Automation of fine motor actions in the functional training of patients with stroke in the early recovery period

Objective. The aim of the research is to study the automation of fine motor skills in the functional training of patients with stroke in the early recovery period. Materials and methods: the total selection amount was 41 patients (aged 45 to 60 years) with ischemic type of stroke with a clinical diagnosis: I63 - “Brain infarction” (according to ICD-10). Neurological status was assessed using the NIHSS scale; the degree of cognitive impairment was assessed by the MMSE scale. The organization of the study included three stages: ascertaining (assessment of the initial degree of functional impairment); formative (functional learning); the stage of control testing (assessment of the dynamics of indicators before and after the passage of functional training). The study used the following methods and techniques: Frenchay arm test, a set of functional neuropsychological tests (“fence” test, Rey-Osterrieth complex figure test (ROCF), “fist-palm edge-palm” test, reciprocal coordination test), «Visual Medicine» hardware-software complex. Results. The study revealed an improvement in the functional state of the leading hand, an improvement in dynamic praxis indicators according to the differentiation and coordination criteria, an improvement in visual-constructive skills, an improvement in reciprocal coordination according to the criteria of tempo, accuracy, differentiation, and coordination. The obtained data testify to the positive dynamics of the functional state of the leading (right) hand of patients according to the tempo-dynamic, coordination and differentiating bases. Sequential activation of voluntary and automatic movements through the repeatable arbitrary start of motor programs, which are based on fine-motor actions, ensures their automation. Conclusion. The possibility of using software-hardware complex “Visual Medicine”, namely visual demonstration of patterns of both individual fine-motor actions and fine-motor actions that make up the motor program, used in functional training of patients with stroke, provides for the transition from a voluntary level of movements to an automatic one through the mirroring mechanism.

automation of fine motor actions, functional training, acute disorders of cerebral circulation, levels of organization of movements