Kibern. vyčisl. teh., 2018, Issue 3 (193), pp.
International Research and Training Center for Information Technologies and Systems of the National Academy of Sciences of Ukraine and of Ministry of Education and Science of Ukraine, Acad. Glushkov av. 40, Kyiv, 03187, Ukraine
FORMATION OF INDIVIDUAL COMPLEX OF CONTROL ACTIONS FOR MOTOR AND SPEECH REHABILITATION AFTER A STROKE
Introduction. At present, one of the leading directions in the healthcare system is an individual approach to treatment. Restoration of movements and oral speech after a stroke suggests the formation of an individual complex of control actions – programs, techniques for general limb movements, fine motor hand training to reduce the deficit of motor and speech functions acquired as a result of pathology.
The purpose of the article is to determine on the basis of which algorithms, the informative criteria for estimating the deficit of motor and speech functions, as well as rules to be solved, an individual set of movements, programs and training schedule to restore motor and speech functions after a stroke are formed.
Results. A general and additional algorithms for the formation of an individual complex of control actions for motor and speech functions rehabilitation after a stroke have been developed. According to the algorithms, the patient is tested for general and specific contraindications to the use of muscle electrical stimulation and / or biofeedback training, quantitative assessment of motor and speech functions, muscle tonus according to new original techniques, verification of limitations to the application of programs and the duration of training. Additional algorithms are designed taking into account both hyper- and hypotonic parameters. A special feature of these algorithms is the introduction of additional restrictions, for which intervals of muscle tone values are formed.
Decision rules have been developed using the algebra of predicates, logical variables corresponding to the specified criteria and indicators. According to these rules, in each stage of rehabilitation, a set of movements and training programs recommended by priority (“Synthesis”, “Donor”, “Threshold”, “Biofeedback” according to TRENAR® technology) and their schedule are determined in binary form.
Conclusions. The considered approach to the formation of an individual complex of control actions for movement and speech rehabilitation after a stroke is the theoretical basis to synthesize the mobile information technology of digital medicine for assistance the physician in diagnosing and carrying out individual rehabilitation of motor and speech functions after a stroke.
Keywords: stroke, movement, speech, rehabilitation, quantitative assessment, algorithm, decision rules, individual control actions, programs, electrical muscle stimulation, biofeedback training.
1. Vovk M.I. New opportunities for movement and speech rehabilitation. Kibernetika i vyčislitel’naâ tehnika. 2016. Iss.186. P. 78–93 (in Russian).
2. Vilensky B.S. Stroke: … SPb: Foliant, 2002. 397 p. (in Russian).
3. Vovk М.І., Kutsyak О.А., Lauta A.D., Ovcharenko М.А. Information support of researches on the dynamics of movement restoration after the stroke. Kibernetika i vyčislitel’naâ tehnika. 2017. №3 (189). P. 61–78. (in Ukrainian).
4. Vovk M.I., Peleshok S.R., Galian E.B., Ovcharenko M.A. Method for assessing motor and sensory speech disorders. Collection of articles of the scientific and information center “Znanie” on the basis of the XI international correspondence scientific-practical conference: “The development of science in the XXI century” 3 part, Kharkov: a collection with articles (standard level, academic level). Donetsk: Scientific and Information Center “Knowledge”, 2016. pp. 70–76. (in Russian).
5. Belova A.N., Schepetova O.N. Scales, tests and questionnaires in medical rehabilitation. Moscow: Antidor, 2002. 440 p. (in Russian).
6. Kadykov A.S., Chernikova L.A., Shakhparonova N.V. Rehabilitation of Neurological Patients. Мoscow: MEDpress-inform, 2008. 560 p. (in Russian).