Method for applying neuropsychological rehabilitation of cerebrovascular disease patients accompanying dyscirculatory encephalopathy and insults

FIELD: medicine.

SUBSTANCE: method involves doing complex of physical training exercises on the background of medical rehabilitation treatment. First, dominant hemisphere is determined. Next, exercises are done expanding in turn over higher and higher levels of the nervous system beginning from homolateral movements of extremities. Then, heterolateral movements are done with extremities: first, without crossing median line of the body and then with shoulder girdle rotation to one side and pelvic girdle to the opposite side ending in movements crossing the median line. Then, the heterolateral movements are combined with eye movements and functional loads upon the hemispheres. Infinity sign drawing is carried out in the air with the right hand, left hand and with both hands, following the imaginary drawings with eyes and transferring center of gravity from one leg to the other one. Then, symmetrical figures are drawn simultaneously using both hands. Then, autotraining exercises are done consisting in creating and fixing in memory image of both working hemispheres.

EFFECT: enhanced effectiveness of influence exerted to both hemispheres in activating interhemispheric links and restoring injured cortical functions.

8 dwg, 2 tbl

 

The invention relates to medicine, in particular, neurology, rehabilitation medicine, neuropsychology.

Pathology of higher cortical functions (MCFs) for violations of cerebral circulation hinders social ties and brings suffering to the patients. For example, speech disorders cause severe emotional reactions due to the difficulty of communication with other people, which is no less important than motor function (Shklovsky V.M. Concept neurorehabilitation of patients with stroke. Journal of neurology and psychiatry. Saw, the application of “Stroke”, 2003, vol. 8, p.10-23). Special attention is paid to the question of the correction of these disorders in patients with left-sided localization center. To restore the MCFs is primarily applied drug therapy and various non-pharmacological methods, an important part of which are different types of exercises - non-specific (therapeutic exercise) and specific (using special training of the disturbed functions).

Known close in fact a method of using the same mechanisms as claimed, which is used in education to improve learning ability. It uses a set of exercises aimed at improving inter-hemispheric connections (BRAIN GYM Educational Kinesiology Foundation, No. 2.003.128 United States Patent and Trademark Office).

Fault is: the method is not used in practice, the recovery of higher cortical functions in sick people, as used in primary and special school education. In addition, the complex haphazard exercises are used without regard to Philo and ontogenetic organization of the brain, with its gradually increasing, there are no techniques combination of oculomotor reactions with functional loads on both hemispheres, besides exercise, there are no detailed descriptions, in the form of General recommendations and may not always be clear to elderly patients, especially after disturbances of a cerebral circulation.

Medical therapy is used both in the acute and recovery period cerebral circulation. For drug effects on brain tissue in the Arsenal neurologist has correctors of cerebral metabolism, antihypoxants, neuroprotective agents, vasoactive drugs, etc. (Gusev E.I., V.I. Skvortsova cerebral Ischemia. M.: Medicine, 2001).

The disadvantage of the method: With medication, with all its importance, the patient takes only a passive part in the recovery process, often the person has hope for a miracle pill, while the active participation of the individual in understanding their disease and the involvement of the patient in the recovery process can bring great results. In addition, many drugs require length is high use, have side effects and unpredictable long-term consequences. Moreover, patients often have no possibility to apply new expensive drugs - especially when acute process has ended and required months of maintenance therapy.

Besides medication, using methods that activates the regenerative processes in the brain due to different types of training.

Important role in the treatment and rehabilitation activities play different complexes of physiotherapy. Physical exercises are nonspecific irritant, because they stimulate the physiological processes in General, activate neurohumoral-hormonal mechanisms, enhance apparently with tendons and muscles, motor-visceral regulation of autonomic functions and backup mechanisms circulation (V. Moshkov. Therapeutic physical culture in the clinic of nervous diseases. M, Medicine, 1972, p.43-59).

The disadvantage of the method: a set of exercises, which are traditionally used in neurological wards, usually aimed at restoring musculoskeletal disorders (strength and muscle tone, coordination). Although exercises bring undoubted favorable physiological results, but they don't have a specific impact on higher cortical functions. As PR is usually remedial physical education is a division of the body of the patient on the affected and unaffected side, some of the exercises used in unilateral paresis of the extremities, may even increase hemispheric asymmetry.

Closest to the claimed method specific neuropsychological rehabilitation is targeted training of the impaired function (Tsvetkova PS Neuropsychological rehabilitation of patients. Speech and intellectual activity. Moscow University publishing house, 1985, 326 pages (p.16-18, 21-24, 120-135). For example, failure to account training is reduced to the solution of problems, in violation reading - training ability to read. Along with a special speech therapy training methods speech, reading, writing and arithmetic in the rehabilitation of these patients find the use of special methods of exercise therapy exercises for speech muscles, special logopedic massage, disinhibition speech by means of non-verbal communication, oral stimulation of the muscles, ensuring an appropriate sequence of motor acts when apraxia, recovery of cognitive functions of attention, memory. In the course of this work with patients focuses on intellectual and logical functions. Special methods of neuropsychological rehabilitation addressed the damage is established or blocked areas of the cerebral cortex, located in the dominant hemisphere.

