F.A. KHABIROV¹, T.I. KHAIBULLIN^1, 2, E.V. GRANATOV²

 ¹Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan

²City Clinical Hospital No. 7 named after M.N. Sadykov, Kazan

Contact details:

Khabirov F.A. — MD, Professor, Head of the Department of Neurology

Address: 6 Bari Galeev St., 420061 Kazan, Russian Federation, tel.: +7-987-297-88-29, e-mail: faritkhabirov@yandex.ru

Motor disorders in multiple sclerosis (MS), which are formed due to a complex lesion of the CNS pathways, are one of the key causes of persistent disability.

The purpose — to study the effectiveness of integrated MS neurorehabilitation with simultaneous impact on the central and peripheral motor system mechanisms using navigational transcranial magnetic stimulation (NTCMS), the introduction of a neurotrophoprotective agent (NTPA) and proprioceptive neuromuscular facilitation (PNF).

Material and methods. The study included 73 patients with MS, randomized into the main (1) group, which consisted of 48 patients who received a complex combined effect of several rehabilitation methods (NTCMS, intravenous NTPA and kinesiotherapy (PNF)) and the control (2) group, where 25 patients received standard treatment. Before and 30 days after treatment, we evaluated the Rivermead Motor Assessment (RMA) function, ISS household adaptation, and EDSS disability.

Results. In the main group, there was a statistically significant improvement in RMA and ISS (p < 0.05) in the absence of EDSS dynamics; there were no significant changes in the control group. The expressed RMA improvement was negatively correlated with the baseline EDSS (r = 0.39; p < 0.05).

Key words: multiple sclerosis, neurorehabilitation, navigational transcranial magnetic stimulation, neurotrophoprotective agents, proprioceptive neuromuscular facilitation.

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