WO2007071295A1

WO2007071295A1 - Method of activating lost motion functions and defining recovery efficiency performance related to central nervous system injuries

Info

Publication number: WO2007071295A1
Application number: PCT/EP2006/009009
Authority: WO
Inventors: Andrei Stepanovich Bryukhovetskiy; Georgy Ruslanovich Pugachev; Olga Palumbo
Original assignee: Meditech Industries Llc
Priority date: 2005-12-19
Filing date: 2006-09-15
Publication date: 2007-06-28
Also published as: RU2005139565A; RU2316334C2

Abstract

This invention can be related to the field of neurophysiology, molecular pharmacology and biophysics, and is namely focused on activation of the motion functions of a patient's extremities after injuries affecting the central nervous system. Activation methods to address lost motion functions related to central nervous system injuries are provided. Completion of preliminary tests and dynamic neurophysiologycal investigations by method of electroneuromyography (ENMG) are administered while taking into account the following parameters: amplitude and latent period of M-response from muscle fiber, pulse velocity passing along the nerve fiber, real latent period and dispersion of the F-wave. Combined stimulation of MPs follows according to a specified algorithm. In cases of spinal cord injury stimulation is provided on the back surface of the body and extremities first in locations proximally above and below the site of the injury and secondly at the site of the injury itself . In cases of cerebral injury stimulation is provided first to the head and neck, then to the MPs on the back surface of the body, and lastly to the MPs on the distal parts of the higher and lower surfaces of both extremities. Stimulation is first provided by the method of acupressure on the MPs and then on each of the selected skin areas and MPs where a biogenic stimulating elixir is applied according to an indicated algorithm and held for a period of 20-30 minutes. This method allows for sufficient activation of the motion functions lost due to spinal cord or cerebral injuries.

Description

DESCRIPTION

METHOD OF ACTIVATING LOST MOTION FUNCTIONS AND DEFINING RECOVERY EFFICIENCY PERFORMANCE

RELATED TO CENTRAL NERVOUS SYSTEM INJURIES FIELD OF THE INVENTION

[0001] . This invention can be related to neurophysiology, molecular pharmacology, biophysics and in particular to the activation of motion functions in the extremities after injuries that effect the central nervous system.

BACKGROUND OF THE INVENTION

[0002] . In spite of significant developments in the field of rehabilitation of a variety of nerve-related pathologies, cases of dramatically successful rehabili- tation remain few. Most of the general casework is related to posttraumatic and other brain or spinal cord injuries. Existing rehabilitation methods very often can not recover specific motion functions that were lost. Occupational invalidism in these groups of patients re- mains high, and prognoses for a future active life are likewise often negative. Therefore, the search for techniques of activation and rehabilitation of abnormalities related to injuries where significant nerve damage has occurred, especially those in central nervous system which can cause disability of entire groups of motion functions, has become extremely important. [0003] . A prior patent publication in the same field as the present invention shows scientific work that de- scribes a method of rehabilitation of motion functions for patients who have experienced peripheral nervous trauma (Russian Federation, No. 2185202, 2002) . [0004] . In this well-known method, the goal is reached by implementation of a two-stage rehabilitation plan. In the first stage, there was reported a therapeutic physical training and exposure by contact to a pulsing magnetic field which is placed on a coverlet and reaches the patients nerve trunks and muscles through a bandage and/or splint . The frequency of the magnetic field is set at 30 pulses per minute, induction at 0.5 - 1.08 TL (Tesla) , for 10 - 12 minutes. This therapy is administered daily along with other morning procedures in the two-hour period between 7am - 9am. [0005] . In the second stage, 12 - 15 electrical stimu- lation procedures are carried out by squared-shaped pulses with a fixed delay of 5 milliseconds. The pulse is set at a discretely increasing frequency from 1 to 10 Hz and the patient is exposed to the current on each frequency for 5 - 10 seconds at each of the distal and proximal points of peripheral and central traumatized nervous sections as well as the innervated motion points of the affected muscles. These procedures pass pulses of electricity through the distal and proximal motion points with their corresponding nerve connections in or- der to evaluate the functional condition of patients' traumatized extremities and neuromuscular apparatus. The procedures are done before therapeutic physical training, immediately after and every 25 - 30 minutes during a 2.5 - 3 hour time period. This evaluation provides an opportunity to define the time of decreasing functional parameters in the neuromuscular apparatus for a particular period after administration of stimulated therapy and after therapeutic physical training. [0006] . In tests conducted, daily morning therapeutic physical training activated all functions of a target muscle group or nerve section and improved all levels of regulation and self-regulation of organs. Trophic action was defined by an increase in the functions of the existing capillary net. Apart from times of muscle con- traction, prostogladines were seen to be released, which promoted activation of esodic nerve ending and was accompanied by vascular reflex reactions.

[0007] . It must be noted that the above-mentioned method along with many other methods (Pat. Russian Fed- eration 2136328, 1999, Pat. 2179009, 2002, Pat. 2175251, 2001) is not suitable for patients with spinal cord or cerebral injuries specifically, and injuries that affect the central nervous system (CNS) in general. This method and the like may be used to attempt to recover motion function after injuries involving peripheric nerve damage. Moreover, in some cases it has also been observed a decrease in the conduction of the electric impulse along the nervous fibers after such a treatment . SUMMARY OF THE INVENTION [0008] . The specific technical objectives of this invention is the development and activation of lost motion function using methods that involve dynamic monitoring of the recovery efficiency of these methods when applied with patients who have experienced trauma and other CNS injuries.

