MODERN APPROACHES TO REHABILITATION OF PATIENTS AFTER STROKE

Аннотация

Their timely detection and correction can improve the functional outcome. Currently, the use of many drugs with neuroprotective properties does not have a serious evidence base. The most effective rehabilitation schemes with theinclusion of modern drugs are actively sought. The article provides an overview of the latest studies on the possibilities of using memantine in ischemic stroke. Kеywоrds:ischemicstroke, rehabilitation, cognitive impairment. INTRОDUСTIОN In recent decades, there has been a global increase in the prevalence of cerebrovascular diseases, including strokes, the consequences of which are the main cause of disability in older people [1]. The proportion of patients unable to live independently and care for themselves, already one year after a stroke, is approximately 30% [2]. In this regard, one of the main tasks of Russian healthcare is to slow down the increase in disability of the population, which is achieved through theactive development of therehabilitation system in ourcountry, including neurorehabilitation. MАTЕRIАLSАNDMЕTHОDS Neurorehabilitation is one of the relatively young areas of rehabilitation. It is a progressive, dynamic and targeted process, the task of which is to achieve an optimal level of physical, cognitive, emotional, social, communicative and functional activity by a patient with existing disorders [3]. Restoration of impaired functions by selecting effective rehabilitation means and choosing adequate drug treatment is a complex and lengthy process that requires the participation of a multidisciplinary team of specialists. Due to the occurrence of a complex neurological deficit in most patients after a stroke, rehabilitation includes a variety of measures aimed at restoring or compensating for impaired functions of the nervous system. The basis of recovery processes are the mechanisms of neuroplasticity – the ability of nervous tissue to undergo structural and functional restructuring that occurs after its damage, which contributes to the restoration of not only impaired motor functions, but also memory, learning, and the acquisition ofnew skills[4]. RЕSULTSАNDDISСUSSIОN Restoration of cognitive functions is necessary at all stages of rehabilitation, since their decline causes insufficient patient involvement in the rehabilitation process, which can significantly complicate it, as well as significantly reduce the quality of life. Cognitive abilities are important for combating the entire range of neurological disorders present in the patient, since patients with a higher cognitive status at the start of rehabilitation measures achieve better results in recovery [2]. Cognitive impairments can reduce the ability to learn instructions, plan and independently perform exercises, as well as solve various types of problems. The level of preservation of cognitive functions in patients after a stroke has an independent correlation with the degree of involvement in the rehabilitation process in a hospital [3]. Cognitive rehabilitation of patients who have suffered a stroke accelerates information processing, allows the patient to obtain a www.wordlyknowledge.uz ILMIYMETODIK JURNAL JOURNAL OFIQRO –ЖУРНАЛ ИҚРО –IQRO JURNALI –volume 14,issue02,2025 ISSN:2181-4341, IMPACT FACTOR( RESEARCH BIB )–7,245,SJIF–5,431 correct idea of ​ ​ the preserved functions of the body and promotes more successful social and everyday adaptation taking into account the existing deficit. The results of a number of studies demonstrate the effectiveness of some drugs in improving cognitive functions at different stages of recovery of patients after a stroke. Thus, drugs with a neurotrophic effect can contribute to better recovery after a stroke, although the data available to date are contradictory and require further research [4]. A number of recent studies that assessed the effectiveness of restoring cognitive functions in the process of rehabilitation of patients after a stroke also did not note significant improvement inrelation to attentionand executivefunction disorders [2]. In order to develop a correct rehabilitation strategy for the correction of cognitive deficit in patients after a stroke, it is first necessary to understand the underlying causes of these disorders, as well as their timely diagnosis at early stages of occurrence and assessment of their severity in order to determine theeffectiveness oftreatment andrehabilitationmeasures. Today, inRussiathere is athree-stage rehabilitation system forpatients after a stroke: •acute stage ofstroke(stage I) -primary vasculardepartments; •early recovery period (stage II) -specialized care in early rehabilitation departments (hospital); •late recovery period (stage III) -outpatient clinicand rehabilitation centers. The staging of rehabilitation measures underlies the algorithm for identifying cognitive disorders and conducting cognitiverehabilitationin patients with acute cerebrovascular accidents (ACVA). At stage I, after clinical and neuroimaging