ABSRTACT

RELEVANCE. Stroke remains one of the most significant interdisciplinary medical and social challenges, ranking among the leading causes of mortality and long-term disability worldwide. Effective and timely initiated post-stroke rehabilitation plays a crucial role in reducing neurological deficits, restoring lost functions, and improving patients’ activities of daily living.

AIM. To conduct an analytical review of current literature on innovative methods of medical rehabilitation in post-stroke patients, with a particular focus on massage-based technologies.

MATERIALS AND METHODS. A qualitative scientometric analysis of high-level evidence secondary sources was performed, including systematic reviews and meta-analyses indexed in PubMed and the Cochrane Central Register of Controlled Trials, published between 2010 and 2025.

RESULTS AND DISCUSSION. The synthesis of clinical research data demonstrates the significant therapeutic effectiveness of thermomassage interventions in post-stroke rehabilitation. Randomized controlled trials indicate that thermal massage contributes to a statistically significant reduction in spasticity, alleviation of pain, improvement of functional status, and reduction of oxidative stress levels. Mechanical thermal massage using the N6 "Nuga Best" personal thermotherapeutic massage-stimulator may be considered a promising component of comprehensive rehabilitation programs.

CONCLUSION. The analysis of contemporary scientific evidence reveals a substantial body of high-quality studies confirming the pronounced therapeutic effects of combined mechanical and thermal modalities in post-stroke patients. These findings support the rationale for further implementation and investigation of such technologies in clinical rehabilitation practice.

KEYWORDS: stroke, rehabilitation, "Nuga Best" technology

For citation: Rachin A.P. Innovative Methods of Medical Rehabilitation in Post-Stroke Patients. "Nuga Best" Concept: A Review. Comorbidity Neurology. 2026; 3 (1): 62–72. https://doi.org/10.62505/3034-185x-2026-3-1-62-72

For correspondence: Andrei P. Rachin, Dr. Med. (Sci.), Professor, President of the National Association of Experts in Comorbid Neurology, Moscow, Russia, e-mail: 7851377@gmail.com.

REFERENCES

1. Клинические рекомендации. Ишемический инсульт и транзиторная ишемическая атака, 2024. (In Russ.)

2. Неврология: национальное руководство. Под ред. Е.И. Гусева, А.Н. Коновалова, В.И. Скворцовой. 2-е изд., перераб. и доп. М.: ГЭО-ТАР-Медиа 2018; 1: 880 с. (In Russ.)

3. Инсульт: руководство для врачей. Под ред. Л.В. Стаховской, С.В. Котова. 2-е изд., доп. и перераб. М.: Медицинское информационное агентство 2018; 488 с. (In Russ.)

4. GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May; 18(5): 439–458. https://doi.org/10.1016/S1474-4422(19)30034-1

5. Marotta N., Ammendolia A., Marinaro C., Demeco A., Moggio L., Costantino C. International classification of functioning, disability and health (ICF) and correlation between disability and finance assets in chronic stroke patients. Acta Biomed. 2020; 91: e2020064. https://doi.org/10.23750/abm.v91i3.8968

6. Stakhovskaya L.V., Klochikhina O.A., Bogatyreva M.D., Kovalenko V.V. Epidemiology of stroke in the Russian Federation: results of territory's population registry (2009–2010). S.S. Korsakov Journal of Neurology and Psychiatry. 2013; 113 (5): 4–10. (In Russ.)

7. Stakhovskaya L.V., Klochikhina O.A., Bogatyreva M.D., Chugunova S.A. Analysis of epidemiological indicators of recurrent stroke in regions of Russian Federation (On the basis of territorial and population registry 2009–2014). Consilium Medicum. 2016; 18 (9): 8–11. (In Russ.)

8. Mikhailova A.A., Illarionov V.E., Slipka D.S., Kotenko K.V. Patient-oriented medical rehabilitation after stroke in long-term recovery period. Problems of Balneology, Physiotherapy and Exercise Therapy. 2022; 99 (4–2): 66–71. https://doi.org/10.17116/kurort20229904266 (In Russ.)