[0009] . The main strength of the invention is the development of a composed method for recovering motion function activation after a spinal cord and/or cerebral injury. This is done by means of neurophysiological monitoring of transcutaneous, acupressure and biogenic action at determined motor points (MP) , corresponding to myoneural junction, on extremities of the body with subsequent activation of lost motion functions in the extremities when in a "facilitated position", as will be explained in detail hereinafter. This method also in- eludes forming conditioned reflexes and subsequent unconditioned reflexes of hands and legs through the application of complex intensive therapeutic physical training carried out in the following order: a) develop- ment of muscle strength and endurance; b) fixing and coordination of the large joint at rest and in motion; c) posing constitutive elements of ambulation and fine motor activity; d) forming dynamic stereotypes for motion of the extremities. [0010] . Technical problems were addressed throughout by monitoring the efficiency of motion function recovery, including use of stimulation of motor points (MP) on the body of the patient, neurophysiology investigation, and therapeutic physical training. [0011] . A first object of the present invention is, therefore, a method for monitoring of the neural impulse along neural fibers during the stimulation of motor points to recovery the efficiency of motion function. [0012] . A second object of the invention is a method of activating lost motion functions related to central nervous system injuries.

[0013] . Further objects and advantages of the invention will be described in the following with reference to the detailed description of the invention. DETAILED DESCRIPTION OF THE INVENTION [0014] . In particular, the method for monitoring of the nerve impulse along nerve fibers during the stimulation of motor points to recovery the efficiency of motion function, comprises the step of performing a neuro- physiology investigation on a target nerve impulse pathway by means of electroneuromyography before and during the stimulation of motor points (MPs) .

[0015] . In cases of injury to the central nervous system, neurophysiology investigation on initial phase by electroneuromyography method (ENMG) was carried out. This included investigation of amplitudes and concealed period M-responses from muscular fiber, velocity of transmission nervous pulse along nerve (meters per second) , and the minimal latent period of the F-wave . [0016] . Therefore, the above investigation comprises an initial phase wherein electroneuromyography has been performed considering the following parameters: amplitude and concealed period M-responses from muscular fibers, velocity of transmission nervous pulse along nerves, minimal latent period of the F-wave.

[0017] . After the above initial phase, the stimulation of motor points was conducted according to the following schemes. In case of trauma to the spinal cord, MPs, on the back surface of body and extremities, should be se- lected at higher and lower areas proximal to the injury. The stimulation can be carried out by means of exposure to a pulsing magnetic field or conventional electrical stimulation procedures. However, preferably the stimulation comprises acupressure at the MPs on the distal parts of both legs and arms. In fact, acupressure has been surprisingly found to be the best way to obtain optimum results. It is also to be noticed that stimulation can be performed using the above methods singularly or in any combination with acupressure. [0018] . Then the MPs should follow in view of the area of injury. In case of cerebral injury - the MPs should be stimulated on the head and neck, then the MPs on the back surface of the body and finally on the MPs of distal parts of a patient's higher and lower extremities. [0019] . Stimulation of the MPs is achieved through acupressure applied fully perpendicular to the surface of the skin in the relative area placement on the body of the patient and it is again monitored by the ENMG. [0020] . Further, the method according to the invention can comprise a step of application of a composition on each area of skin identified with the MP consistent with the above schemes. The patient should be treated with a composition comprising an activating mixture (elixir) that consist of biogenic stimulators and the mixture should remain on the skin for periods of 5-10 minutes. [0021] . After biogenic stimulation, a further step of neurophysiology investigation by means of ENMG should be carried out . In the cases where positive dynamic results come from the parameters of an ENMG, a complex stimula- tion of each MP consisting in acupressure and application of a biogenic mixture can be performed following a time course of not more than 5 days with intervals of 2- 3 days. In particular, acupressure stimulation on each MP should be held for 5-15 seconds. [0022] . In testing, the elixir was applied over an area of about 50 - 75 mm² at the location of an MP. The biogenic elixir used was consisted of the following components: 10% water solution of aloes juice, 10% water tincture of jasmine (Jasminum L.), 2% water solution spirit extract of propolis and 25% solution dimexide in proportion ranging from 0.8:3:0.8:0.8 to 1.1:3:1.1:1.2, preferably 1:3:1:1.

[0023] . As stated above, the method should be applied according to the following: Patients must pass previous observation on an ENMG within no more than one month after the injury (in the case of long-term motion function loss and all CNS injuries, the observation is likewise necessary) . On the basis of results of a neuromyogram, the following indexes should be taken into account: 1) Amplitude M - response from muscular fiber, 2) Latent period of M - response from muscular fiber, 3) Velocity of pulse going along nervous fiber (meters per second) , 4) Minimal latent period of F-wave and other indicator findings with the ENMG if necessary. This previous analysis allows to establish the diagnosis before the stimulation starts and, in addition, to prepare for future quantitative evaluation of the recovery of dynamics as well as the transmission of pulses along both the peripheral nervous system and the segmental structures of the spinal cord and cerebrum.

[0024] . Each following stage of activation will need to involve ENMG monitoring of the parameters listed above . According to the developed scheme of the stimulation of MPs used, transcutane, extremity and also bio- genie actions should be provided on corresponding motor points of the body and extremities. Localization of essential MPs is detected with the help of standard instructions (see for instance examples 1 and 2) which are known in the art of acupressure and depend on the local- ization of the injury and, thus, are not herein reported in detail . Pressure on each MP at direct right angles to the surface of the body should follow a stimulation period of 5-15 seconds according to the following scheme: in case of injury to the spinal cord stimulation of MPs on the back surface of the body and extremities should be placed at higher and lower areas proximal to the injury, stimulation of the MPs on distal parts of both legs should follow, and finally an MP stimulation should be performed at the site of injury. [0025] . In case of cerebral injury, stimulation of the

MPs should be conducted on the head and neck, on the MPs on the back surface of the body, and on the MPs on the distal parts of the higher and lower extremities.