The disadvantage of the method: In this method, insufficient attention is paid to the participation subdominant hemisphere in the recovery of impaired functions and improve the interaction and exchange of information between the two hemispheres. In addition, specific training requires specialists with methods of neuropsychological diagnostics and rehabilitation, so in most hospitals, patients do not receive this expert assistance in the necessary volume.

The objective of the invention: improvement of neuropsychological rehabilitation in patients with cerebrovascular disease with dyscirculatory encephalopathy and after stroke by using a set of special exercises aimed at strengthening the hemispheric relations.

This object is achieved in that on a background of conventional restorative treatment is a complex of special exercises, consistently involving all higher levels of the nervous system. After determination of the dominant hemisphere by standard methods begin complex with homolateral exercises to activate the lower parts of the brain stem and separate hemispheres. Then make heterolateral movement to engage the upper parts of the brain stem and enhance interhemispheric the links - at first simple, then more complex with the rotation of the shoulder girdle in one direction, and the pelvic girdle in the other direction and crossing the midline of the body. Next, combine heterolateral movement with eye movements and functional loads on hemisphere - dominant hemisphere is logical load for subdominant with a creative load. Then draw the infinity sign in the air with the right hand, left hand and both hands together, watching an imaginary figure and shifting the center of gravity from one foot to the other. Then draw a symmetric shape at the same time two hands, including both hemispheres in a single mission. After gymnastics perform psychological trick metaphorical connection of the hemispheres.

The novelty of the invention lies in the selection and sequence of exercises involving various departments of the brain stem and its hemispheres and enhance interhemispheric communication.

The essential features of the invention allows to obtain a new technical result:

1. Through exercises the main impact is on the higher cortical functions and higher mental processes, not only on the musculoskeletal system.

2. Uses a holistic approach to brain activity taking into account the dynamic localization of f is NCCI, conducted training both affected and unaffected side.

3. Achieved part subdominant hemisphere in the recovery of impaired higher cortical functions.

4. Activated interhemispheric communication, which improves the interaction and interchange of information between the two hemispheres in patients with cerebrovascular disease.

5. Achieved physiology and natural exercises for the body due to the gradual complication and sequence developed in accordance with the stages of brain development in Filo - and ontogenesis.

In the vascular pathology of the brain are observed as acute disorders of cerebral blood flow (infarction, hemorrhage), and chronic ischemia of the brain (encephalopathy). There may be pockets of impaired circulation in those areas of the brain that are involved in the provision of higher cortical functions and mental processes. This leads to the development of neuropsychological disorders, among which, depending on the localization distinguish frontal, temporal, parietal, occipital, syndrome lesion of the deep structures of the brain, right hemisphere syndrome “split brain” and others.

Higher cortical functions in neuropsychology have a local preference in the interaction of all systems (Luria, A.R., fundamentals of neuropsychology. Ed is the government of Moscow state University, 1973, 374 pages). We can consider the brain as a functional system consisting of many links and different not only complexity, but also by the mobility of its constituent parts. It is not so much dominance as the specialization of each hemisphere into a single functional system of the brain.

Recent studies have shown that participation subdominant (figurative) hemisphere in the intellectual work is no less important: to him belongs modulating and supporting function, it provides motivation, recognition of objects, the consolidation of memory traces, creation of prototype motion and completed tasks, configured and emotional (Simerica EG the human Brain and mental processes in ontogenesis. Publishing house of Moscow state University, 1985; Popper K.P., J.C. Eccles, The Self and It's Brain, Routleg, L., N.Y., 1993, p.352). In neurological clinics monitor right with lesions of the right hemisphere show that these patients ignore their defect, do not want to actively work independently and as a result take longer to restore because fall out the above functions of the right hemisphere. Thus, despite the fact that the centers responsible for intellectual activity, in most cases, are located in the left hemisphere, both hemispheres contribute to complex mental activity.

The process Voss is the resolution violated the higher cortical functions depends on the degree of destruction of nervous tissue: in the case of blocking or braking function is its disinhibition, and in case of destruction of the nerve centre - the reconstruction of the whole functional system with new parts to replace the broken (intrasystem and intersystem perestroika) - (Anokhin P.K. Biology and neurophysiology of the conditioned reflex. M., 1963). Plays a big role in this psychological activation of patients, increased motivation and attitudes to recovery, creating emotionally-shaped support subdominant hemisphere. Therefore, it becomes clear the importance of strengthening hemispheric relations and the integration of the right and left hemispheres.

Communication between the right and left hemispheres of the brain are made using fibers passing through the corpus callosum connecting the two hemispheres. Information from joints and muscles, including the oculomotor muscles, brings activating the stream of pulses passing through the corpus callosum in both hemispheres of the brain.

