Issue 3 (193), article 3

DOI:https://doi.org/10.15407/kvt192.03.043

Kibern. vyčisl. teh., 2018, Issue 3 (193), pp.

Vovk M.I., PhD (Biology), Senior Researcher,
Head of Bioelectrical Control & Medical Cybernetics Dep.
e-mail: vovk@irtc.org.ua; imvovk3940@gmail.com

Galyan Ye.B., PhD (Engineering), Researcher,
Bioelectrical Control & Medical Cybernetics Dep.
e-mail: galian@irtc.org.ua

Kutsyak A.А., PhD (Engineering), Researcher,
Bioelectrical Control & Medical Cybernetics Dep.
e-mail: spirotech85@ukr.net

Lauta A.D., PhD (Medicine), Senior Researcher,
Bioelectrical Control & Medical Cybernetics Dep.
e-mail: dep140@irtc.org.ua

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.

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REFERENCES1.    

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).

Received 4.06.2018

Issue 3 (189), article 4

DOI:https://doi.org/10.15407/kvt189.03.061

Kibern. vyčisl. teh., 2017, Issue 3 (189), pp.

Vovk М.І., PhD (Biology), Senior Researcher,
Head of Bioelectrical Control & Medical Cybernetics Department
e-mail: dep140@irtc.org.ua
Kutsyak A.А., PhD (Engineering), Researcher, Bioelectrical Control & Medical Cybernetics Department
e-mail: spirotech85@ukr.net
Lauta A.D., PhD (Medicine), Senior Researcher,
Bioelectrical Control & Medical Cybernetics Department
Ovcharenko М.А., Junior Researcher,
Bioelectrical Control & Medical Cybernetics Department
e-mail: ovcharenko-marina@i.ua
International Research and Training Center for Information Technologies and Systems of the NAS of Ukraine and Ministry of Education and Science of Ukraine,
Acad. Glushkova av., 40, Kiev, 03680, Ukraine

INFORMATION SUPPORT OF RESEARCHES ON THE DYNAMICS OF MOVEMENT RESTORATION AFTER THE STROKE

Introduction. The results of clinical testing of the innovative technology TRENAR® confirmed its effectiveness in motor and speech recovery after a stroke. The main advantage of the technology that enables a more efficient motor and speech recovery is advanced training programs, based on different methods. This allows one to select individual approach to the rehabilitation process. In order to determine a personalized recovery plan it is necessary to develop criteria to quantify motor recovery dynamics.
The purpose of the research is to determine criteria for separately quantifying recovery dynamics in proximal and distal parts of the upper and lower extremities, as well as to perform an integral quantitative assessment of the severity of motor function disorders after a stroke.
Results. The method for quantitative estimation of the effectiveness of motor function rehabilitation after a stroke was developed.
One special feature of the technique is separate quantitative assessment of the motor function deficit dynamics of the affected lower and upper extremities, their proximal and distal sections, including fine motor skills, according to basic and additional criteria. The technique allows us to study the contribution of these indicators to the integral quantitative evaluation of the effectiveness of motor recovery during rehabilitation process. The technique has successfully passed pilot clinical trials during the studies of motor function recovery dynamics after a stroke when innovative technology TRENAR® for motor training / recovery was used. It is intended for informational support of medical decision-making when devising an individual plan for the rehabilitation of motor and speech functions after a stroke.
Conclusion. The method for quantitative assessment of motor function recovery dynamics forms the basis for assessing the effectiveness of rehabilitation processes in patients after a stroke and for developing individual plans for rehabilitation. It serves as the digital informational support for physicians and will be essential for developing mobile applications for smartphones and tablets that can be used during the rehabilitation process.
Keywords: quantitative assessment, criteria, rehabilitation, effectiveness, stroke, motor functions, speech, disorders.

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REFERENCES

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Received 9.06.2017