PLANE IN PATIENTS WITH PERIPHERAL-ONLYAND COMBINED CENTRALAND PERIPHERALVESTIBULOPATHY
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Department of Physiotherapy and Rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria
Department of Physiotherapy and Rehabilitation, National Sports Academy “Vassil Levski” – Sofia, Bulgaria
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The aim of this study is to evaluate the effect of one-month vestibular rehabilitation (VR) on the body’s sway path in the frontal and sagittal plane in patients with unilateral peripheral vestibulopathy (UPV) and in patients with predominantly peripheral types of vertigo combined with а central dysfuncion (CVP).
The aim of this study is to evaluate the effect of one-month vestibular rehabilitation (VR) on the body’s sway path in the frontal and sagittal plane in patients with unilateral peripheral vestibulopathy (UPV) and in patients with predominantly peripheral types of vertigo combined with а central dysfuncion (CVP).
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For successful rehabilitation and to facilitate the recovery process patient-oriented refinements of VR are needed.
Although further research is needed, the postural control responsible for the minimization of sway path in a static posture shows a tendency of improving in peripheral-only vestibulopathies and a tendency of worsening in combined central and peripheral dysfunctions. For successful rehabilitation and to facilitate the recovery process patient-oriented refinements of VR are needed.
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postural control, posturography, sway path, vestibular rehabilitation
postural control, posturography, sway path, vestibular rehabilitation
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Department of Physiotherapy and Rehabilitation,
Department of Physiotherapy and Rehabilitation,
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Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski”,
Department of Physiotherapy and Rehabilitation, National Sports Academy “V. Levski”,
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Department of Physiotherapy and Rehabilitation, National
Department of Physiotherapy and Rehabilitation, National
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Department “Kinesitherapy and rehabilitation”,
Department “Kinesitherapy and rehabilitation”,
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Studies show that the mortality rate after stroke can be reduced by intense and targeted neuro-rehabilitation.
Stroke is a social, significant, and widespread disease with severe disability complications. Studies show that the mortality rate after stroke can be reduced by intense and targeted neuro-rehabilitation.
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functional mobility, ischemic stroke, neuro-rehabilitation
functional mobility, ischemic stroke, neuro-rehabilitation
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Department of Physiotherapy and Rehabilitation, National
Department of Physiotherapy and Rehabilitation, National
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Department of Physiotherapy and Rehabilitation, National
Department of Physiotherapy and Rehabilitation, National
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Department of Physiotherapy and Rehabilitation, National
Department of Physiotherapy and Rehabilitation, National
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Department of Physiotherapy and Rehabilitation,
Department of Physiotherapy and Rehabilitation,
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All patients participated in a rehabilitation programme consisting of individual sessions, performed once daily; starting on the first postoperative day and ending on the day of discharge (average stay – 16 days).
age 61.8±9.5) with intracranial frontal and occipital tumors (meningioma) were examined. All patients participated in a rehabilitation programme consisting of individual sessions, performed once daily; starting on the first postoperative day and ending on the day of discharge (average stay – 16 days). The physical therapy programme included breathing exercises, active/assisted exercises, active exercises for the trunk and limb muscles, stimulating exercises for weak muscles (if there was hemiparesis), Kabat diagonals for the upper limbs, balance exercises from different positions, PNF-techniques, coordination exercises from Frenkel’s method, ambulation training, exercises to help perform daily activities, sensory training, and cognitive therapy. For the purposes of the study and to evaluate the functional outcomes, the patients were assessed twice – on the third postoperative day and on the day before discharge – with specific scales for functional assessment of patients with neurological conditions: Berg Balance Scale and Barthel Index.
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Changes in the patient's motor activity are followed twice in conditions of home rehabilitation.
1 min walking (number of steps). Changes in the patient's motor activity are followed twice in conditions of home rehabilitation.
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Ekaterina Titianova is a Professor of Neurology, Doctor of Sciences, Head of the Clinic of Functional Diagnostics of Nervous System at the Military Medical Academy, Sofia, a member of the Faculty Council and Head of the Department of Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health at the Medical Faculty of St Kliment Ohridski Sofia University.
Ekaterina Titianova is a Professor of Neurology, Doctor of Sciences, Head of the Clinic of Functional Diagnostics of Nervous System at the Military Medical Academy, Sofia, a member of the Faculty Council and Head of the Department of Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine and Public Health at the Medical Faculty of St Kliment Ohridski Sofia University. Since 2013 she has been Academician of the Bulgarian Academy of Sciences and Arts, and since 2015 – Academician of the Serbian Royal Academy.
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26. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 15, 2019, No. 1 , , ,

It was attended by 217 delegates from Austria, Bulgaria, Germany, Republic of Macedonia, Croatia, Finland, Latvia and Hungary, students in medicine, nursing, kinesitherapy, medical rehabilitation and ergotherapy from various Bulgarian medical universities and the National Sports Academy “V. Levski”.
The Fourth National Congress of the Bulgarian Association of Neurosonology and Cerebral Hemodynamics with International Participation was held in the National Palace of Culture in Sofia from October 5 to 7, 2018. Traditionally, the Congress was multidisciplinary and integrating the interests of various specialists – neurologists, neurosurgeons, angiologists, interventionists and others. It was attended by 217 delegates from Austria, Bulgaria, Germany, Republic of Macedonia, Croatia, Finland, Latvia and Hungary, students in medicine, nursing, kinesitherapy, medical rehabilitation and ergotherapy from various Bulgarian medical universities and the National Sports Academy “V. Levski”.
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Keywords related to: 'rehabilitation'

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