In the present developed complex sequence of movements, corresponding to the gradual complication of motor acts in Filo - and ontogenesis. Homolateral movement associated with the lower divisions of the brain stem, and heterolateral with the average brain and overlying departments (MacLean P. A Mind of Three Minds: Educating the Triune Brain. Seventy-Seventh Yearbook of the National Society for the Study of Education. Chicago, 1978). So at the beginning of the complex are homolateral the movement to activate the lower parts of the brain stem and separate hemispheres, then heterolateral movement to engage the upper parts of the trunk and simultaneous impact on both hemispheres at first without crossing the midline of the body, and then crossing the midline of the body. Sweeping motions with a twist of the body and crossing limbs midline create the rotation of the body and provide enhanced flow of proprioceptive activity in both hemispheres. The following exercises are complicated due to the complex cross-unusual movements that require attention and control on the part of both hemispheres - the “lock”. Then there is the further complication due to the combination of cross movements with the movements of the eyes and the load on the dominant hemisphere (Boolean load) and subdominant (creative force), draw the infinity sign and handed the letter. Performing these exercises causes the flow of impulses from muscle and tendon receptors, providing links between training centres that control the movements of the limbs, oculomotor nuclei of the brain stem, optic centers and cortex on the right and left. Completes complex creating and remembering a vivid metaphorical image hemispheres working together.

The method is as follows.

Exercises are performed on the background of normal vosstanovitelem the x events they are simple and do not require special equipment or premises.

The duration of each exercise for 1-2 minutes. But at the same time, it is useful to focus on your own feelings and to perform each element of the complex as much as one feels necessary. The complex takes 15-20 minutes a day for 2 weeks or more.

- Before performing exercises need to drink clean water (100-200 ml). This preparatory phase, eliminating the deficit of body fluids, including brain tissue, are extremely sensitive to dehydration.

- Perekrestie steps in their different variations you can perform at a fast pace (about 1 step per second), as a rhythmic dance to the music. Perhaps smooth performance at a slow pace (1 step in a few seconds).

- Starting position for all exercises : standing with feet hip width apart. Exceptionally exercises can be performed sitting or even lying down. In the absence of independent movements variant passive exercises with instructor LFK or relatives.

- Neuropsychological rehabilitation is carried out against medical treatment, or after it.

Exercises are performed after the determination of the dominant hemisphere using standard tests taken in neuropsychology (dominant eye, the house is based hand).

Homolateral (unilateral) steps to strengthen lower divisions of the brain stem and separate hemispheres (figure 1).

To raise your right hand and at the same time to take a step on the spot right leg.

To return to the original position.

Lift your left hand to step in place with your left foot.

Heterolateral movement to engage the upper parts of the trunk, the integration of the brain and activation of hemispheric relations - first conducted without crossing the midline of the body (Fig.2-4). Can be performed in different ways. Exercises like movement creeping lizards or running horse.

"Pistol" (2) - from the starting position to simultaneously stretch his left leg and right arm to the horizontal line. For balance supporting leg (in this description is right bent at the knee. To return to the original position, then the same movement to perform the right leg and left hand. The support leg left. To return to the original position.

"Lizard" (figure 3) From the starting position to take the right leg to the side to 45 degrees, while the left arm away from the body and lift up to 45 degrees. Take the starting position, then the same movement to do the opposite limbs (left foot and right hand).

"Skier" (figure 4) step forward with your right foot, move the EU body, left hand stretched forward. Left leg straightened and flattened in the hip joint, the foot touches the floor. To return to the original position, put your right leg to the left, i.e. taking a step back. Then the same exercise is performed with the opposite limbs. When doing this exercise it is necessary to monitor the imposition of the support leg is forward, this takes a step forward in conjunction with pulling the hand from the opposite side.

Heterolateral forced movement crossing the middle line, the rotation of the shoulder girdle in one direction, and the pelvic - to another - the same purpose as in paragraph 2, but with increased signal intensity due to the effort required for carrying out the movement and involvement of a larger number of nerve centers.

"Player" (figure 5) to move at a movement of the left leg crosses the middle line of the body and the front surface of the right thigh. At the same time the right hand move the movement crosses the middle line of the body and the front surface of the left shoulder joint. The trunk at the time of this movement produces rotation: the pelvis rotates in one direction, and the shoulder belt in another. Take the starting position and repeat the movement of the opposite limb (right foot and left hand).

“Lock” is a complex cross-unusual movements that require attention and control with the parties of both hemispheres (Fig.6).

Right foot to put ahead of the left, cross-legged. Arms stretched forward with your thumbs down, back to each other. Move the right hand over the left and hook your fingers into the castle. Arms get twisted. Bend the arms at the elbow joints, the hands so that the lock was on the chest. If flexibility or disease of the joints do not allow you to do this movement in full, there may be a lightweight version of it, available to perform a specific person. To maintain this position for 1-2 minutes.

The combination heterolateral movements eye movements and functional load on both hemisphere (dominant hemisphere is the logical load for subdominant - creative task) - to strengthen ties between the centers that control the movements of the limbs, oculomotor nuclei of the brain stem, optic centers and cortex on the right and left.

With the dominance of the left hemisphere exercises are performed as follows.

The patient looks to the left, at the same time making arithmetic calculations in mind. The computational complexity depends on the age and prior preparation.

