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Scenar and Stroke Rehabilitation

B.P.Kulizhskiy
S.S.Kulizhskaya
A.I.Maar
O.V.Minayev
 
SCENAR therapy in Ischemic Stroke Rehabilitation
 
According to statistics from the Ministry of Health Care and Social Development of the Russian Federation and the World Health Organization (WHO),  stroke incidence has risen greatly in recent years. Yet  after  discharge  from hospital, patients rarely receive rehabilitation, and even then, measures are usually incomplete. Local  outpatient clinics  are  often  unable  to  provide  adequate  care  to  such  patients  due  to  lack  of  time,  staff (rehabilitation and speech therapists, psychologists, masseurs etc.) and facilities.  This research is current as we suggest a new multiple approach to post-stroke rehabilitation, with SCENAR as a basic therapy.
 
SCENAR therapy provides the following well-known effects:
 
Restoration, and compensation of lost, nervous connections (somatic component):
•   Autonomic Nervous System regulation
•   Superficial sensation
•   Deep sensation
•   Body scheme
•   Gross motor skills
•   Fine motor skills

Recovery of cognitive functions:
• Gnosis
• Praxis
• Speech

Recovery of higher mental and behavioral functions
• Emotional component
• Behavioral component
 

Research objective – a clinical trial using SCENAR as a basic therapy in post-stroke rehabilitation.
 
Tasks:

• Determine and evaluate practical effectiveness of SCENAR therapy in rehabilitation.
• Develop most effective methods of SCENAR use.
• Work out guidelines on using SCENAR in post-stroke rehabilitation.
 
The patient population included post-stroke patients who had the disease for 3 months to 1 year and had no special rehabilitation care before. All the patients had the diagnosis confirmed by neuro-imaging, and received in-patient care for a total of 43 people - 37 male and 6 female - examined and treated from 01.11.08 till 01.07.09. Patient ages ranged from 45 to 75 years, mean age - 58. As a control group, we examined 18 more people (male), having conventional drug rehabilitation under the care of a district neurologist and therapist, who suffered ischemic stroke at the same time as those who received SCENAR-therapy. The age of people included in the control group corresponds to the target age of the therapeutic groups. 
 
Treatment Design

Combination of SCENAR therapy and corrective mechanical therapy in order to restore deep proprioceptive sensation and coordination of movements.

The patients were divided into 2 groups depending on the therapeutic strategies applied:

• Treatment of central zones only (‘Collar zone’, ‘3 pathways and 6 points’), head (comb electrode).
• Treatment of distal parts of the limbs and head (comb electrode).

All patients received 12 sessions daily from a SCENAR therapist, followed by treatment at home for 2 weeks (the sessions were given by family members using the guidelines provided by the doctor). In addition to SCENAR therapy, all patients received conventional drug therapy considering the severity of condition and coexistent pathology.
 
Control methods
 
In view of the heterogeneity and small size of the total population, we used short statistical processing. Initially, therapeutic groups included the same number of patients but because of heterogeneous gender patterns and one out-of-order case, we have selected 18 patients in each group to be compared. So, we had 3 groups (18 people each): Central Techniques (Group 1), Peripheral Techniques (Group 2), and the Control (Group 3).

The patients were checked twice – prior to the treatment period and right after the treatment period, that is 1 month after the initial check-up. The following methods have been selected for control:

• Standard clinical and neurological examination with a detailed analysis of complaints and clinical presentations.
• Quality-of-life assessment on a 10-point visual analogue scale.
• 10 Words Test to evaluate short-term memory.
• Schultz tables for attention assessment.
 
Overall Findings
 
Among all the patients treated, the condition has improved in 37 patients, 5
patients had no significant changes, and in 1 patient - aggravation (patient aged 75, thrombosis in the region of posterior cerebral artery caused by chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes mellitus, and multiple organ pathology).

Neurological examination revealed an improvement in all patients in the therapy groups,
especially when compared with the control group. Two patients recovered from motor alalia with
lingual embol (which lasted for 7 and 11 months), both cases – from Group 2.

Within groups 1 and 2, despite obvious improvement, no significant difference in neurological picture was found. In the psychological test, significant difference was found between Group 1 (central techniques) and Group 2 (peripheral techniques); and a significant difference of the clinical picture as compared with the control Group 3. The psychological data are summarized in the Chart below.