9. Background Concepts in Stroke Rehabilitation, EBRSR – Evidence-Based Review of Stroke Rehabilitation. Available online: http://www.ebrsr.com/evidence-review/3-background-concepts-stroke-rehabilitation

10. Rossi F., Savi F., Prestia A., Mongardi A., Demarchi D., Buccino G. Combining action observation treatment with a brain – computer interface system: Perspectives on neurorehabilitation. Sensors. 2021; 21: 8504. https://doi.org/10.3390/s21248504

11. Langhorne P., Bernhardt J., Kwakkel G. Stroke rehabilitation. Lancet. 2011 May 14; 377 (9778): 1693–1702. https://doi.org/10.1016/S0140-6736(11)60325-5

12. Cramer S.C., Sur M., Dobkin B.H. et al. Harnessing neuroplasticity for clinical applications // Brain. 2011 Jun; 134 (Pt 6): 1591–1609. https://doi.org/10.1093/brain/awr039

13. Nudo R.J. Neural bases of recovery after brain injury. J Commun Disord. 2011 Sep-Oct; 44 (5): 515–520. https://doi.org/10.1016/j.jcomdis.2011.04.004

14. Pollock A., St George B., Fenton M., Firkins L. Top 10 research priorities relating to life after stroke. Lancet Neurol. 2012 Mar; 11 (3): 209.
https://doi.org/10.1016/S1474-4422(12)70029-7

15. Canadian Stroke Best Practice Recommendations: Acute Stroke Management, 7(th) Edition Practice Guidelines Update, 2022. Can J Neurol Sci. 2024 Jan; 51 (1): 1–31. https://doi.org/10.1017/cjn.2022.344

16. Jiang L., Ding H., Seo H., Chun B. Optimal exercise modalities for post-intervention motor function changes in stroke survivors: a pairwise and network meta-analysis. J Neuroeng Rehabil. 2025 Oct 29; 22 (1): 228. https://doi.org/10.1186/s12984-025-01756-z

17. Hidler J., Lum P.S., Kahn L.E. et al. ZeroG: overground gait and balance training system. J Rehabil Res Dev. 2011; 48 (4): 287–298. https://doi.org/10.1682/jrrd.2010.05.0098

18. Billinger S.A., Arena R., Bernhardt J. et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Aug; 45 (8): 2532–2553. https://doi.org/10.1161/STR.0000000000000022

19. Polo-Ferrero L., Torres-Alonso J., Sánchez-González J.L., Hernández-Rubia S., et al. Mirror Therapy Versus Motor Imagery in Stroke Neurorehabilitation: A Systematic Review with Comparative Narrative Synthesis. Life (Basel). 2026 Feb 10; 16 (2): 306. https://doi.org/10.3390/life16020306

20. He W., Yaning L., Shaohong Y. Effect of electrical stimulation in the treatment on patients with foot drop after stroke: a systematic review and network meta-analysis. J Stroke Cerebrovasc Dis. 2025 May; 34 (5): 108279. https://doi.org/10.1016/j.jstrokecerebrovasd is.2025.108279

21. Mehrholz J., Pohl M., Platz T., Kugler J., Elsner B. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev. 2018 Sep 3; 9 (9): CD006876. https://doi.org/10.1002/14651858.CD006876.pub5

22. Amirbekova M., Kispayeva T., Adomaviciene A., Eszhanova L., Bolshakova I., Ospanova Z. Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke. Front Hum Neurosci. 2025 Jul 21; 19: 1622661. https://doi.org/10.3389/fnhum.2025.1622661

23. Estebanez-Pérez M.J., Pastora-Estebanez P., Vinolo-Gil M.J., Martín-Valero R., Pastora-Bernal J.M. Tele-Assessment Compared With In-person Assessment in Stroke Individuals: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2026 Jan 20: S0003–9993(26)00002-X. https://doi.org/10.1016/j.apmr.2025.12.030

24. Laver K.E., Lange B., George S., Deutsch J.E., et al. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2025 Jun 20; 6 (6):CD008349. https://doi.org/10.1002/14651858.CD008349.pub5

25. Pyrrou M., Tsiakiri A., Vadikolias K., Proios H. Barriers and Facilitators in Secondary Stroke Prevention Among Older Adults: An International Systematic Review of Randomized Controlled Trials. Healthcare (Basel). 2025 Dec 12; 13 (24): 3260. https://doi.org/10.3390/healthcare13243260

26. Пономаренко Г.Н. Общая физиотерапия: учебник. М.: ГЭОТАР-Медиа, 2020. 368 с. (In Russ.)