[0026] . After the acupressure procedures are completed the biogenic activation of motion functions is initiated, which involves application of a biogenic elixir on the skin around the site of injury (the area should total 50 - 75 mm²) as well as on areas surrounding each chosen MP according to the scheme listed above. The mix- ture consists of the following components: 10% water solution juice of aloes, 10% water extract of jasmine, 2% water solution spirit extract of propolis and 25% water solution of dimexide (DMSO) in volumetrical proportion ranging from 0.8:3:0.8:0.8 to 1.1:3:1.1:1.2, preferably 1:3:1:1.

[0027] . Transcutaneous activation may be provided by hand deposition or with the help of a wadding stick watered with the elixir solution warmed for example to 40 - 45⁰C. The time needed to complete the full procedure (acupressure and elixir) ranges from 20 to 60 minutes. After this procedure, a check of the ENMG should follow. [0028] . The ENMG results allow for evaluation of the efficiency of provided complex procedures: transcutane- ous biogenic stimulation and acupressure MP. If the ENMG parameters results are positive (positive changes of amplitude and latent period of M - response, increasing of velocity going along nerve, decreasing of dispersion and minimal latent period F - wave) then complex stimulation (CSMP) may be completed.

[0029] . The course of CSMP follows a period of not more than 5 days with pauses of 2-3 days in between. If the ENMG results do not change after the CSMP has been completed, a standard course of transcranial magnetic stimulation in the area of the injury and MPs is recommended, followed by another ENMG.

[0030] . After confirmation of the efficiency of the CSMP and its effects on the ENMG, the method of activating lost motion functions related to central nervous system injuries can comprise a next stage which involves motion functions activation. In the absence of positive results from the ENMG after the CSMP, this may indicate disturbance of techniques and (or) of methods of stimulation to the MPs, as well as possible anatomic disrup- tion of the spinal cord. In these cases it is necessary to cease therapy and not pursue the following recovery- actions .

[0031] . This additional stage of proposed motion functions activation involves forming a motion "image" within the patient's consciousness. With this goal in mind, the patient is advised to close his eyes and mentally visualize the desired motion recovery. The process is designed to awake in the patient the psychological possibility of motion fulfillment. For this procedure, the patient is placed in a light-weight position on his side or on a sliding surface such as one created by multi-blocks mounted with a counterbalance. In any case, the patient should be positioned in a posture that reduces as far as possible the effect of gravity ("facili- tated position") . For example, if the limb involved in the training is an arm, this arm can be positioned onto a sliding horizontal surface while the patient is sitting. If the limb involved is a leg, the patient can be positioned so that only his thigh is horizontally sup- ported on a sliding surface, the rest of the leg with the foot being suspended.

[0032] . The patient is then asked to make an attempt at motion function of the extremities. If there is the appearance of positive dynamic of motion functions (start up or increase of function) at this time, an on- command conditioned motion reflex plan should then be formed and implemented as a repeated training program. If necessary, the ENMG parameters are monitored and checked regularly throughout this process . [0033] . The method of activating lost motion function can further comprise a next stage which includes forming the unconditioned reflexes in the hands and legs by using regulated, complex therapeutic physical training comprising the following guidepoints: a) evolution of muscular strength and muscle endurance; b) fixing and coordinating of large joints in motion and in rest; c) focus on the main ambulation elements and fine motor activity; d) forming dynamic stereotypes of the motion in the extremities throughout the process of ambulation training.

[0034] . In these cases it is expedient to use different simulators, i.e. training machines, from different companies known to the physician expert in physiotherapy: e.g. a multipleblock mounting with counterbalance and support for the knee, an adaptation kit provided with an extremities slide, an adaptation kit for training fine motor activity, an exercise bicycle, a simulator for leg presses, a simulator of a running track with external devices such as gymnastics parallel bars, a suspended parachute system with counterbalances, etc. The activities in this stage may be repeated from 5 to 15 times during a 3-week course with pauses from 1 week up to 3 months .

[0035] . During the conventional physiotherapy it is important to focus the training on singular and precise motor functions working on the corresponding anatomic structures .

[0036] . In the following, there will be reported non limiting embodiments of the present invention. [0037] . The efficiency of the proposed method of motion functions activation was evaluated for 43 patients with spinal cord and cerebral injuries. This cross- section (7 women and 21 men) was divided into 2 test groups. Seven of the patients had cerebral injuries, which formed the first group, and 21 patients had spinal cord injuries, which became the second group. Evaluation of results was aided by comparison with a control group of 15 patients that underwent treatment composed of traditional methods of intensive rehabilitation. The evaluation was conducted according to guidelines from the International scale of the Committee of Medical Research (see List of the Literature, reference 3) . [0038] . For first group, recovering of motion in proximal parts of the hands was marked for 5 patients, in the arm flexor for 6 patients, in the finger flexor for 1 patient, and in the arm extensor for 3 patients. Motion of legs was recovered with 5 of the patients in this group.

[0039] . For second group, marked motion recovery in proximal parts of the hands was achieved for 14 patients, in the arm flexor for 7 patients, in the finger flexor for 5 patients, and in the arm extensor for 4 patients. Motion recovery in the proximal parts of legs was achieved for 17 patients, and motion recovery in the distal parts of the legs was achieved for 7 patients in this group.

