[Evaluation of the efficiency of combined neuroprotection and high-intensity magnetotherapy in the medical rehabilitation of patients with ischemic stroke].

OBJECTIVE

To conduct a comparative analysis of the effectiveness of combined neuroprotection in conjunction with high-intensity magnetic therapy for patients with ischemic stroke in the vertebrobasilar system.

MATERIAL AND

METHODS

This clinical study was a multicenter, prospective, observational, comparative, parallel-group study conducted in both public and private clinics as well as in rehabilitation facilities in St. Petersburg and Moscow. The study enrolled 98 participants, comprising 59 women and 39 men, aged 40 to 68 years (mean age: 54±1.5 years). Participants were randomized into three groups, each receiving standard therapy comprising exercise therapy, massage, and physiotherapy, as per established clinical guidelines. Group I (n=34) also received Cortexin at a dosage of 10 mg intramuscularly twice daily for 15 days, and Recognan oral solution at 1000 mg, 10 ml, once daily for 21 days, along with high-intensity magnetic muscle stimulation. Participants in Group II (n=33) received Cortexin at the same dosage and schedule, coupled with high-intensity magnetic muscle stimulation. Group III (n=31) received no additional treatment. Treatment effectiveness was evaluated based on clinical and neurological metrics, cognitive function assessments, electroencephalography data, ultrasound dopplerography (USDG) of cervical and cranial vessels, and neuropsychological testing administered on days 14 and 21 post-onset of the stroke.

RESULTS

In Group I, a 27% reduction in lower limb spasticity was noted on day 14, whereas Group II exhibited a 25% reduction, with Group III demonstrating a 15% reduction. USDG data indicated that 52% of patients in Group I showed increases in maximum and linear blood flow velocity in both the right and left vertebral arteries after treatment, compared to 41% in Group II and 20% in Group III. The mean score on the NIH Stroke Scale for Group I patients at discharge was 9.3±0.2 points, and the Rankin scale score was 2.1±0.2 points.

CONCLUSION

The findings suggest that a multimodal approach to restorative treatment, combining neuroprotective medications with high-intensity magnetic therapy, demonstrates considerable therapeutic efficacy in the medical rehabilitation of patients with ischemic stroke.