 

  Central Techniques (n = 18)

 Peripheral Techniques (n = 18)

  Control (n = 18)

 Before  After  Before  After Before After
 10 Words Test   Primary  4.1 (±0.15)

 7.3 (±0.15)

 4.2 (±0.15)  7.8 (±0.15)

 4.4 (±0.15)

 4.5 (±0.15)
  Secondary  3.5 (±0.15)  6.3 (±0.15)  3.3 (±0.15)  7.0 (±0.15)  3.7 (±0.15)  3.6 (±0.15)
 Schulz Tables  242 (±2)  185 (±2)  253 (±2)  174 (±2)  233 (±2)  238 (±2)
 Quality of Life  4.4 (±0.2)  8.3 (±0.2)  4.7 (±0.2)  8.1 (±0.2)  4.5 (±0.2)  4.8 (±0.2)

 
Discussion

In the therapy groups, we achieved a significant neurological improvement that was also proven by neuro-imaging. From objective neurological data, we cannot judge yet which is more advantageous – Central or Peripheral Techniques. To do so, we need additional instrumental research, and a more homogeneous population whose data can be validated.

However, we can state with confidence that month-long rehabilitation that includes SCENAR therapy is definitely far more effective than drug monotherapy. From psychological test data, peripheral techniques provide a more pronounced recovery of higher mental and cognitive functions, when used in rehabilitation after ischemic stroke. Nevertheless, central techniques also provide a significant effect as compared with the control group. To determine more clearly the tropism of the techniques to the patient’s condition, a more extensive study is required.

Such rehabilitation also improves the patients’ quality of life, and decreases the level of
depression and autoaggression. This allows recommending SCENAR therapy for treating psychosomatic and psychological disorders accompanied by depression. SCENAR therapy in multiple rehabilitation after ischemic stroke would allow highly optimistic results. Its therapeutic techniques are easy to learn and use. They can be safely applied by nurses and paramedical personnel – psychologists, rehabilitation and speech therapists, etc. Moreover, the treatment does not end in a therapist’s office, since patients can be trained to continue their treatment at home. 
 
 
Conclusions
 
1. SCENAR therapy can be used as a basic therapy for rehabilitation of post-stroke patients.
2. SCENAR therapy can be used not only by medical professionals but psychologists,
rehabilitation and speech therapists (since it improves the quality of psychosomatic therapy, restores speech and cognitive functions and promotes faster recovery).
3. Additional research and investigations are required, and treatment techniques should be further improved.

 
References

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Terry Waller, Insurance Manager, London (Frozen Shoulder)

"After lifting some heavy machinery, I found that trying to raise my left arm above my waist was very painful. My osteopath told me I had a frozen shoulder and although I got some relief from his treatment, he said it could take up to 12 months for things to normalise. Some weeks later I was introduced to Paul and his Scenar equipment. I was a little sceptical at first but after 2-3 sessions I began to notice improvement. To my amazement, after just 8 sessions I realised that I could raise my left arm as high and easily as my right. It's now just over a year later and I have remained completely pain free ever since. There is no hard sell with Paul who I found to be very knowledgeable and a consummate professional."

 

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John Hayward, Engineer and Landscaper, Westham, Sussex (Neck + Shoulder Pain)

"The pain had reached levels that stopped my physical workload. The diagnosis was nerve compression due to an old injury to the C5/6/7 vertebrae. After four Scenar treatments, I was able to stop the painkillers. After three months and 10 treatments I can sleep on my side again, write and sign my signature fluently again, turn my head fully to the right and left..." 

Six months followup: "I'm doing heavy physical work again as part of my job, and despite needing occasional top-ups, I'm basically pain-free. Altogether, a phenomenal success."

 

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Don Elwick, Managing Director, Brighton Media Centre (Cracked Ribs)

"On December 21st, 2009, I went out running, slipped on some ice, and fell heavily on my back. A nurse and a doctor both confirmed I had two or three cracked ribs. I spent the next week hardly sleeping due to the pain. On December 29th I saw Paul Lowe for a Scenar treatment, and that night I slept properly again. Over the next few days, almost all the pain had gone. I had a second Scenar treatment January 1st, and on January 4th, the doctor found it hard to believe there was nothing left from the accident."

 

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Venus Villa, First Artist, The English National Ballet, London (Muscle Injury)

"I had a very painful injury to my leg and I tried several therapies. Scenar was the best for really deep healing. Thank you Paul."