[0040] . For the control group, marked motion recovery in the proximal parts of the hands was achieved for 4 patients, in the arm flexor for 3 patients, in the fin- ger flexor for 2 patients, and in the arm extensor for 2 patients. Motion recovery in the legs was achieved for 2 patients in this group.

[0041] . Accordingly, markedly higher efficiency was noted when the proposed method of motion function acti- vation was utilized as is shown through evaluation of dynamic muscle strength recovery with use of the scale of the Committee of Medical Research (see List of Literature, reference 3) . [0042] . A further object of the present invention is a composition comprising a mixture of 10% water solution juice of aloes, 10% water extract of jasmine, 2% water solution spirit extract of propolis and 25% water solution of dimexide (DMSO) in volumetrical proportion ranging from 0.8:3:0.8:0.8 to 1.1:3:1.1:1.2, preferably 1:3:1:1, for use in a method for activating lost motion functions related to central nervous system injuries. [0043] . In fact, as stated above, it has been surprisingly found that the composition or elixir participate actively to the activation of the motion functions. [0044] . Preferably, the composition is applied after the above described method of activating by means of stimulation of the MPs following the same scheme already disclosed. [0045] . In addition, the present invention related to the use of said composition or elixir for the preparation of a medicament in the activation and recovery efficiency performance caused by injuries at the central nervous system and at the spinal cord. [0046] . The elixir can be prepared in any form suit- able to be applied to and absorbed by the skin. Preferably, it is in the form of a conventional cream to be applied with massage.

[0047] . The following examples of medical supervisions may further illustrate the efficiency of the proposed method of motion functions activation. EXAMPLE 1

[0048]. Patient J. M._# 43 years old placed in a clinic with the following diagnosis: consequences of permanent spinal cord injury, compression-splintered fracture C6 vertebra, and permanent contusion of spinal cord with spinal cord compression on this level . Antecedent anamnesis: injury occurred in 2003. Patient arrived at a city hospital under emergency conditions, was admitted and stayed in the hospital reanimation department for 3 days with the following diagnosis: vertebral spinal cord injury, fracture, dislocation of vertebral C6 body with contusion and spinal cord compression on this level, traumatic tetra syndrome. [0049]. Intensive therapy was carried out, including traction of the neck section of the vertebral column. After this the patient was transferred to an out-patient clinic. Surgical operation were made to the anterior spondylosyndesis and the posterior spine fusion. Later, the patient received rehabilitation treatment at differ- ent healthcare centers and hospitals within the Russian Federation. Results of medical inspection while in clinic: muscle strength in proximal parts of hands up to 2 - 3 points, plegia in distal parts, symmetrical reflexes increased, Rossolimo syndrome discovered in both hands and legs, volume of active and passive motions limited in distal parts, plegia in the legs. [0050] . The patient followed a course of the recovery- motion functions activation outlined in this article, according to the declared method. A preliminary ENMG and standard neurophysiology investigation was made for the patient. Full block neurophysiology conductivity from the level vertebral body S6 was discovered after completion of the neurophysiology investigation. The ENMG was investigated and the following parameters were taken into account: 1) amplitude of the M-response from muscle fiber; 2) the latent period of the M- response from muscle fiber; 3) the pulse velocity along nerve fiber (meters per second) ; 4) dispersion and mini- mal latent period of the F-wave; along with other significant parameters. Stimulation of MPs was made according to the scheme described above. Acupressure on the MP was provided in the area of the sternocleidomastoid muscle, in view of the accessory (XI cranial) nerve, the trapezoidal muscle MP (m. trapecius) on level of the 5-6 jugular. This was followed by acupressure on the levels between 2 and 3 of the thoracic vertebra, on the abdominal muscle MP (m. infraspinatus) , the unbent muscle vertebra MP (m. erector trunci) , the abdominal external oblique muscle MP (m. obliquos abdominis externus) , the gluteus medius muscle MP (m. gluteus medius) , the gluteus maximus muscle MP (m. gluteus maximus) , the tibial nerve MP (n. tibialis) , the gastrocnemius muscle MP (m. gastrocnemius) , the adductor big finger of leg MP (m. abductor hallucis) , the back surface of the hand in the deltoid area MP (n. deltoideus) , the teres minor muscle MP (m. teretes) , the radial nerve MP (n. radialis) , the ulnar MP (n. ulnaris) , the instep muscle MP (m. supina- toris) , the MP on the front surface of the body and ex- tremities near the femoral nerve MP (n. femoralis) , the sartorius MP (m. sartorius) , the peroneal nerve MP (n. peroneus communis) , the median nerve of the shoulder MP

(n. medianus) and the flexor of the big finger muscle MP

(m. flexor pollicis brevis) . After acupressure was given in the areas of each named points, an elixir was applied as a biogenic stimulator that consisted of 10% water solution aloe juice, 10% jasmine water solution, 2% water solution propolis spirit extract and 25% dimexide water solution in volume proportion 1:3:1:1. A process of transcutane activation of the MP was carried out after heating the mixture with the help of an outside vessel set at 40 - 45⁰C for a period of 20 - 30 minutes. [0051] . After the ENMG check showed positive neurophysiology results, a comparison with the preliminary investigation was made. The comparison showed an ampli- tude increase of the M-response in the hands from 2.5mV up to 7.3 mV, in the legs from 1.5 mV up to 6.2 mV. A velocity increase along the nerve fiber from 31.3 m/sec to 47.6 m/sec in the hands and from 29.8 m/sec to 44.3 m/sec in the legs was noted. A dispersion decrease of the F-wave in the hands from 10.1 m/sec to 5.6 m/sec, and from 13.6 m/sec to 7.4 m/sec in the legs was apparent . [0052] . With this proven positive (effective) dynamic of recovering lost motion functions, additional neurophysiology actions were provided: in a light-weight position the extremities were "activated," the legs put in motion at the femoral and knee joints and the hands at the elbow joint. Special therapeutic physical training was provided, and fifteen gymnastic procedures executed during the course of 3 weeks .

