Therapeutic hypothermia as part of a second-stage rehabilitation program for patients аfter ischemic stroke

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Abstract

BACKGROUND: Implementation of new approaches to enhance the effectiveness of poststroke rehabilitation remains a pressing challenge. Promising experimental data on the neuroprotective effects of hypothermia and the beneficial outcomes of craniocerebral hypothermia in the acute phase of ischemic stroke formed the basis for this study.

AIM: To evaluate the effectiveness of craniocerebral hypothermia as part of a rehabilitation program at the early recovery phase of ischemic stroke.

MATERIALS AND METHODS: This single-center prospective pilot study included 95 patients (70 in the intervention group and 25 in the control group) who were at the early recovery phase of moderate ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score 5–15) with an activity limitation of 3–4 on the modified Rankin Scale. Both groups received standard rehabilitation therapy, while patients in the intervention group additionally underwent daily 90-minute craniocerebral hypothermia sessions for 10 days. Intracranial temperature in the frontal region was measured before and after treatment in both groups using noninvasive radiothermometry. Clinical effectiveness of the craniocerebral hypothermia was assessed using functional and cognitive scales.

RESULTS: Scale-based assessment revealed significant improvements in functional independence, mobility, and self-care ability.

CONCLUSION: Craniocerebral hypothermia may be recommended as part of an early rehabilitation program after ischemic stroke to improve treatment outcomes.

About the authors

Dmitry V. Torshin

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Author for correspondence.
Email: torshin.dmitrii@rambler.ru
ORCID iD: 0000-0002-0134-5284
SPIN-code: 1205-9474

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Oleg A. Shevelev

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples’ Friendship University of Russia

Email: shevelev_o@mail.ru
ORCID iD: 0000-0002-6204-1110
SPIN-code: 9845-2960

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Marina V. Petrova

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples’ Friendship University of Russia

Email: mpetrova@fnkcrr.ru
ORCID iD: 0000-0003-4272-0957
SPIN-code: 9132-4190

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Ilya V. Borisov

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: realzel@gmail.com
ORCID iD: 0000-0002-5707-118X
SPIN-code: 7800-6446

MD

Russian Federation, Moscow

Maxim K. Levin

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: batterbin@yandex.ru
ORCID iD: 0009-0008-8631-9149
Russian Federation, Moscow

Elias M. Mengistu

Peoples’ Friendship University of Russia

Email: drmengistu@mail.ru
ORCID iD: 0000-0002-6928-2320
SPIN-code: 1387-7508

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Andrey V. Grechko

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples’ Friendship University of Russia

Email: avgrechko@fnkcrr.ru
ORCID iD: 0000-0003-3318-796X
SPIN-code: 4865-8723

MD, Dr. Sci. (Medicine), Professor, corresponding member of the Russian Academy of Sciences

Russian Federation, Moscow; Moscow

References

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  3. Gutsalyuk AG, Petrova MV, Borozenets KF, et al. Craniocerebral hypothermia in the acute period of ischemic stroke. S.S. Korsakov journal of neurology and psychiatry. 2023;123(12-2):43–48. doi: 10.17116/jnevro202312312243 EDN: MKAIPS
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  11. Shevelev OA, Petrova MV, Mengistu EM, et al. Mechanisms of low-temperature rehabilitation technologies. Natural and artificial hypothermia. Physical and rehabilitation medicine, medical rehabilitation. 2023;5(2):141–156. doi: 10.36425/rehab345206 EDN: NOQORA

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Changes in stroke severity after the rehabilitation course according to the NIHSS scale: a) intervention group; b) control group; c) comparison of treatment efficacy between groups (p <0.05).

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3. Fig. 2. Changes in cognitive impairment after the rehabilitation course according to the MoCA scale: a) intervention group; b) control group; c) comparison of treatment effectiveness between groups (p <0.05).

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