KINESIOLOGICAL INDICATORS OF THE DIAGNOSTICS AND CRITERIA FOR THE RESTORATION OF PHYSICAL FULLNESS IN THE DYNAMICS OF THE RECOVERY OF CONSCIOUSNESS AFTER HEAVY CRANIOCEREBRAL INJURY IN PATIENTS WITH UNCONSCIOUSLY MOTOR ACTIVITY

Abstract

Post-traumatic post-comatose states of a long-term disorder of consciousness are a group of syndromes that characterize the impairment of consciousness and at the same time the staging of its recovery after an acute long-term cerebral coma resulting from severe brain injury.

The group of these syndromes include post-comatose syndromes of repressed consciousness, consciousness reintegration syndromes, transient syndromes and syndromes of clear consciousness.

The aim of the study – to substantiate and develop a system of medical (physical) early rehabilitation of patients with post-comatose disorders of consciousness due to severe traumatic brain injury, to determine the predictors of neurological (motor) deficiency and highly informative prognostic indices of recovery of consciousness.

Material and Methods. The study included 220 patients with traumatic post-comatose disorders of consciousness who were examined and underwent courses of neurorehabilitation treatment in the state institution “Institute of Neurosurgery named after academician A. P. Romodanov of the Academy of Medical Sciences of Ukraine” and Nodus Scientific and Practical Center from January 2007 till July 2018.

Results. It was proved a direct correlation dependence of the recovery of fine coordinator-locomotor acts with the level of "quality" of consciousness. Tetraparesis at the stage of depressed consciousness syndromes necessarily led to a pronounced motor dysfunction of all the extremities, which were fully preserved until the syndrome of clear consciousness.

Moreover, in all patients, without exception, hidden, significant, kinesiological disorders of varying manifestations were revealed, while the clinical and neurological status was considered acceptable. The latent course of this kind of disorders was inherent in patients with transitional syndromes and syndromes of clear consciousness, which is due to the need to continue the complex rehabilitation treatment.

Conclusions. Conducting a kinesiological examination of the studied patients according to the developed KO scenarios made it possible to differentiate and optimize the methods of kinesiological testing, depending on the initial capabilities of the patients, which were determined by post-comatose abnormalities in the dynamics of the traumatic disease.