[0053] . Over the next three months the patient was provided with therapeutic physical training conducted under the special technical conditions describes above in order to carry out motion functions activation in the main directions . A marked increase of muscle strength was achieved. Over time the patient repeated a course of treatment by complex method for recovering activation. During the following three months the patient noticed positive dynamic change: muscle strength in the back was increased, and an increased ability to remain in a sitting position for longer periods of time was evident. [0054] . Objectively speaking, the general state of the patient was positive. Constitution was normal sthenic. The skin was colourless at a normal humidity level . Subcutaneous fat was in normal condition. The post- operation cicatrix along the spinous process of the vertebra in the lowest level on the front-side surface of the knee was not commeasured with the subjacent cellular tissue. Color was normal, palpation was painless. Muscle hypotrophy of the buttocks and lower extremities was noted. Contractions in the joints of lower extremities were absent . Respiratory motion frequency was 14 per minute. Arterial pressure (AP) was 110/70 mm of Hg. [0055]. Neurological state: consciousness was clear. Pupils were equal, middle size. Photo response was alive, R (right) = L (left). Face was symmetrical. Craniocerebral nerves (CN) were without visual pathology. [0056] . In-motion: muscle strength in proximal parts of hands satisfactory, in distal parts - decreased to 3 points; reflexes symmetrical and increased, marked Ros- solimo symptoms. Volume of active and passive motions limited in distal parts of hands. In legs - paraparesis at 3 points, and distally at 2 points. Patient could stand on knee support for up to one hour, could squat without help from hands. Knee and talocrural joints began "to close." Patient could take 20 steps with the support of crutches.

[0057] . Disturbance of pelvic organs functions with type of enuresis. General analysis of urine: specific gravity - 1010; light, transparent. Protein - 0.04; sugar absent. Leucocytes - 6 - 8 in field of view; erythrocytes - 1 - 2 in field of view; bacterium absent. Biochemistry of blood: glucose - 4.9; blood urea - 4.6; creatinine - 105; whole bilirubin - 10; whole protein - 72.7; albumin - 43.1; alanine amino transferase - 18.3; aspartate amino transferase - 16.5; lactate dehydrogenase - 286; gamma - 27; alkaline phosphatase - 296. Coagulation test: APTV - 34; fibrinogen - 354; prothrom- bin relation - 90; PKMF- negative; minute normalized relation - 1.07; aggregation - 93; prothrombin time- 14. HBs-ag, HCV, RW, AIDS negative. MRT in neck area: detected thinning and intermittence of spinal cord at distance of 1.25 centimeters on the S6 level with cyst in- elusions. ENMG: on the whole there were clear positive dynamic changes when compared with the previous results : increased amplitude of the latent period of M-response from the hands and legs, decreased dispersion and minimal latent period of the F-wave, increased pulse and ex- citation velocity along the nerve fibers. Urine dynamic tests: neurogenic hyperactivity of detrusor; increased maximal interior urethral pressure. Radiography iliosac- ral articulation: ossificate with shadow that overlapped on the contour of the left iliac bond. Dynamic of indi- 5 cators for the J. M. patient's muscle strength according to the scale of the Committee of Medical Research is shown in table 1. TABLE 1

10

[0058] . Results from treatment include positive dynamic changes in the form of increased muscle volume in the legs, and appearance of motion in the proximal parts of the hands and lower extremities. Patient provided up-

15 dates about his improving quality of life and increased ability to provide own care independently. The patient was then discharged to his home in a satisfactory condition. EXAMPLE 2

[0059]. Patient K. S., 23 years old, (Case history No. 05/0038824) was placed in the hospital "NevroVita" with the following diagnosis: "Traumatic disease of the spinal cord, late period. Consequence of fracture TnIl and Tnl2 vertebral bodies in 2002. Repeated operations with interbody spondylolysis autogenous bone graft and in- stallation of transpedicular fixed construction carried out . Lower paraparesis present . "

[0060] . Antecedent anamnesis: Arrived from USA to Russia for treatment. From patient testimony and medical documents information shows that there was trauma as re- suit of a traffic accident on a motorcycle. Within a week after the trauma and stabilization of vital signs, the patient underwent two surgical operations involving interbody spondylolysis autogenous bone graft and installation of a transpedicular fixed construction. In the post-operation period there was a regression of paraplegia to the lower pyramidal paraparesis . Over the following three years the patient engaged in rehabilitation courses at some of the best medical centers in the USA. As a result of the rehabilitation process the pa- tient was then able to sit in an invalid carriage, showed motion of the left finger when resting on leg, and began to ambulate in recovery adaptation (prosthesis) for up to 10-15 meters with the support of a go- cart . [0061] . Objectively speaking the general condition of the patient was satisfactory, and of the normosthenic type. The appearance of the skin was pure, with normal color. Breathing vesicular, crepitations absent, and the frequency of breathing motions registered at 14 per min- ute. Pulse was 70 per minute, and rhythmic, arterial blood pressure at 110/80 mm of Hg.

