Implementation of a personal approach to rehabilitation of obese patients with mechanical injury

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The effectiveness of the treatment of injury depends not only on the quality of the operation or reposition, but also on post -traumatic rehabilitation. The main methods of rehabilitation in patients with an excess body weight after an injury are therapeutic physical education, manual therapy, massage, physiotherapy, mechanotherapy, labor therapy, psychotherapy, diet therapy and drug therapy. The combination of several rehabilitation techniques gives the best restoration result. The basis of modern treatment of obesity is the recognition of the chronic nature of this disease and, therefore, the need for long -term treatment. The selection of a diet and rehabilitation methodology is the basis of a personalized approach in the treatment of patients with mechanical trauma and an excess body weight.

Full Text

Restricted Access

About the authors

А. А. Shevchenko

S.M. Kirov Military Medical Academy, Ministry of Defense of Russia

Author for correspondence.
Email: shevchenko-leha@list.ru
ORCID iD: 0000-0002-7658-8766
SPIN-code: 4726-9079
Russian Federation, Saint Petersburg

M. A. Trofimov

S.M. Kirov Military Medical Academy, Ministry of Defense of Russia

Email: shevchenko-leha@list.ru
ORCID iD: 0000-0001-7610-2669
SPIN-code: 5152-6278
Russian Federation, Saint Petersburg

А. А. Mikhailov

S.M. Kirov Military Medical Academy, Ministry of Defense of Russia

Email: shevchenko-leha@list.ru
ORCID iD: 0000-0001-5656-2764
SPIN-code: 3957-6107

