| Abstract [eng] |
The aim of the work: Based on the selected scientific literature, to analyze and evaluate the effectiveness of the strategies used for the restoration of spinal cord reflexes. Work tasks: Based on selected scientific articles, to analyze the effectiveness of different strategies for restoring the H reflex. Based on selected scientific articles, to analyze the effectiveness of different strategies for restoring the stretch reflex. Based on selected scientific articles, to present conclusions about the most effective strategies to restore the H and stretch reflex. Research methodology: The systematic literature review was prepared in accordance with the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analyses) guidelines for preparing a systematic literature review. The search for scientific articles was performed in PubMed and Web of Science databases by one researcher, according to search strategies adapted to individual databases. The selection of scientific articles was carried out taking into account the date of publication of the research, which should cover the period from 2013 to 2023. Based on the combination of keywords, the number of selected publications was 277, and after applying the inclusion and exclusion criteria of the systematic literature review, 8 publications were included in the systematic literature review. Research results: In order to achieve the purpose of evaluating the effectiveness, the data of all selected scientific publications were organized into one table of research results, which presents the average and standard deviation of the different evaluation indicators of the experimental and control groups of the research before and after the application of the intervention. The effectiveness was evaluated according to the obtained results of the research with statistical significance within the groups and between the aforementioned experimental and control groups. Five indicators were included in the systematic literature review: 1) Hmax/Mmax ratio. Both study groups showed statistically significant results (p-value equal to <0.001*, 0.014*), but the result achieved by the control group was slightly higher. This proves that a conventional physical therapy program is more effective than a stretching exercise program in terms of the Hmax/Mmax ratio in order to restore spinal cord reflexes. 3) H reflex amplitude indicator. The multimodal program, together with ventroflexion and H reflex traction, had an effect on the recovery of the H reflex. The obtained results showed statistically significant changes in the H reflex amplitude indicator in all groups (p value <0.005*). 4) Hmax index. Data presented in the scientific publication show that statistically significant changes (p-value <0.05*) were observed in the AIS C and AIS D groups after the intervention, suggesting that locomotor training may help to improve Hmax. 5) The magnitude of the stretch reflex. The p-value between groups was <0.01* (statistically significant) before the intervention and <0.05* after the intervention, which is evidence that the heating and cooling procedures are suitable for restoring the stretch reflex. Conclusions: 1. Based on the data of the systematic literature review, multimodal locomotor training performed for 4 weeks and approximately 9 weeks of locomotor training have the highest effectiveness for restoring the H reflex, while stretching exercises and a regular physiotherapy program have the lowest effectiveness. 2. Based on data from a systematic literature review, moderate efficacy can be achieved with heating (37°C temp.) or cooling (7°C temp.) to restore the stretch reflex. 3. Based on the data of the systematic literature review, the H reflex can be most effectively restored with the help of a multimodal program, but currently the available data are not sufficient to determine an effective strategy for the restoration of the stretch reflex. |