Then the patient looks to the right, simultaneously invented singing the melody.

With the dominance of the right hemisphere look to the left combined with humming along to the melody, and look in the right - with arithmetic operations in mind. Described steps may be performed in the background heterolateral movements.

Draw the infinity sign (Fig.7). Draw the infinity sign in the air, watching imaginary figure and shifting the center of gravity from one foot to the other - right hand, left hand, both hands together. The point of intersection of the lines is at the level of the midline of the body. At the point of intersection of the direction of movement of the up sides and down. When this exercise is synchronized bilateral heterolateral impulses from the eyes, hands and whole body.

Two-handed letter and symmetric figures (Fig). Drawing symmetrical shapes at the same time two hands includes both hemispheres in a task.

Divide a sheet of paper in half by a vertical line. To draw the right and left hands simultaneously, so that movement and performed the drawings turned out the mirror.

You can start with drawing simple images (butterfly, tree, geometric shapes) and to make it more difficult to write the words in italics. After performing the exercise, you will understand what is required of him, in this exercise encourages creativity, creating your own images, and do not follow the pattern. To vary the exercise and adapt it to run in different environments: drawing in the air, on Board m is scrap, on the floor, on the sand sticks or directly by the fingers and palms. Stimulation of receptors in the skin of the palms in the latter case creates additional stimulation of areas of the cortex of the hemispheres from two sides.

After gymnastics perform auditory training - creating a metaphorical image hemispheres working together by taking a mental connection hemispheres.

Put your right palm on the left half of the head, then figuratively and clearly present in the palm of half of the brain. Put your left hand on the right half of the head and do the same.

Slow to join hands in the castle, creating an imaginary picture of the connections of the brain into a single unit.

Examples.

History 1. Patient K., 59 years old, retired. Delivered to the neurology ward “first aid” in connection with the appearance of weakness and numbness in the right extremities and difficulty speaking. HELL 150/90. In neurological status easily expressed hemiparesis with increased tone and reflexes. Elements of motor aphasia: speech clear, but poor verbs, sometimes there is a permutation of letters and syllables, misuse cases, omission of prepositions and pronouns, rare perseverative. When talking on the phone a speech defect becomes more noticeable. Understanding speech, repetition of syllables and words, reading and writing saved.

Diagnosis: ischemic stroke is a disease (CVB), acute violation of cerebral circulation in ischemic type in the basin of the middle cerebral artery on the left. Right-sided hemiparesis, hemihypesthesia, elements of motor aphasia. Moderate severity.

Within a week received a vasodilator, Cerebrolysin, piracetam, trental, massage of the left extremities. Movement in the leg recovered, disappeared numbness, weakness in the hand and speech disorders persisted.

Against the background of ongoing medical treatment the patient was admitted in the course of special gymnastics. Before beginning were conducted standard tests for the determination of the dominant hemisphere, the patient is right - handed) during neuropsychological examination, in addition to the easily pronounced motor aphasia, we found a decrease in attention and short-term verbal memory.

Course of special brain training conducted within 15 days. After three practice has improved it has become faster, more confident, gone perseverative. After completion of the course: become more confident talking on the phone, the difficulty in rearranging the letters marked only in compound words (“shipwrecked, electricity). Repeated neuropsychological study, the results are presented in table 1.

Until of course
Table 1.
IndicatorsAfter a course
Table Schulte:  
the best time57 sec45 s (N)
jam4 timesno
fatigueno
Correction test:  
time3 min 20 sec3 min 5 sec
error3210
Series Crepeline:  
a number of examples6378
error2no
Study memory increase memory:  
after 1 presentation45
after 5 presentations88
after 10 presentations89
pseudodominance2no
the lability of the curveno
perseverative2no

History 2. Patient D., 53, teacher. During the consultation at Neuve is Hepatology complained of memory loss: forgetting the words during the lessons, sometimes have difficulty Recalling the names of their friends and frequently used phone numbers. Also worried about the headaches, dizziness when changing position of the body, sometimes a slight staggering when walking, increased blood pressure up to 170/100. This state of the last 2-3 years, received vasodilator drugs, nootropics, vitamins, noted a slight improvement, but the condition gradually worsens. In neurological status: melcorazmashisty horizontal nystagmus in extreme abduction of the eyeballs, a slight stagger in the Romberg test, pomahivaya when performing planosol and knee-heel samples, iambic pathological signs Rossolimo with 2 sides. Magnetic resonance imaging of the brain: multiple small foci of discirculatory mainly in the posterior hemispheres of the brain. Diagnosis: CWB, dyscirculatory encephalopathy in vertebrobasilar pool, vestibulotoxicity and gipoplasticeskih syndrome, moderate severity. To strengthen hemispheric relations and improvement of higher mental functions, the patient is trained to perform a set of exercises that were performed under the guidance of the instructor the first 3 times, and then independently for 15 minutes a day for two weeks. From medical treatment the patient refused the settlement of olcu received drugs a month ago. The results of neuropsychological studies are presented in table 2.