[0062]. Neurologic state: Clear consciousness, orientation in space, time, and sense of own personality remained. Meningeal stigma was absent. Visual disturbance was absent. Motion of the eyeballs in full volume was present, and nystagmus absent. Sensitivity in the face was saved. Photoreaction (direct and concomitant) remained alive. The site of the exit trigeminal nerve with palpation was without pain. Muscle strength of hand was at 5 points in all groups, tendinous reflexes equal, normal and alive. Muscular tonus in legs increased in the spastic type, R > L, and according to the Ashworth scale registered 4 points. Lower paraparesis went to 2 points in the left leg, and motion of the big toe of the right foot saved. Muscles of lower extremities showed moderate hypotrophy. Tendinous reflexes were animated with expanding of reflexogenic zones, R > L, clonuses of patella and foot, the abdominal reflexes were reduced, and pathological reflexes on the legs were revealed. Pa- tient could stand without help and ambulate freely for 10-20 meters. Painful hypoesthesia was noted from level Ll. Tactile sensitivity was disturbed according to the mosaic type. Deep sensibility was saved. Coordination tests were fulfilled satisfactorily. [0063]. General analysis of blood: WBC-4.34; RBC-4.65; HGB-13.7; HCT-401; PLT-186; leukocyte - 39; H-37, monocyte - 9; erythrocyte - 3; flat nucleus -12. General analysis of urine: specific gravity - 1012; light, transparent. Protein - no; sugar - no; leukocyte - 5-7 in field of view; erythrocyte - 2-3 in the field of view. Biochemistry of blood: glucose - 4.7; blood urea - 5.3; creatinine - 70; whole bilirubin - 10; whole protein - 72.2; albumin - 37; alanine amino transferase - 27.7; aspartate amino transferase - 18.9; lactate dehy- drogenase - 240; gamma - 67; alkaline phosphatese - 207; cholesterol - 6.16; triglyceride - 1. Coagulation test: APTV - 34; fibrinogen - 382; PKMF - negative; minute normalized relation - 1.02; aggregation - 85; prothrombin time - 13. Clinical analysis of liquor: protein - 0.33; quantity of cells - 0; HBs-ag, HCV, RW, AIDS negative .

[0064] . Patient passed an additional ENMG with somato- sensory-created potentials (SCP) . With stimulation of the lower extremities data was collected that showed double disturbance pulse conductivity through proprioceptive sensitivity in the spinal cord. This resulted in a marked decrease in amplitude of the (SCP) with a left emphasis, and a decreased pulse velocity in the central nerve system as a whole. Disturbance factors affecting the functions of the distal parts of the lower extremities were not significant. According to the data, the H reflex detected disturbance at the root of the vertebra Sl left. [0065] . At this time the method outlined in this article for motion functions activation was initiated. The patient underwent a preliminary ENMG. The activation course followed the above method: programmed action on motor points by acupressure was performed according to the developed algorithm at both the higher and lower disturbance places in the distal parts of the legs and on the level of the disturbance. After each acupressure procedure was completed a biogenic elixir like that described in detail in example 1 was applied transcutanly with indirect heat (40 - 45⁰C) in selected areas rela- tive to the scheme of MPs. The motion functions activation was positive (taking into account the ENMG parameters, see table 4) , and motion of the legs was "initiated" at the femoral and knee joints in the light-weight position. This was followed by complex therapeutic physical training with specialized simulators. After the fourth full course of activation the patient demonstrated a marked ability for independent leg motion (flexion and extension) , and increased muscle strength in the lower extremities. After the eighth full course of activation the patient could fix his knee and stand independently with the support of a go-cart. After the twelfth course the patient succeeded in taking a step with a fixed knee-joint, and also independently took a step on a running-track with parallel beams as support. During the fifteenth course the patient succeeded in taking a sequence of 5 steps without additional support . After the twentieth course the patient went 60 meters independent of aid. The results of the indicators of muscle strength (during the activation process) according scale of Committee of Medical Research are presented in table 2. The ENMG check (see table 4) indicated legible positive dynamic change in comparison with previous results: increased amplitude of M-response from the legs, decreased dispersion and minimal latent period of the F-wave, and after providing combination courses of acupressure and lubrication from the biogenic elixir in the MP areas an increased excited pulse velocity along nerve fiber was registered.

