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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ssmu</journal-id><journal-title-group><journal-title xml:lang="ru">Бюллетень сибирской медицины</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Siberian Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-0363</issn><issn pub-type="epub">1819-3684</issn><publisher><publisher-name>Siberian State Medical University, the Ministry of Healthcare of the Russian Federation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20538/1682-0363-2019-4-55-62</article-id><article-id custom-type="elpub" pub-id-type="custom">ssmu-2556</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL PAPERS</subject></subj-group></article-categories><title-group><article-title>Клинико-лабораторная оценка эффективности ранней реабилитации пациентов с инсультом с применением вспомогательных роботизированных механизмов</article-title><trans-title-group xml:lang="en"><trans-title>Clinical and laboratory assessment of the effectiveness of early rehabilitation of patients with stroke using assistive robotic tools</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1911-166X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Королева</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Koroleva</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>канд. мед. наук, доцент, кафедра неврологии и нейрохирургии, </p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>PhD, Associate Professor, Department of Neurology and Neurosurgery,</p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><email xlink:type="simple">kattorina@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4140-3223</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алифирова</surname><given-names>В. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Alifirova</surname><given-names>V. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д-р мед. наук, профессор, зав. кафедрой неврологии и нейрохирургии,</p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>DM, PhD, Professor, Head of the Department of Neurology and Neurosurgery,</p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0706-9735</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бразовская</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Brazovskaya</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>канд. мед. наук, доцент, кафедра медицинской и биологической кибернетики, </p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>PhD, Associate Professor, Department of Medical and Biological Cybernetics,</p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5528-1634</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Плотников</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Plotnikov</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>канд. мед. наук, доцент, кафедра неврологии и нейрохирургии,</p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>PhD, Associate Professor, Department of Neurology and Neurosurgery,</p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1982-8492</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левчук</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Levchuk</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>канд. биол. наук, ст. науч. сотрудник, лаборатория молекулярной генетики и биохимии, </p><p>634014, г. Томск, ул. Алеутская, 4</p></bio><bio xml:lang="en"><p>PhD, Senior Researcher,</p><p>4, Aleutskaya Str., 634014, Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2955-9057</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бойко</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Boyko</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>канд. мед. наук, науч. сотрудник, лаборатория молекулярной генетики и биохимии, </p><p>634014, г. Томск, ул. Алеутская, 4</p></bio><bio xml:lang="en"><p>PhD, Researcher, Molecular Genetics and Biochemistry Laboratory,</p><p>4, Aleutskaya Str., 634014, Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5827-4897</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Запекин</surname><given-names>С. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Zapekin</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>студент, 4-й курс,</p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>4th-year Student,</p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7564-7322</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семененко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenenko</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>студент, 5-й курс,</p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>5th-year Student,</p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2241-5656</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Катаева</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kataeva</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д-р мед. наук, профессор, кафедра неврологии и нейрохирургии,</p><p>634050, г. Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>DM, Professor, Department of Neurology and Neurosurgery, </p><p>2, Moscow Trakt, Tomsk, 634055</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7078-323X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иванова</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanova</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>ст. науч. сотрудник, центральная научно-исследовательская лаборатория, 634050, г. Томск, Московский тракт, 2;</p><p>д-р мед. наук, профессор, зав. лабораторией молекулярной генетики ибиохимии, зам. директора по научной работе, 634014, г. Томск, ул. Алеутская, 4</p></bio><bio xml:lang="en"><p>DM, Professor, Head of the Molecular Genetics and Biochemistry Laboratory, Deputy Director,</p><p>2, Moscow Trakt, Tomsk, 634055;</p><p>4, Aleutskaya Str., 634014, Tomsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Сибирский государственный медицинский университет (СибГМУ)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University (SSMU)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт (НИИ) психического здоровья, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Mental Health Research Institute, Tomsk National Research Medical Center (NRMC) of Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Сибирский государственный медицинский университет (СибГМУ);&#13;