Table 2.
IndicatorsUntil of courseAfter a course
Table Schulte:  
the best time55 sec43 s (N)
jam3 timesno
fatiguenono
Correction test:  
time5 min 12 sec4 min 17 sec
error61
Series Crepeline:  
a number of examples5675
error21
Study memory increase memory:  
after 1 presentation67
after 5 presentations58
after 10 presentations810
pseudodominance1no
lability Cree is Oh pronouncedno
perseverativenono

After the course of training, the patient reported a decrease dizziness when you change body position. As for memory disorders, subjectively, any changes she did not notice, but an objective study of short-term verbal memory showed that increased the speed and the number of remembered words, improved attention. The test results for the patient were so significant that she continues to do this exercise daily.

The proposed method is used in the neurological Department of the municipal hospital №2 core 90 patients. 18 of them have been conducted neuropsychological study that showed improvement in short-term verbal memory, concentration at and read, the more uniform the execution of tests, the decrease in fatigue compared with the results obtained in the control group, carrying out the usual set of physical therapy.

Output.

Thus, the proposed method neuropsychological rehabilitation of patients with cerebrovascular disease allows for the consistent inclusion of higher and higher levels of regulation affect the nerve is s centers in separate hemispheres, to enhance interhemispheric communication, to carry out the integration of the brain, involve subdominant hemisphere in the restoration of disturbed cortical functions and, consequently, to improve the quality and speed of their recovery.

The way neuropsychological rehabilitation of patients with cerebrovascular disease with dyscirculatory encephalopathy and stroke by holding on the background of restorative treatment exercises, characterized in that initially define the standard tests-dominant hemisphere; then perform exercises that consistently involve all higher levels of the nervous system, starting with homolateral movements of the limbs, then do heterolateral movement - initially without crossing the midline of the body, then rotation of the shoulder girdle in one direction, and the pelvic girdle in the other direction and crossing the midline of the body, then combine heterolateral movement with eye movements and functional loads on hemisphere - dominant hemisphere with a logical load for subdominant with creative load, and then draw the infinity sign in the air with the right hand, left hand and both hands together, watching an imaginary figure and shifting the center of gravity from one foot to the other; then draw a symmetric f is Gora at the same time two hands, after gymnastics perform auditory training - create and memorize the way hemispheres working together.



 

Same patents:

FIELD: medicine, thoracic surgery, anesthesiology.

SUBSTANCE: as non-narcotic medicinal preparation one should apply heparin to be introduced intratracheally at the dosage of 300-500 IU/kg, moreover, heparin should be introduced during the first 30 min after the operation is over. The present innovation enables to create prolonged anesthetizing effect in combination with prophylaxis of postoperational thrombohemorrhagic complications due to heparin capacity to be kept in the body due to its accumulation by mast cells at blockade of their fermentative activity followed by its gradual release into the blood.

EFFECT: higher efficiency.

1 cl, 1 ex, 3 tbl

FIELD: medicinal cosmetology.

SUBSTANCE: at first, one should perform target psychological tuning up for the work with a certain patient. Then, at the fist stage it is necessary to remove articular blocks, relax muscular-ligamentous apparatus of body joints with light swingings of patient's head and limbs. Moreover, one should apply long smoothing movements for limbs. The first stage should be finished with respiratory exercises. Then comes relaxing massage of jugular area and hands, plastic impact upon facial fasciae and muscles, massage of biologically active points and linear facial massage. Then one should do the complex of strengthening exercises for the neck and face. At the same time, one should concentrate patient's attention upon coming feelings in jugular and facial areas. Complex of strengthening exercises for the face and the neck should be performed every day. The present innovation enables to maintain daily tonicity of facial myofascial layer well.

EFFECT: higher efficiency.

1 cl, 4 ex

FIELD: medicine, cardiology.

SUBSTANCE: the present innovation includes hypolipidemic diet. Additionally, in the state of meditation one should induce the feeling of thermal disposition in intestinal area due to autosuggestion spirally starting from dextral ileal area and performing about 3-5 circles clockwise, only by narrowing the radius of movement towards navel's area, then about 3-5 circles clockwise by widening the radius of movement against initial circumference. Then one should similarly work with feelings of colic pains and cold. Moreover, autosuggestive impact should be carried out twice daily for 30-40 d, and then - once daily every other day to maintain cholesterol level at normal value. The method enables to treat hypercholesterolemia in patients despite cholesterol level.

EFFECT: higher efficiency of therapy.

1 cl, 1 tbl

FIELD: medicine, anesthesiology, intensive therapy, surgery.

SUBSTANCE: the present innovation is suggested to correct anesthetic therapy in postoperational period. One should apply a modified visual-analog scale of pain on which patient should mark independently his (her) pain feelings by fixing them on vertical sections of the above-mentioned scale of pain every 2 h during the day, then doctor should plot an algogram of daily fluctuations of patient's pain feelings to analyze them for estimating the strength of pain feelings and adequacy of analgetic therapy conducted; and by taking into account the data obtained to conduct correction anesthetic program next day. The present innovation enables to adequately evaluate patient's pain feelings in postoperational period for subsequent performing adequate preventive analgetic therapy of pain syndrome, that, in its turn, enables to prevent pathological postoperational syndromocomplex.

