Intermittent hypoxic exposure in post-stroke rehabilitation in residual period: exercise tolerance, psychoemotional state, and cognitive status (a pilot study)

 But isn't your competent? doctor already using these other methods? Oh, incompetently DOESN'T KNOW ABOUT THEM, RIGHT!

• in-bed exercises (2 posts to August 2017)
• 5 Chair Exercises That Build Core Strength Faster Than Planks After 60 May 2026
• 'Exercise-in-a-pill' (8 posts to May 2017)

Intermittent hypoxic exposure in post-stroke rehabilitation in residual period: exercise tolerance, psychoemotional state, and cognitive status (a pilot study)

• Authors: Nyamukondiwa M.¹, Koneva E.S.^1,2, Dudnik E.N.¹, Glazachev O.S.¹
• Affiliations:
  1. Sechenov First Moscow State Medical University
  2. Corporate group MEDSI

• Abstract

  BACKGROUND: Rehabilitation of patients with severe residual deficits after an acute cerebrovascular accident (stroke) is frequently insufficiently effective, necessitating the search for new therapeutic approaches. Hypoxic conditioning using intermittent hypoxic–hyperoxic exposures (IHHE) has demonstrated efficacy in improving physical and mental performance in various patient populations. However, this approach has not previously been applied in post-stroke rehabilitation.

  AIM: The study aimed to evaluate the efficacy and safety of incorporating IHHE into comprehensive rehabilitation programs for patients in the late post-stroke period (≥ 6 months) regarding exercise tolerance, psychoemotional state, and cognitive status.

  METHODS: This prospective study included 50 patients who had an ischemic or hemorrhagic stroke ≥ 6 months ago. Patients were randomized to either the treatment group (n = 20) or the control group (n = 30). The treatment group received a standard 3-week rehabilitation program plus 10–12 IHHE procedures (hypoxic phase, FiO₂ = 0.11–0.12; hyperoxic phase, FiO₂ = 0.35–0.40). The control group received the standard rehabilitation program only. The following parameters were assessed before and after the intervention: six-minute walk test (6MWT) score, work performed (W), Borg scale score, heart rate, blood pressure, oxygen saturation, psychoemotional state (DASS-21, Epworth Sleepiness Scale), quality of life (SF-12), functional independence (Barthel Index), and cognitive function (USEFO test).

  RESULTS: The treatment group showed a more pronounced increase in exercise tolerance, with an increase in 6MWT distance of 58.9 ± 24.3 m vs. 15.8 ± 18.7 m (p = 0.005) and work performed of 7.7 ± 3.8 vs. 3.7 ± 3.1 (p = 0.018). A clinically relevant improvement (≥ 35 m) was achieved in 60% of patients in the treatment group compared with 16.7% in the control group. Furthermore, a greater reduction in depression, anxiety, and stress severity according to DASS-21 (p <  0.05), decreased daytime sleepiness, increased SF-12 scores, and improved Barthel index were observed. IHHE procedures were well tolerated; adverse effects were minimal and transient, occurring during the first 1–3 procedures.

  CONCLUSION: Adding a personalized IHHE course to standard post-stroke rehabilitation resulted in pronounced improvements in exercise tolerance, psychoemotional state, quality of life, and functional independence. The method was safe and well tolerated. Larger-scale studies are required to confirm long-term efficacy.