EUROMEDICA  Hanover 29-30  Mai 2006	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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Rehabilitation of patients with poststroke hemipareses, complicated by secondary myofascial pain syndrome is actual problem of neurology and rehabilitation medicine because of the high incidence of these phenomena in patients, who had brain stroke.

We studied clinical aspects of pain syndrome and its correlation with motor symptoms in 142 poststroke hemyplgia patients on different stages of the illness.

In the study we suggested treatment methods of pain syndrome and evaluation of its efficacy in different stages of rehabilitation of poststroke patients.

Myofascial pain syndrome, associated with trigger zones, develops in 80% of patients during the first several weeks after cerebral stroke and it severely complicates rehabilitation of motor functions, decreases patients’ routine activities.

Most common localization of triggers in the paretic upper extremity is biceps and deltoid (40%) and also subscapular muscle (33%). In the paretic lower extremity myofascial syndrome occurs rather rare and it is characterized by mostly common localization in the rectus muscle of the thigh.

The combination of cryotherapy and stretching is most effective in early stages of rehabilitation in patients with cerebral hemipareses. In later stages it is a combination of cryotherapy and stretching with injections of local anesthetics in trigger zones.

Cessation of pain syndrome as well as the traditional methods of rehabilitation (massage, exercises) contributes to increasing of the muscle strength and volume of movements, improves a social adaptation of patients with motor disturbances after cerebral stroke.