TABLE 2

EXAMPLE 3 [0066]. Patient M. Ju., 34 years old, was placed in the "NeuroVita" hospital with the following diagnosis: "Consequences of disease - typical stroke in Adamke- vich's artery basin with a lower pyramidal paraparesis". [0067]. Antecedent anamnesis: In December 2002, during pregnancy, the patient reported a sensation of weakness in the legs and paresthesia. In the same month weakness in the legs and sensory disorders and disturbances of the pelvic organ functions suddenly appeared again dur- ing the morning part of the day. Over the course of the next 2.5 years the patient, in spite of constant rehabilitation treatment in specialized centers, in practice showed no changes in her neurologic state and no posi- tive dynamic changes. In April, July and November the patient completed her observations and particularized rehabilitation treatments in the hospital "NeuroVita" . [0068] . Objectively speaking the general state of the patient was satisfactory at this point in time. Skin tegument and visible mucous tunic were pure and showed their usual color. Vesicular respiration and crepitation were absent. The frequency of respiration motions was 15 per minute. Pulse was 74 per minute, rhythmical, blood arterial pressure 110/70 mm of Hg. The patient's heart sounds were rhythmical. Abdomen was soft and palpations when they occurred were painless . Liver and spleen did not increase in size. Symptom tapotement was negative from both sides. Neurological state: consciousness clear. Eye fissures were R = L, and the motion of eye- ball was in complete volume. Pupils R = L, photo reaction satisfactory. Muscle strength in hands was at 5 points. Reflexes were alive and symmetrical in the hands. Lower paraplegia noted. Tendinous reflexes in hands were animated with expansion of the reflexogenic zones. Babinski ' s phenomenon was noted from both sides. Increased muscular tonus in the legs of the spastic type were more evident from the right . There were signs of enuresus. Disturbances caused by pain, temperature change and tactile sensitivity tested were marked at level Th₇. General urine analysis: specific gravity - 1010; light, transparent. Protein absent, and sugar undiscovered. Leukocytes 0 - 1 in field of view; erythrocytes - 0 - 1 in field of view; bacteria isolated. Biochemistry of blood: glucose - 4.7; blood urea - 4; creatinine - 68; whole bilirubin - 13; whole protein - 73.1; albumin - 41.4; alanine amino transferase - 3; aspartate amino transferase - 14; lactate dehydrogenase - 310; gamma - 11; alkaline phosphatase - 205. Coagulation test: APTV - 33; fibrinogen - 392; prothrombin relation - 107; PKMF negative; minute normalized relation - 0.96; aggregation - 105; prothrombin time - 13. HBs-ag, HCV, RW, AIDS negative. ECG: sinus rhythm, normal direction of electrical axis. [0069] . The ENMG with somatosensory-created potentials (SCP) : SCP from both sides considerably deformed, and slow components expressed weakly. Complex P37N45 was registered only with considerable stimulation. With stimulation of the lower extremities data gave evidence of coarse disturbances of conductivity in the ways of proprioceptive sensitivity in the spinal cord. This was more pronounced with left side stimulation. The patient completed the preliminary ENMG: account parameters such as those in example 1 were taken into account and the results are presented in table 4. Included are marked signs of moderate double-sided disturbances in the proximal and distal parts of nerves in the lower extremities like the type myelinopathy with a left accent. Electroencephalography: positive dynamic changes in the form of decreasing evidence of slow wave activity. The patient completed the full course of the motion functions activation: programmed action on motor points by acupressure were applied according to the above- mentioned algorithm at the higher and lower disturbance sites and in the distal parts of the legs. These distur- bances were monitored for their neurophysiological impact. After each application of acupressure, a biogenic elixir as an example 2 was administered. As results of the dynamic ENMG after different stages of activation showed increased efficiency in recovering motion func- tions, the conclusion was drawn that legible positive dynamic change had occurred when compared with the starting data (see table 4) . The amplitude along with other indicators of M-response from the legs increased while the minimal latent period of the F-wave de- creased. The patient marked positive dynamic changes from treatment: after treatment she was able to stand with knee support for a period of several hours, to move a distance of several meters with help, to squat without assistance, and to turn the wheels of an exercise bicy- 5 cle with resistance. The activation results achieved by the applied method showed an increase of muscle strength that was measured in points according to the scale of the Committee of Medical Research (see table 3) .

0 TABLE 3

[0070] . Intelligible positive dynamic change was noted when compared with previous results: decreased deformation from both sides, though more dramatic on the left side, amplitude M-response from the legs increased, 5 again more so on the left, dispersion and minimal latent period decreased after treatment with combination courses of acupressure and use of the biogenic elixir in MP areas, and increased exited pulse velocity along the nerve fibers along both sides. Results of the ENMG check 5 (including SCP for examples 2 and 3) demonstrated general positive dynamic changes in activity development for motion functions (see table 4 below for all examples) . Table 4 shows the following indicators to describe the conditions of the above-mentioned individual

10 patients. This includes amplitude M-response from muscle fibers (aMr) , latent period of the M-response from muscle fiber (IMr) , pulse velocity along the nerve fiber (pVn) and the minimal latent period of the F-wave (pwF) . [0071] . Through this process a unique integrated

15 method was developed for helping people who are experiencing complete or partial loss of motion functions. This method has been shown to be sufficiently effective for the activation of functions for patients living with the effects of a cerebral or spinal cord injury when it

20 is combined with acupressure and biogenic elixir stimulation of the MPs the specifications for which were developed according to the original scheme consecution. TABLE 4

Patients/ aMr IMr pVn pwF Indicators*

Starting 2 .1 Starting 1 .1 Starting 16 .3 Starting59 .3

Example 1 Elixir 2 .3 Elixir 1 .0 Elixir 16 .8 Elixir 59 .1 CSMP 6.1 CSMP 1.1 CSMP 18.4 CSMP 58.6

Starting 1.8 Starting 5.8 Starting 11.8 Starting36.9

Example 2 Elixir 1.9 Elixir 5.7 Elixir 12.0 Elixir 36.8

CSMP 2.4 CSMP 5.3 CSMP 13.2 CSMP 36.4

Starting 0.3 Starting 2.3 Starting 15.4 Starting51.3

Example 3 Elixir 0.3 Elixir 2.2 Elixir 16.1 Elixir 51.2

CSMP 2.4 CSMP 2.4 CSMP 2.4 CSMP 2.4

♦Each indicator shows the statistical treatment of data by a computer program, p< 0.01

List of Literature:

- Sandrigajlo L. I. Neurologist Anatomical Atlas, Minsk, "The Highest School", 1979, 269 pages.

- Scales, Tests and Inquirers in Medical Rehabilitation. Editors Belova A. N., Shepetova 0. V., Moscow, "Anti- dor", 2002, 440 pages.

- «Medical research council Scale*, R. Van der Ploeg at al., 1984

Claims

1. Method for monitoring of nerve impulse along nerve fibers during the stimulation of motor points to recovery the efficiency of motion functions, comprising the step of performing a neurophysiology investigation on a target nerve impulse pathway by means of electroneuromy- ography before and during said stimulation of motor points (MPs) .