EFFECT: higher efficiency of correction.

2 cl, 3 dwg, 1 ex

FIELD: medicine, human weight correction.

SUBSTANCE: while elaborating self-realization formula a dietologist should develop weight correction mode for a patient during certain period of time without health deterioration. A psychotherapist should detect several targets for weight correction followed by psychotherapeutic seance by applying neurolinguistic programming. For this purpose, a patient should provide picturesque and detailed description of desirable function. Moreover, a psychotherapist detects positive, emotional and autonomic manifestations to form conditionally reflector relationship due to tactile contact. Under supervision of a psychotherapist due to suggestion technique a patient should imagine "a part of personality" responsible for weight correction. Then his psychotherapist has communication with mentioned "part of personality", arouses patient's attention to desirable result and fixes elaborated conditioned reflex. Then a psychotherapist illustrates communication with physical feelings that correspond to either negative or positive answer and their appearance in "a part of personality". At establishing tactile contact a psychotherapist suggests to choose new ways of behavior directed onto weight correction, obtains agreement from "a part of personality" to take care of this very function, which a psychotherapist should monitor by physiological manifestations and fix with conditioned tactile contact. A patient suggests new ways of alimentary behavior, analyze them and choose not less than 3 really achievable ones and "a part of personality" is responsible for automatic implementation of these new ways of alimentary behavior in patient's next life and at achieving positive answer from "a part of personality" sйance of psychotherapy should be finished by returning a patients into awakening state. Moreover, one should prescribe a diet at decreased caloricity of 800-900 kcal during the 1st mo, then - 1200 kcal for another month with subsequent achieving its value to correspond to normal body requirements. Psychotherapy lasts for 3-4 seances in 3-5 d at repeated maintenance therapy in a month, 1 seance. The method enables to achieve stable weight decrease during preset period of time for prolonged terms.

EFFECT: higher efficiency of weight correction.

1 cl, 1 ex

FIELD: medicine.

SUBSTANCE: method involves carrying out physiological examination with electroencephalogram recorded. Cognitive evoked potential method is additionally applied as neuropsychological examination for detecting hard and latent organic brain lesions causing central nervous system pathological disorders. An additional psychophysiological examination is carried out with vision analyzer test, visuomotor response test being applied for obtaining estimations of selection, discrimination, noise immunity and muscle endurance index, movement coordination, response to moving object and integral estimation of attention and ability for perceiving significant information, motor analyzer rapid response production estimation, estimation of nature of cardiovascular system response to given psychoemotional loading estimation. The examination is sequentially carried out as primary control when hiring personnel, as intermediate control in following a training course and emergency training. Psychological testing is of multi-purpose nature. To achieve it, a set reliable tests and methods of prognostic and substantial validity are applied, including intellect and project-building tests and standardized self-reports. When making decisions concerning professional validity based on test and examination results, risk group is selected from operation personnel.

EFFECT: enhanced effectiveness of occupational skill assessment.

FIELD: medicine, in particular, narcology.

SUBSTANCE: method involves using computer as apparatus for displaying on monitor screen of brain colored images reflecting at least two states of brain: before coding by separating portions colored with yellow, green and blue colors and tints thereof reflecting increasing extent of brain affection, and after coding by separating big portion of bright-red color on the background of portions colored with yellow, green and blue colors and tints thereof, respectively; explaining to patient that portion of bright-red color is his dominant code resulted from treatment; before coding procedure, applying and fixing on patient's forehead electrodes simulating elimination of brain potentials; in the course of coding, exposing patient to light flashes with switched-off common illumination and to continuous acoustic signals generated by means of acoustic synthesizer; during coding procedure, exposing patient to light flashes issued from, for example, stroboscope, said light flashes being emitted at frequency of 1-3 Hz; providing immediate suggestion by means of microphone and telephone headsets electrically connected to microphone and secured on patient's head. Method allows preliminary treatment procedure to be avoided.

EFFECT: increased therapeutic effect.

4 cl, 3 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: the present innovation deals with the ways to treat alcoholism, narcomania, tobacco smoking, obesity, sexual disorders, gambling-mania and others. Videopicture contains either one or two additional exposures, the 25th and 26th, correspondingly, each of them contains verbal information of either prohibiting or encouraging character and depictive information that corresponds to the character of verbal information. Moreover, at first, it is necessary to show the 25th exposure only, then - the 25th and the 26th exposures together, then again - the 25th exposure only. Duration of seance for videopicture watching should last for about 20-40 min. The method enables to perform less severe impact upon a patient.

EFFECT: higher efficiency of therapy.

1 cl

FIELD: medicine, psychiatry, psychotherapy.

