Hematological and Non-Hematological Mechanisms of Adaptation to Intermittent Hypoxia in Post-Stroke Patients During Rehabilitation

The rationale for and development of hypoxic conditioning techniques is an actively developing area in physiology and medical rehabilitation. The purpose of the study is to investigate the hematological and non-hematological mechanisms of adaptation to intermittent hypoxia-hyperoxia exposures (IHHE) in post-stroke patients to enhance the effectiveness of comprehensive neurorehabilitation. Materials and methods. A prospective randomized controlled trial was conducted involving 34 patients (males and females aged 46–73) with residual effects after a stroke. The patients were divided into a study group (19 subjects, standard rehabilitation + IHHE course) and a control group (15 subjects, standard rehabilitation only). The IHHE course consisted of 12 procedures administered using the ReOxy® device in an individualized mode. Clinical and functional indicators (using the 6-minute walk test (6MWT), the Barthel Index, psychometric scales, short-term memory and attention span tests) and hematological parameters were assessed before and after the course. Results. The patients in the study group demonstrated a significant and more pronounced improvement compared to the controls in exercise tolerance, as well as an increased self-care ability. Moreover, a more pronounced reduction in symptoms of asthenia (MFI-21) and daytime sleepiness, as well as better recovery of cognitive functions were observed. By the end of the rehabilitation course, signs of erythropoiesis activation were detected in the blood of the study group subjects: moderate increases in hemoglobin levels, reticulocyte concentration, and reticulocyte hemoglobin content, while the erythropoiesis stimulation index (OFF-Score) was statistically significantly higher than control values. Thus, incorporating IHHE into the standard rehabilitation program for post-stroke patients leads to significant functional and cognitive improvements, which is likely due to the synergy of hematological and non-hematological adaptive mechanisms. The IHHE method demonstrates high clinical potential as an adjuvant non-pharmacological technique for neurorehabilitation.