Научно-исследовательский институт (НИИ) психического здоровья, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University (SSMU);&#13;
Mental Health Research Institute, Tomsk National Research Medical Center (NRMC) of Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>14</day><month>01</month><year>2020</year></pub-date><volume>18</volume><issue>4</issue><fpage>55</fpage><lpage>62</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Королева Е.С., Алифирова В.М., Бразовская Н.Г., Плотников Д.М., Левчук Л.А., Бойко А.С., Запекин С.П., Семененко А.В., Катаева Н.Г., Иванова С.А., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Королева Е.С., Алифирова В.М., Бразовская Н.Г., Плотников Д.М., Левчук Л.А., Бойко А.С., Запекин С.П., Семененко А.В., Катаева Н.Г., Иванова С.А.</copyright-holder><copyright-holder xml:lang="en">Koroleva E.S., Alifirova V.M., Brazovskaya N.G., Plotnikov D.M., Levchuk L.A., Boyko A.S., Zapekin S.G., Semenenko A.S., Kataeva N.G., Ivanova S.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://bulletin.ssmu.ru/jour/article/view/2556">https://bulletin.ssmu.ru/jour/article/view/2556</self-uri><abstract><p>Введение. Применение внешних роботизированных устройств на этапе ранней реабилитации пациентов с ишемическим инсультом активирует механизмы нейропластичности, уменьшая тем самым объем зоны ишемии и улучшая неврологические исходы заболевания.Цель исследования – оценить эффективность ранней реабилитации пациентов с ишемическим инсультом в Региональном сосудистом центре г. Томска (РСЦ ТОКБ) с применением вспомогательных роботизированных механизмов путем корреляционного анализа клинико-лабораторных маркеров пластичности мозга.Материалы и методы. В исследовании участвовали 68 пациентов с ишемическим инсультом в бассейне средней мозговой артерии. Ранняя реабилитация проводилась в РСЦ ТОКБ с применением вспомогательных роботизированных механизмов согласно протоколу. Нейротрофические факторы определяли в сыворотке крови методом твердофазного иммуноферментного анализа и на мультиплексном анализаторе. Тяжесть неврологических симптомов в контексте моторной реабилитации оценивали по шкале Фугл – Мейера (FMA).Результаты. Клиническую эффективность ранней моторной реабилитации в РСЦ ТОКБ подтверждает статистически значимый прирост по шкале FMA на (5,2 ± 2,4) баллов, p = 0,008. Положительная корреляционная взаимосвязь между уровнем нейротрофических факторов и суммарным баллом по шкале FMA позволяет интерпретировать полученные клинико-лабораторные данные как доказательства нейропластичности, механизмы которой активируются на фоне двигательного обучения во время проведения систематизированных стандартизированных тренировочных сессий с постуральной коррекцией и использованием пассивно-активных циклических роботизированных электромеханических технологий.</p></abstract><trans-abstract xml:lang="en"><sec><title>Background</title><p>Background. Using external robotic tools in rehabilitation of patients after stroke could activate neuroplasticity mechanisms, thus reducing the ischemic area and improving the neurological outcome of the disease.</p></sec><sec><title>Aim</title><p>Aim. To evaluate the effectiveness of early rehabilitation of stroke patients in Tomsk Regional Stroke Center using assistive robotic tools by correlational analysis of clinical and laboratory biomarkers of brain neuroplasticity.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study included 68 patients who suffered from stroke of the middle cerebral artery. Early rehabilitation was carried out in Tomsk Regional Stroke Center using assistive robotic tools according to the protocol. Neurotrophic factors in blood serum were measured by the enzyme-linked immunosorbent assay. The severity of neurological disorders was characterized based on the Fugl – Meyer assessment scale (FMA).</p></sec><sec><title>Results</title><p>Results. The clinical effectiveness of early motor rehabilitation in Tomsk Regional Stroke Center is confirmed by the statistically significant increase on the FMA scale by 5.2 ± 2.4 points (p = 0.008). Positive association between neurotrophic factors in blood serum and FMA total score enables to consider the resulting data as an evidence of neuroplasticity activation associated with the use of robotic electromechanical technologies. </p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>ишемический инсульт</kwd><kwd>нейрореабилитация</kwd><kwd>постуральная коррекция</kwd><kwd>пассивно-активные роботизированные электромеханические технологии</kwd><kwd>нейропластичность</kwd><kwd>мозговой нейротрофический фактор</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ischemic stroke</kwd><kwd>neurorehabilitation</kwd><kwd>postural correction</kwd><kwd>passive-active robotic electromechanical technology</kwd><kwd>neuroplasticity</kwd><kwd>Brain-derived Neurotrophic Factor</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Rowe J.B., Chan V., Ingemanson M.L., Cramer S.C., Wolbrecht E.T., Reinkensmeyer D.J. 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