Scenar and Stroke Rehabilitation
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
• Autonomic Nervous System regulation
• Superficial sensation
• Deep sensation
• Body scheme
• Gross motor skills
• Fine motor skills
Recovery of cognitive functions:
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.
• Determine and evaluate practical effectiveness of SCENAR therapy in
• 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
Combination of SCENAR therapy and corrective mechanical therapy in order to
restore deep proprioceptive sensation and coordination of
The patients were divided into 2 groups depending on the therapeutic strategies
• Treatment of central zones only (‘Collar zone’, ‘3 pathways and 6 points’), head
• 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.
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
• 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.
Among all the patients treated, the condition has improved in 37 patients,
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
especially when compared with the control group. Two patients recovered from motor
lingual embol (which lasted for 7 and 11 months), both cases – from Group
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)
| 10 Words Test
|| 4.1 (±0.15)
| 4.2 (±0.15)
|| 7.8 (±0.15)
| 4.5 (±0.15)
|| 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)
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
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.
1. SCENAR therapy can be used as a basic therapy for rehabilitation of post-stroke
2. SCENAR therapy can be used not only by medical professionals but
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.
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