Vitalii KovalchukPavlov's St.-Petersburg Medical University, Russian Federation
Title: Motor, cognitive and social rehabilitation in patients after brain lesion
There are some conditions of efficacious and successful rehabilitation in brain lesion’s patients. First one is the early rehabilitation. Early verticalization is a guarantee of success, but we must consider the certain demands to condition of a patient. For example, if patients have less than 5 points according Glasgow Scale, we’re not carrying out the verticalization. We have absolute contraindications to verticalization. Knowledge of risk factors of poor reaction on verticalization is very important. More often we use the coefficient of overshoot as the main indicator. It is calculated according this Doppler’s formulation. If overshoot is more than 10%, we choose regular regime of verticalization, if overshoot is from 3 till 10%, we choose more spared regime. And at last, if overshoot is less than 3%, verticalization during the first and the second days is not carried out, since the 2nd–3rd days we choose the most spared regime and only up to 60°. In two previous cases – up to 80°.
There are some so called stop signals which testify that we must stop verticalization immediately. The next important condition of successful rehabilitation is posture correction. It is necessary to find out the dominating patient's pose in a sitting position before the beginning of rehabilitation because the type of this pose will influence the choice of rehabilitation methods. There are two such pathological poses. Pull-syndrome – a patient "moves" himself on a healthy part of a body. Push-syndrome – deviation at the defeated side, and the difficulties with patient’s verticalisation. Push-syndrome often forms in the presence of a neglect-syndrome, when brain blocks information about the left part of a body and of a space.
We’ll consider the main strategies of rehabilitation: physiotherapy, occupational therapy, technology constraint-induced movement therapy. This technology is applied at light and moderate paresis, when the healthy arm is rigidly fixed during 5-6 hours a day, and the weak arm is in training involuntarily.
Psychotherapeutic rehabilitation is one more criterion of efficacious and successful rehabilitation. We’ll note the principle of eight psychoemotional strengths which we try to cultivate in our patients.
His research and practical areas including the rehabilitation of patients with damage of brain (stroke, drain injury and so on), chronic brain ischemia, pain syndromes, cognitive and psychoemotional impairments, and has published widely in these fields and has lectures and master-classes at different region and countries all over the World.
Career: resident of Pavlov's St.-Petersburg Medical University (Neurological Department, 1993-1995); researcher (Neurological Department, 1995-1997); associated professor of Medical Faculty of St.-Petersburg University (2008-2011); Honorary Doctorate of Letters (since 2013), Vice-President of World Congress of Arts, Sciences and Communications (since 2015).
Career Related: Fellow of Stroke Association of UK (since 1998); Chairman of St.-Petersburg's Society of Rehabilitation (since 2008); Adjunct Professor of Neurological Association of Russian's NorthWest Region (since 2009); Adjunct Professor of European Academy of Natural Sciences (since 2012); Fellow of Presidium of St.-Petersburg's Neurological Association (since 2016).
Awards: Best Researcher of Year, 2011 (Academy of Medical Science, Russia); Best Doctor of Russian Federation (Ministry of Health 2011); Lifetime Achievement Award of World Congress of Arts, Sciences and Communications (2012); Great Minds of the 21st Century Award (ABI – 2012); Hall of Fame Award (IBC – 2012); World Lifetime Achievement Award (ABI – 2012); American Hall of Fame Award (ABC – 2012); Honoured Scientist of Europe (European Academy of Natural Sciences – 2012); Albert Schweitzer Medal Award for Humanism and Service to the People (European Academy of Natural Sciences – 2012); Max Joseph Pettenkofer's Medal Award for outstanding achievements and merits in the field of medical researches (European Academy of Natural Sciences – 2014); Honoured Doctor of Russia (2015).