27. Пономаренко Г.Н. Физические методы лечения: справочник. 5-е изд., перераб. и доп. СПб., 2024. 294 с. (In Russ.)

28. Seiger Cronfalk B., Åkesson E., Nygren J., Nyström A., et al. A qualitative study – Patient experience of tactile massage after stroke. Nurs Open. 2020 May 29; 7 (5): 1446–1452. https://doi.org/10.1002/nop2.515. eCollection 2020 Sep.

29. Yunhui X., Hao G.U., Qing Z., Dejie L.I., Ying G., Junxing X., Guofeng S. Efficacy of meridian massage for motor function after a stroke: a systematic review and мeta-analysis. J Tradit Chin Med. 2022 Jun; 42 (3): 321–331. https://doi.org/10.19852/j.cnki.jtcm.2022.03.001

30. Cabanas-Valdés R., Calvo-Sanz J., Serra-Llobet P., Alcoba-Kait J., González-Rueda V., Rodríguez-Rubio P.R. The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021 Apr 21; 18 (9): 4424. https://doi.org/10.3390/ijerph18094424

31. Chen Y.F., Mao M.C., Zhu G.Y., Sun C.C., et al. The changes of neuroactivity of Tui Na (Chinese massage) at Hegu acupoint on sensorimotor cortex in stroke patients with upper limb motor dysfunction: a fNIRS study. BMC Complement Med Ther. 2023 Sep 21; 23 (1): 334. https://doi.org/10.1186/s12906-023-04143-0

32. Moraska A.F., Pollini R.A., Boulanger K. et al. Physiological adjustments to massage: a review of the literature. Evid Based Complement  Alternat Med. 2010 Dec; 7 (4): 409–418. https://doi.org/10.1093/ecam/nen029

33. Field T. Massage therapy research review. Complement Ther Clin Pract. 2016 Aug: 24: 19–31. https://doi.org/10.1016/j.ctcp.2016.04.005

34. Sebők J., Édel Z., Váncsa S., et al. Heat therapy shows benefit in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Int J Hyperthermia. 2021; 38 (1): 1650–1659. https://doi.org/10.1080/02656736.2021.2003445

35. Li Y., Wang D., Ping X., et al. Local hyperthermia therapy induces browning of white fat and treats obesity. Cell. 2022; 185 (6): 949–966. https://doi.org/10.1016/j.cell.2022.02.004

36. Lämås K., Häger C., Lindgren L., Wester P. Touch massage for stroke patients: a randomized controlled trial protocol. BMC Complement Altern Med. 2016 Feb 4: 16: 50. https://doi.org/10.1186/s12906-016-1029-9

37. Lee Y.H., Park B.N., Kim S.H. The effects of heat and massage application on autonomic nervous system. Yonsei Med J. 2011; 52: 982–989. https://doi.org/10.3349/ymj.2011.52.6.982

38. Liu C., Pang T., Yao J., Li J., et al. Acupuncture and massage combined with rehabilitation therapy for hemiplegia after stroke: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022 Feb 11; 101 (6): e28732. https://doi.org/10.1097/MD.0000000000028732

39. Ponomarenko G.N. The Use of Physiotherapy Mats T11P and T20P "Nougat Best" in the Treatment of Patients with Diseases of the Nervous and Endocrine Systems: A Review. Comorbidity Neurology. 2025; 2 (4): 43–50. https://doi.org/10.62505/3034-185x-2025-2-4-43-50 (In Russ.)

40. Информация о массажной кровати «Нуга Бест № 6». https://nugabest.ru/catalog/massazhnaya-krovat-nuga-best-n6/ (In Russ.)

ADDITIONAL INFORMATION
 

Andrei P. Rachin, Dr. Med. (Sci.) Professor, President of the National Association of Experts in Comorbid Neurology, Moscow, Russia. E-mail:7851377@gmail.com. ORCID: https://orcid.org/0000-0003-4266-0050

Author contributions. The author confirms the compliance of their authorship, according to international ICMJE criteria.
 

Funding. This study was supported by external sources of funding.

Disclosure. The material was prepared with the support of TRIA LLC.