 

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Tali Saar, Shiatsu and Cranio-Sacral Therapist, Lewes, Sussex (Facial Paralysis)

"I was treated by Paul Lowe for facial paralysis, I also had pain in my face and ear canal. The pains disappeared after the first two treatments, and soon there was a huge improvement in the paralysis and my energy levels. The treatments reminded me of a deep, relaxing place I had lost for many years. I experienced changes at many levels, far beyond my original symptoms. Paul has been both supportive and inspiring. He is a unique practitioner with vast knowledge in his field."

 

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Erica Yonge, Energy Therapist, Marlborough, Wiltshire (Back Pain)

"Paul, I just wanted to say thank you so much for sorting out my back problem so effectively with Scenar. I was told I had a potential herniated disc in my lower back, and I was in a lot of pain for many years. In recent months, I was frequently unable to stand up straight for minutes at a time. After six Scenar sessions, not only am I completely pain free in my back for the first time in years, but my posture has corrected itself naturally. I wouldn't have believed I could be this pain free after so many years of pain.

Eighteen months followup: My back is still very good and posture is better than it's ever been. If you weren't so far away, I'd come for regular top-ups!"

 

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Lucienne Atkinson, Business Owner, Oulston, Yorkshire  (Back Pain)

"Life had been years of debilitating pain. I was at my wit's end. Finding Paul Lowe and the Scenar treatment has been nothing short of a miracle for me. After two long treatments with him, the worst problem area for pain changed, almost disappeared."

18 months followup: "It's truly a miracle. I have gone back to the athletic person I was before. I can train hard on my mountain bike for 3 or 4 days in a row with no back pain!"

 

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Tim Cornwall, Works Manager, Herstmonceaux, Sussex (Back Pain)

"I've had hip and lower back problems for over 30 years. This episode was the worst I've had for two years: I could hardly walk or drive. Until now, I'd go to the chiropractor for several treatments and take at least three weeks to recover. With Paul it took five days and four Scenar treatments to get back to normal. On day 1, I could barely walk. On day 3, I took the dog for a one-hour walk."

 

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Barry Chapman, Designer, Hove, Sussex (Leg pain)

"I would recommend anybody with health challenges to talk to Paul. I had a combination of polymyalgia, extremely sore feet, low energy and limited mobility. I thought I had tried everything and had resigned myself to sliding down the slippery slope. Paul, his guidance and treatments, gave me hope when I had none, and for this I am extremely thankful. I've adjusted my lifestyle and diet and worked hard. I am now fit, energetic and strong."

 

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Angela Gilroy, Media Designer, London (Back Pain)

"When I hurt my lower back, the pain made it impossible to move my right leg backwards when walking, so I had to shuffle. Paul Lowe gave me a brief Scenar treatment that night and I felt some relief immediately and got a good night's sleep. The next morning he gave me a full back treatment, and this produced a major change. It still felt a little tender but I could walk around almost normally."

 

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Marco Crivello, Artist, Lewes, Sussex (Shoulder + Back Pain)

"I had acute pain in my right shoulder. I tried osteopathy and cranio-sacral over several weeks, but with negligible results. Paul treated me with Scenar daily for four days, and by the end I was pain-free. On another occasion, I was in acute pain months after Achilles tendon surgery -- after one treatment from Paul, the pain went away. I also threw my back out twice. Each time, one Scenar treatment was enough to put it back to normal."

 

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Stephanie Davies-Arai, Sculptor, Lewes, Sussex (Back Pain)

"I was rushed to hospital on three occasions and given four strong painkillers including morphine. I finally collapsed at work in agony, unable to walk. After 10 daily treatments with Paul, I was able to stop the painkillers and drive 80 miles to a work event."

Six months followup: "I'm still pain free."

 

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Phil Turtle, Company Director, Brighton  (Fracture, Post Surgery)

"I broke the humerus bone in my arm and had it operated on, in January 2014. I then had frequent Scenar and pulsed electromagnetic field treatments from Paul Lowe and quickly regained use of the arm. Five weeks after the operation, I saw my consultant and he was obviously shocked at how 'back to normal' my arm was at such an early stage." 

 

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Dolores Goodey, School Teacher,  Newhaven, Sussex  (Chronic Whiplash Pain)

"It works, and I tried everything. I have more energy and I'm sleeping well. I used to get aches all the way down my back but not now. I'm also impressed that the treatments had such long lasting effects."

 

Plesae note: These testimonials are from real individuals but since every individual is unique, there is no guarantee that others will experience the same results.