2. Method according to claim 1, further comprising an initial phase wherein electroneuromyography has been performed considering the following parameters: amplitude and concealed period M-responses from muscular fibers, velocity of transmission nervous pulse along nerves, minimal latent period of the F-wave.

3. Method according to claim 1 or 2, wherein said stimulation has been carried out by means of acupressure eventually in association with exposure to pulsing magnetic field and/or electrical stimulation procedure.

4. Method according to any one of claims 1 to 3 , wherein said stimulation is carried out using acupressure applied perpendicularly to the surface of the skin of a patient in correspondence of said motor points .

5. Method according to any one of claims 1 to 4 , wherein said stimulation is carried out following the scheme: if trauma involves spinal cord, MPs, on the back surface of body and extremities, are stimulated at higher and lower areas proximal to the injury, preferably followed by stimulation at distal parts of both legs, and then at the area of injury; if trauma involves cerebral injury, MPs are stimulated on the head and the neck, then on the back surface of the body and finally on the distal parts of a patient ' s higher and lower extremities .

6. Method according to any one of claims 3 to 5 , wherein when acupressure is carried out the stimulation period ranges from 5 to 15 seconds.

7. Method according to any one of claims 1 to 6, wherein the said stimulation comprises applying a composition on each area of skin identified with said MPs comprising an activation mixture consisting of 10% water solution of aloes juice, 10% water tincture of jasmine, 2% water solution spirit extract of propolis and 25% solution of dimexide (DMSO) in proportion of ranging from 0.8:3:0.8:0.8 to 1.1:3:1.1:1.2, preferably 1:3:1:1.

8. Method according to claim 7, wherein said composition is applied over an area of about 50-75 mm² around each

MPs for a period from 20 to 60 minutes.

9. Method according to claim 7 or 8, wherein said composition is applied with light heating of 40°C-45°C.

10. Method according to any one of claims 7 to 9, wherein said monitoring of the nerve impulse by elec- troneuromyography is carried out before and after said step of application of said composition.

11. Method according to any one of claims 1 to 10, wherein said method is carried out for a period not more than 5 days with pauses of 2-3 days.

12. Method according to any one of claims 7 to 11, further comprising a step of positioning a patient in a light-weight position in order to reduce as far as possible the effect of gravity and asking him to create a mental imagine of the desired motion followed by an attempt to perform said motion

13. Method according to claim 12 , further comprising a step of physical training aimed at a precise motor function working on a corresponding anatomic structure.

14. Composition comprising a mixture of 10% water solution of aloes juice, 10% water tincture of jasmine, 2% water solution spirit extract of propolis and 25% solution of dimexide (DMSO) in proportion of ranging from 0.8:3:0.8:0.8 to 1.1:3:1.1:1.2, preferably 1:3:1:1.

15. Use of the composition according to claim 14 for the preparation of a medicament in the activation and recovery efficiency performance following injuries at the central nervous system (CNS) .

16. Activation method of lost motion functions under control of the determination efficiency of this recov- ery, including stimulation of the motor points (MPs) on the patient's body, neurophysiologycal investigation and therapeutic physical training, self-diagnosis of injuries to the central nervous system (CNS) , further com- pletion of preliminary neurophysiologycal investigations by methods of electroneuromyography (ENMG) which takes into account the following parameters: the amplitude of M-response from muscle fiber, the latent period of M- response from muscle fiber, the pulse velocity when passed along the nerve fiber, and the minimal latent period of the F-wave.

17. Method according to claim 16, wherein a combined stimulation of the MPs is provided according to the following scheme: in cases of spinal cord injury stimula- tion is provided on the back surface of the body and extremities that are located „ proximally higher and lower than the site of the injury, following this comes the MPs of distal parts of both legs and arms, and finally stimulation of the MP at the site of the injury; in cases of cerebral injuries stimulation is provided first to the head and neck, then to the MP on the back surface of the body and lastly to the MP on the distal parts of the higher and lower surfaces of both extremities.

18. Method according to claim 17, wherein initially stimulation is provided by applying acupressure at a full right angle to the skin surface at MPs on the body of the patient.

19. Method according to claim 18, wherein acupressure stimulation is combined with lubrication using a bio- genie stimulating elixir that is applied in sequences that are indicated in the scheme of claim 16 for each selected MP and sustained for 5-10 minutes.

20. Method according to claim 16 comprising the use of a biogenic stimulated elixir that consists of: 10% water solution of aloe juice, 10% water solution of jasmine extract (Jasminum L.), 2% water solution of propolis spirit extract and 25% water solution of dimexide in proportion 1:3:1:1.

21. Method according to claim 20 comprising the applica- tion of the elixir to the surface of the skin at an MP area at size of approximately 50 75 mm², and the volume of the biogenic elixir measured 0.2 - 0.5 ml.

22. Method according to 16, further comprising an additional neurophysiologycal exercise: the physician pro- posed to the patient the exercise of mentally imagining motion work with closed eyes while laying his side in a light-weight position in order to psychologically incite the possibility of motion.

23. Method according to claim 22, wherein the patient uses a multiblock device with counterbalances, or a slide surface when the physician asks the patient to imagine his extremities in motion, and if an increase of the electroneouromyography parameters values is detected.

24. Method according to any one of claims 16 to 23, wherein said method is repeated up to 5 times but not more than 15 during a 3-week course and then restarted in a period from 1 week to 3 months after completion of the first cycle.