SUBSTANCE: the present innovation deals with carrying out dietotherapy and psychotherapeutic impact in the course of group seances. Moreover, the main psychotherapeutic impact should be performed during two seances per 8 h each, each due to marathon technique under asthenization conditions, biorythmical misfunctioning and behavioral stereotypes. Motivation should be elaborated for patient's healthy nutrition along with self-confidence and belief into success. Program for losing body weight should be developed to visualize and concretize therapy. Diary for nutritive behavior should be written, psychological protection should be performed in case of affected dietary situation. After the main seances one should carry out psychotherapeutic impact during one seance of 3 h duration in 1 or 3 mo. During seances the results obtained should be fixed by discussing and excluding situations provoking obesity relapse. The method enables to prolong duration and stability of remission.

EFFECT: higher efficiency of therapy.

1 tbl

The invention relates to medicine, in particular to cancer, and can be used in the treatment of resectable, including locally common forms of lung cancer

FIELD: medicine, psychiatry, psychotherapy.

SUBSTANCE: the present innovation deals with carrying out dietotherapy and psychotherapeutic impact in the course of group seances. Moreover, the main psychotherapeutic impact should be performed during two seances per 8 h each, each due to marathon technique under asthenization conditions, biorythmical misfunctioning and behavioral stereotypes. Motivation should be elaborated for patient's healthy nutrition along with self-confidence and belief into success. Program for losing body weight should be developed to visualize and concretize therapy. Diary for nutritive behavior should be written, psychological protection should be performed in case of affected dietary situation. After the main seances one should carry out psychotherapeutic impact during one seance of 3 h duration in 1 or 3 mo. During seances the results obtained should be fixed by discussing and excluding situations provoking obesity relapse. The method enables to prolong duration and stability of remission.

EFFECT: higher efficiency of therapy.

1 tbl

FIELD: medicine.

SUBSTANCE: the present innovation deals with the ways to treat alcoholism, narcomania, tobacco smoking, obesity, sexual disorders, gambling-mania and others. Videopicture contains either one or two additional exposures, the 25th and 26th, correspondingly, each of them contains verbal information of either prohibiting or encouraging character and depictive information that corresponds to the character of verbal information. Moreover, at first, it is necessary to show the 25th exposure only, then - the 25th and the 26th exposures together, then again - the 25th exposure only. Duration of seance for videopicture watching should last for about 20-40 min. The method enables to perform less severe impact upon a patient.

EFFECT: higher efficiency of therapy.

1 cl

FIELD: medicine, in particular, narcology.

SUBSTANCE: method involves using computer as apparatus for displaying on monitor screen of brain colored images reflecting at least two states of brain: before coding by separating portions colored with yellow, green and blue colors and tints thereof reflecting increasing extent of brain affection, and after coding by separating big portion of bright-red color on the background of portions colored with yellow, green and blue colors and tints thereof, respectively; explaining to patient that portion of bright-red color is his dominant code resulted from treatment; before coding procedure, applying and fixing on patient's forehead electrodes simulating elimination of brain potentials; in the course of coding, exposing patient to light flashes with switched-off common illumination and to continuous acoustic signals generated by means of acoustic synthesizer; during coding procedure, exposing patient to light flashes issued from, for example, stroboscope, said light flashes being emitted at frequency of 1-3 Hz; providing immediate suggestion by means of microphone and telephone headsets electrically connected to microphone and secured on patient's head. Method allows preliminary treatment procedure to be avoided.

EFFECT: increased therapeutic effect.

4 cl, 3 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves carrying out physiological examination with electroencephalogram recorded. Cognitive evoked potential method is additionally applied as neuropsychological examination for detecting hard and latent organic brain lesions causing central nervous system pathological disorders. An additional psychophysiological examination is carried out with vision analyzer test, visuomotor response test being applied for obtaining estimations of selection, discrimination, noise immunity and muscle endurance index, movement coordination, response to moving object and integral estimation of attention and ability for perceiving significant information, motor analyzer rapid response production estimation, estimation of nature of cardiovascular system response to given psychoemotional loading estimation. The examination is sequentially carried out as primary control when hiring personnel, as intermediate control in following a training course and emergency training. Psychological testing is of multi-purpose nature. To achieve it, a set reliable tests and methods of prognostic and substantial validity are applied, including intellect and project-building tests and standardized self-reports. When making decisions concerning professional validity based on test and examination results, risk group is selected from operation personnel.

EFFECT: enhanced effectiveness of occupational skill assessment.

FIELD: medicine, human weight correction.

