After discharge from the Intensive Care Unit (ICU), more than 50 % of patients experience pathological symptoms that are not related to the primary emergency but reduce the quality of life and require rehabilitation. Post Intensive Care Syndrome (PIСS) include only those conditions that do not have a direct causal relationship with the emergency condition that gave rise to hospitalization in the ICU. The pathophysiological basis of the PICS is the phenomenon of “learned non-use”: a state of artificial limitation of the patient’s motor and cognitive activity as a result of the use of analgosedation, bed rest and immobilization. The clinical picture of PICS is determined by the severity of its individual components, detailed using a package of clinimetric scales. Based on the results of dynamic testing, the PICS severity index is calculated. The sum of the scores in the range from 0 to 10 reflects the severity and effectiveness of rehabilitation measures. For the prevention of PICS, the Union of Rehabilitologists of Russia together with the Federation of Anesthesiologists and Resuscitators of Russia has developed the rehabilitation complex “ReabICU”. In the English-language literature, such a complex is called “Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility” bundle. ReabICU is a complex of technologically therapeutic and diagnostic modules “positioning and mobilization”, “prevention of dysphagia and nutritional deficiency”, “prevention of emotional and cognitive impairment and delirium”, “prevention of loss of self-care skills”. The basis of the multidisciplinary rehabilitation team, which includes a doctor for medical rehabilitation, 2 specialists in physical rehabilitation, a specialist in occupation therapy, a medical psychologist, a medical speech therapist, a nurse for medical rehabilitation. The activity of multidisciplinary rehabilitation team is evaluated on the basis of quality criteria and the achievement of the main goal of ReabICU — the preservation of the premorbid status of the patient’s socialization.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить эффективность и безопасность Проспекты в терапии умеренных когнитивных расстройств у больных в раннем восстановительном периоде ишемического инсульта. МАТЕРИАЛ И МЕТОДЫ В исследование были включены 275 пациентов (средний возраст 64,0±8,1 года), перенесших ишемический инсульт давностью от 3 до 6 мес, с умеренными когнитивными расстройствами и умеренной активностью в повседневной жизни. На этапе скрининга оценивали выраженность когнитивных нарушений по краткой шкале оценки психического статуса, Монреальской шкале оценки когнитивных функций (MoCA); уровень активности в повседневной жизни по шкале Бартел; качество жизни по шкале оценки качества жизни, связанной с инсультом (SS-QOL). Пациенты принимали Проспекту или плацебо по 2 таблетки 2 раза в день 24 нед. Период последующего наблюдения составил 4 нед. Для оценки эффективности конечной точкой исследования была принята доля пациентов с улучшением когнитивных функций (+1 и более баллов по MoCA) через 24 нед лечения. Для оценки безопасности анализировали наличие и характер нежелательных явлений, их степень тяжести, связь с приемом препарата, исход, динамику жизненно важных показателей, долю пациентов с клинически значимыми отклонениями лабораторных показателей. РЕЗУЛЬТАТЫ Положительный терапевтический ответ в виде клинически значимого улучшения когнитивных функций получен у 91,9% пациентов группы Проспекта по сравнению 82,1% группы плацебо (p=0,02). Выявлено 57 нежелательных явлений у 37 (27,4%) пациентов группы Проспекта, 53 нежелательных явления у 39 (27,9%) участников группы плацебо (p=1,0). Ни одно нежелательное явление не было достоверно связано с приемом Проспекты. Клинически значимых изменений жизненно важных показателей, отклонений лабораторных показателей в процессе исследования выявлено не было. ЗАКЛЮЧЕНИЕ Проспекта — эффективный и безопасный препарат для лечения умеренных когнитивных расстройств у пациентов в раннем восстановительном периоде ишемического инсульта.

Objective. Evaluation of the efficacy and safety of Prospect in the treatment of cognitive, behavioral and mental disorders in patients with vascular dementia (VSD). Material and methods. In a double-blind, placebo-controlled, parallel-group randomised clinical trial, 406 patients aged 60—85 years old with a diagnosis of mild/moderate vascular dementia (10—24 on the Mini-Mental State Examination (MMSE)) and without signs of depression (Cornell Scale for Depression in Dementia (CSDD) scores ≤10) were included. At Visit 1, complaints and medical history were collected, vital signs were recorded, cognitive impairment was assessed using MMSE and MoCA, NPI-C and CSDD were completed, and an MRI brain scan was performed. Patients were randomised into two groups: patients in group 1 received Prospekta in a dosage of 2 tablets two times a day for 24 weeks, and patients in group 2 received Placebo according to the study drug regimen. Results. Patients in both groups had no differences in demographic and baseline clinical characteristics. Administration of Prospekta for 24 weeks reduced cognitive impairment in patients with vascular dementia compared to the placebo group. The mean MoCA score increased from 17.0±3.6 [17.1±3.6] to 20.5±4.7 [20.4±4.7] in patients treated with Prospekta, whereas it increased from 17.3±3.7 [17.3±3.8] to 19.2±4.9 [19.2±5.0] in the Placebo group. Treatment with the medication also reduced the severity of neuropsychiatric symptoms as measured by the NPI-C scale. The mean score on this scale decreased from 57.0±26.7 [56.7±25.4] to 39.8±23.6 [39.8±23.5] in the Prospekta group and from 55.5±25.5 [55.3±24.4] to 42.8±27.6 [42.3±25.3] in the Placebo group. The difference in mean MoCA and NPI-C scores between the Prospekta and Placebo groups was statistically significant. Conclusion. Prospekta is an effective and safe drug for treating cognitive, behavioural and mental disturbances in patients with vascular dementia.

The review is devoted to revised international diagnostic criteria for neuromyelitisoptica spectrum disorders (NMOSD).Current diagnostic criteria allow NMOSD diagnosis not only for serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG)-seropositive patients but for AQP4-IgG-seronegative patients as well. New criteria are expected to make NMOSD diagnosis earlier and more accurate as well as to facilitate the differentiation with multiple sclerosis. Furthermore, unify international criteria should help to perform comparable epidemiologic studies and clinical trials of new drugs for NMOSD.

Biomechanical motion capture is the most accurate non-contact instrumental method of studying human locomotion and is increasingly being used in the medical rehabilitation of patients with various diseases. Human motion capture systems are promising tools for clinical use to assess and control the correct execution of movements, as well as to identify injury risk factors. Currently, human motion capture systems are mainly used only in scientific research. The development and implementation of biomechanical motion capture systems in clinical practice can help doctors determine the best solution when planning medical rehabilitation and, thereby, reduce the recovery time of patients. This review aims to present up-to-date data on motion capture techniques and features of their application in the medical rehabilitation of patients with diseases of the nervous system. The review provides a brief overview of the existing technologies for the study of locomotor functions. The principles of operation, advantages and disadvantages of optoelectronic, electromagnetic, inertial and ultrasonic measuring systems are presented. The review describes in detail the possibilities of biomechanical motion capture in conducting a personalized diagnostic process, planning and evaluating the results of medical rehabilitation in patients with stroke, Parkinson's disease, cerebral palsy, spinal cord injury and multiple sclerosis. The search was conducted in the databases eLibrary, PubMed, Scopus, Web of Science and Google Academy (Google Scholar). The review includes studies in which motion capture systems were used and spatial-temporal, kinematic, kinetic and electromyographic parameters were analyzed.