Passive tilting in patients in the acute period of cerebral stroke

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Passive tilt table test is one of the methods of early rehabilitation in the most acute and acute periods of stroke. We included 36 patients with stroke: 17 patients underwent passive tilting using "Lojer 1445YH" (a main group), 19 patients underwent changing position with a functional bed (a control group) on days 1, 2, 3, 5, 7, 14 and 21 after the onset of disease. Some patients were intolerant to passive tilting due to decreasing of systolic blood pressure to more than 20 mm Hg in the first 48 h after stroke. Such patients presented inadequate autonomic tests, had severe neurological deficit on the NIHSS and low heart rate variability (SDNN (standart deviation NN intervals): 19,4±4,3 ms vs 31,8±12,6 ms; TP (total power): 483,4±177,7 ms² vs 1227,1±865,8 ms²; p≤0,05). At the end of the first week after stroke, patients from the main group had higher indices of heart rate variability compared with the control group. Functional outcomes on the Barthel Index and the modified Rankin Scale were better in the main group as well at the 14th day, the between-group difference being the most marked at the 21st day. Passive tilting may be used as one of the methods of early rehabilitation that facilitates abilities of patients and improves functional outcomes provided a careful monitoring of health condition and blood pressure of a patient during the session.

Keywords:

stroke

treatment

rehabilitation

passive tilting

heart rate variability

Authors:

Luk'ianov A.L.

Nauchno-issledovatel'skiĭ institut tserebrovaskuliarnoĭ patologii i insul'ta Rossiĭskogo gosudarstvennogo meditsinskogo universiteta, Moskva

Shamalov N.A.

Research Institute of cerebrovascular pathology and stroke of the Pirogov Russian national research medical University, Moscow, Russia

SPIN RSCI: 2865-9817
Scopus AuthorID: 6507183111
ORCID: 0000-0001-6250-0762

Ivanova G.E.

Research Institute of cerebrovascular pathology and stroke SBEI HPE RNSMU N.I. Pirogov, Moscow, Russia

Skvortsova V.I.

Rossiĭskiĭ gosudarstvennyĭ meditsinskiĭ universitet;
NII tserebrovaskuliarnoĭ patologii i insul'ta, Moskva

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