SUBSTANCE: while elaborating self-realization formula a dietologist should develop weight correction mode for a patient during certain period of time without health deterioration. A psychotherapist should detect several targets for weight correction followed by psychotherapeutic seance by applying neurolinguistic programming. For this purpose, a patient should provide picturesque and detailed description of desirable function. Moreover, a psychotherapist detects positive, emotional and autonomic manifestations to form conditionally reflector relationship due to tactile contact. Under supervision of a psychotherapist due to suggestion technique a patient should imagine "a part of personality" responsible for weight correction. Then his psychotherapist has communication with mentioned "part of personality", arouses patient's attention to desirable result and fixes elaborated conditioned reflex. Then a psychotherapist illustrates communication with physical feelings that correspond to either negative or positive answer and their appearance in "a part of personality". At establishing tactile contact a psychotherapist suggests to choose new ways of behavior directed onto weight correction, obtains agreement from "a part of personality" to take care of this very function, which a psychotherapist should monitor by physiological manifestations and fix with conditioned tactile contact. A patient suggests new ways of alimentary behavior, analyze them and choose not less than 3 really achievable ones and "a part of personality" is responsible for automatic implementation of these new ways of alimentary behavior in patient's next life and at achieving positive answer from "a part of personality" sйance of psychotherapy should be finished by returning a patients into awakening state. Moreover, one should prescribe a diet at decreased caloricity of 800-900 kcal during the 1st mo, then - 1200 kcal for another month with subsequent achieving its value to correspond to normal body requirements. Psychotherapy lasts for 3-4 seances in 3-5 d at repeated maintenance therapy in a month, 1 seance. The method enables to achieve stable weight decrease during preset period of time for prolonged terms.

EFFECT: higher efficiency of weight correction.

1 cl, 1 ex

FIELD: medicine, anesthesiology, intensive therapy, surgery.

SUBSTANCE: the present innovation is suggested to correct anesthetic therapy in postoperational period. One should apply a modified visual-analog scale of pain on which patient should mark independently his (her) pain feelings by fixing them on vertical sections of the above-mentioned scale of pain every 2 h during the day, then doctor should plot an algogram of daily fluctuations of patient's pain feelings to analyze them for estimating the strength of pain feelings and adequacy of analgetic therapy conducted; and by taking into account the data obtained to conduct correction anesthetic program next day. The present innovation enables to adequately evaluate patient's pain feelings in postoperational period for subsequent performing adequate preventive analgetic therapy of pain syndrome, that, in its turn, enables to prevent pathological postoperational syndromocomplex.

EFFECT: higher efficiency of correction.

2 cl, 3 dwg, 1 ex

FIELD: medicine, cardiology.

SUBSTANCE: the present innovation includes hypolipidemic diet. Additionally, in the state of meditation one should induce the feeling of thermal disposition in intestinal area due to autosuggestion spirally starting from dextral ileal area and performing about 3-5 circles clockwise, only by narrowing the radius of movement towards navel's area, then about 3-5 circles clockwise by widening the radius of movement against initial circumference. Then one should similarly work with feelings of colic pains and cold. Moreover, autosuggestive impact should be carried out twice daily for 30-40 d, and then - once daily every other day to maintain cholesterol level at normal value. The method enables to treat hypercholesterolemia in patients despite cholesterol level.

EFFECT: higher efficiency of therapy.

1 cl, 1 tbl

FIELD: medicinal cosmetology.

SUBSTANCE: at first, one should perform target psychological tuning up for the work with a certain patient. Then, at the fist stage it is necessary to remove articular blocks, relax muscular-ligamentous apparatus of body joints with light swingings of patient's head and limbs. Moreover, one should apply long smoothing movements for limbs. The first stage should be finished with respiratory exercises. Then comes relaxing massage of jugular area and hands, plastic impact upon facial fasciae and muscles, massage of biologically active points and linear facial massage. Then one should do the complex of strengthening exercises for the neck and face. At the same time, one should concentrate patient's attention upon coming feelings in jugular and facial areas. Complex of strengthening exercises for the face and the neck should be performed every day. The present innovation enables to maintain daily tonicity of facial myofascial layer well.

EFFECT: higher efficiency.

1 cl, 4 ex

FIELD: medicine, thoracic surgery, anesthesiology.

SUBSTANCE: as non-narcotic medicinal preparation one should apply heparin to be introduced intratracheally at the dosage of 300-500 IU/kg, moreover, heparin should be introduced during the first 30 min after the operation is over. The present innovation enables to create prolonged anesthetizing effect in combination with prophylaxis of postoperational thrombohemorrhagic complications due to heparin capacity to be kept in the body due to its accumulation by mast cells at blockade of their fermentative activity followed by its gradual release into the blood.

EFFECT: higher efficiency.

1 cl, 1 ex, 3 tbl

FIELD: medicine.

SUBSTANCE: method involves doing complex of physical training exercises on the background of medical rehabilitation treatment. First, dominant hemisphere is determined. Next, exercises are done expanding in turn over higher and higher levels of the nervous system beginning from homolateral movements of extremities. Then, heterolateral movements are done with extremities: first, without crossing median line of the body and then with shoulder girdle rotation to one side and pelvic girdle to the opposite side ending in movements crossing the median line. Then, the heterolateral movements are combined with eye movements and functional loads upon the hemispheres. Infinity sign drawing is carried out in the air with the right hand, left hand and with both hands, following the imaginary drawings with eyes and transferring center of gravity from one leg to the other one. Then, symmetrical figures are drawn simultaneously using both hands. Then, autotraining exercises are done consisting in creating and fixing in memory image of both working hemispheres.

EFFECT: enhanced effectiveness of influence exerted to both hemispheres in activating interhemispheric links and restoring injured cortical functions.

8 dwg, 2 tbl

Up!