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

References

  1. Федоров Т.С. Медико-социальные аспекты травматизма в республике Саха (Якутия). Афтореф. дисс. … канд. мед. наук. Якутск, 2015; с. 16 [Fedorov T.S. Medical and social aspects of trauma in the Republic of Sakha (Yakutia). Aftoref. diss. ... kand. med. nauk. Yakutsk, 2015; p. 16 (in Russ.)].
  2. Ягудина Р., Аринина Е., Грушина Н. Классификация травм и подбор лекарственных средств для их лечения. КатренСтиль. 2013; 116: 250 [Yagudina R., Arinina E., Grushina N. Classification of injuries and selection of drugs for their treatment. CatrenStyle. 2013; 116: 250 (in Russ.)].
  3. Иванов Д.Д. Острое повреждение почек. Медицина неотложных состояний. 2012; 3 (42): 16–9 [Ivanov D.D. Acute kidney injury. Medicine of emergency conditions. 2012; 3 (42): 16–9 (in Russ.)].
  4. Выборнов Ю.Д. Гуревич А.И., Немсадзе В.П. Ультразвуковая диагностика консолидации переломов и нарушений репаративного остеогенеза у детей. Совершенствование ортопедотравматологической помощи детям. Материалы симпозиума детских травматологов-ортопедов России с международным участием. 2008; 8: 69–71 [Vybornov Y.D., Gurevich A.I., Nemsadze V.P. Ultrasound diagnostics of fracture consolidation and reparative osteogenesis disorders in children. Improvement of orthopedotraumatologic aid to children. Materials of the symposium of pediatric traumatologists and orthopedists of Russia with international participation. 2008; 8: 69–71 (in Russ.)].
  5. Селезнев С.А., Худайберенов Г.С. Травматическая болезнь. Травма. 1984; 3: 223 [Seleznev S.A., Khudaiberenov G.S. Traumatic disease. Trauma. 1984; 3: 223 (in Russ.)].
  6. Невзорова Т.А. Мордаханова Э.Р., Андреева И.А. и др. Активация и апоптоз тромбоцитов под действием патогенных иммунных комплексов, содержащих тромбоцитарный фактор 4. Гены и клетки. 2015; 10 (4): 47–53 [Nevzorova T.A. Mordakhanova E.R., Andreeva I.A. et al. Platelet activation and apoptosis induced by pathogenic immune complexes containing platelet factor 4. Genes and cells. 2015; 10 (4): 47–53 (in Russ.)].
  7. Грубер Н.М. Дербышева В.Г. Метаболические сдвиги крови при сочетанной черепно-мозговой травме. Современное искусство медицины. 2012; 5: 37–41 [Gruber N.M. Derbysheva V.G. Metabolic changes in the blood at combined craniocerebral trauma. Modern art of medicine. 2012; 5: 37–41 (in Russ.)].
  8. Минченко Б.И. Биохимические показатели метаболических нарушений костной ткани. Клиническая лабораторная диагностика. 1999; 1: 8–15 [Minchenko B.I. Biochemical indicators of metabolic disorders of bone tissue. Clinical laboratory diagnostics. 1999; 1: 8–15 (in Russ.)].
  9. Грубер Н.М. Свертывающая система крови и нейромедиаторы при тяжелой сочетанной травме. Автореф. дисс. … канд. биол. наук. Томск, 1988; с. 18 [Gruber N.M. Blood coagulation system and neurotransmitters in severe combined trauma. Author's abstract. diss. ... kand. biol. nauk. Tomsk, 1988; p. 18 (in Russ.)].
  10. Ткачук Е.А., Лунева С.Н., Стогов М.В. Биохимические показатели сыворотки крови как маркеры осложнений при закрытых переломах костей голени. Клиническая лабораторная диагностика. 2011; 10: 43 [Tkachuk E.A., Luneva S.N., Stogov M.V. Biochemical parameters of blood serum as markers of complications in closed fractures of the shin bones. Clinical laboratory diagnostics. 2011; 10: 43 (in Russ.)].
  11. Корж А.А. Белоус А.М., Панков А.М. Репаративная регенерация кости. Медицина. 1972; 2: 231 [Korzh A.A. Belous A.M., Pankov A.M. Reparative bone regeneration. Medicine. 1972; 2: 231 (in Russ.)].
  12. Lynch D., Martinez-Pineiro L., Plas E. et al. EAU Guidelines on Urological Trauma. Eur Urol. 2005; 47 (1): 1–15. doi: 10.1016/j.eururo.2004.07.028
  13. Sovik S., Isachsen M.S., Nordhuus K.M. et al. Acute kidney injury in trauma patients admitted to the ICU: a systematic review and meta-analysis. Intensive Care Med. 2019; 45 (4): 407–19. doi: 10.1007/s00134-019-05535-y
  14. Kramer H., Luke A., Bidani A. et al. Obesity and prevalent and incident CKD: the hypertension detection and follow-up program. Am J Kidney Dis. 2005; 46 (4): 587–94. doi: 10.1053/j.ajkd.2005.06.007
  15. Shashaty M.G., Meyer N.J., Localio A.R. et al. American race, obesity, and blood product transfusion are risk factors for acute kidney injury in critically ill trauma patients. J Crit Care. 2012; 27 (5): 496–504. doi: 10.1016/j.jcrc.2012.02.002
  16. Câmara N. Kidney disease and obesity: epidemiology, mechanisms and treatment. Nat Rev Nephrol. 2017; 13: 181–90. doi: 10.1038/nrneph.2016.191
  17. Hakam N., Nabavizadeh B., Sadighian M. The Impact of Obesity on Renal Trauma Outcome: An Analysis of the National Trauma Data Bank from 2013 to 2016. World J Surg. 2021; 45 (12): 3633–42. doi: 10.1007/s00268-021-06275-1
  18. Shashaty M.G., Kalkan E., Bellamy S.L. Computed tomography-defined abdominal adiposity is associated with acute kidney injury in critically ill trauma patients. Crit Care Med. 2014; 42 (7): 1619–28. doi: 10.1097/CCM.0000000000000306
  19. Schiffl H. Obesity, acute kidney injury and outcome of critical illness. Int Urol Nephrol. 2017; 49 (3): 461–6. doi: 10.1007/s11255-016-1451-4
  20. Ramachandran A., Shetty S.A., Arun N. et al. Obesity in Asia--is it different from rest of the world. Diabetes Metab Res Rev. 2012; 28: 47–51. doi: 10.1002/dmrr.2353
  21. Ibrahim M.M. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010; 1 (1): 11–8. doi: 10.1111/j.1467-789X.2009.00623.x
  22. Zeng Q., Wang L., Dong S. et al. CT-derived abdominal adiposity: Distributions and better predictive ability than BMI in a nationwide study of 59,429 adults in China. Metabolism. 2021; 115: 154–6. doi: 10.1016/j.metabol.2020.154456
  23. Цушко В.С. Тактика лабораторной диагностики синдрома ДВС. Некоторые вопросы клинической и экспериментальной гемокоагулологии. 1984: 79–81. [Tsushko V.S. Tactics of laboratory diagnosis of DIC syndrome. Some questions of clinical and experimental hemocoagulology. 1984: 79–81 (in Russ.)].
  24. Jiang L., Tian W., Wang Y. et al. Body mass index and susceptibility to knee osteoarthritis: a systematic review and meta-analysis. Joint Bone Spine. 2012; 79 (3): 291–7. doi: 10.1016/j.jbspin.2011.05.015
  25. Дикуль В.И. Реабилитация после травм (посттравматическая реабилитация) [Электронный ресурс]. [Dikul V.I. Rehabilitation after injuries (post-traumatic rehabilitation) [Electronic resource] (In Russ)]. URL: https://www.dikul.net/wiki/reabilitacija-posle-travm
  26. Старостина Е.Г. Принципы рационального питания в терапии ожирения. Часть 1. Кардиология. 2001; 41 (8): 87–92 [Starostina E.G. Principles of rational nutrition in the treatment of obesity. Part 1. Cardiology. 2001; 41 (8): 87–92 (in Russ.)].
  27. Дзгоева Ф.Х. Диетотерапия ожирения: от снижения массы тела до коррекции факторов риска сердечно-сосудистых заболеваний. Ожирение и метаболизм. 2008; 4: 25–8 [Dzgoeva F.H. Diet therapy of obesity: from weight loss to correction of risk factors for cardiovascular diseases. Obesity and metabolism. 2008; 4: 25–8 (in Russ.)].
  28. Стребкова Е.А., Алексеева Л.И. Остеоартроз и ожирение. Научно-практическая ревматология. 2015; 53 (5): 542–52 [Strebkova E.A., Alekseeva L.I. Osteoarthritis and obesity. Rheumatology Science and Practice. 2015; 53 (5): 542–52. (in Russ.)]. doi: 10.14412/1995-4484-2015-542-552
  29. Степанова Н.В., Лакаева Т.С Физическая реабилитация больных с ожирением I–II степени. Ожирение. 2007; 4: 25–32 [Stepanova N.V., Lakaeva T.S. Physical rehabilitation of patients with obesity of I–II degree. Obesity. 2007; 4: 25–32 (in Russ.)].
  30. Каипова А.К. Роль силовых и высокоинтенсивных тренировок в программе комплексной реабилитации женщин с алиментарным ожирением. Современные проблемы науки и образования. 2019; 2: 106 [Kaipova A.K. The role of strength and high-intensity training in the program of comprehensive rehabilitation of women with alimentary obesity. Modern problems of science and education. 2019; 2: 106 (in Russ.)]. doi: 10.17513/spno.28626
  31. Бабичева К.Д., Илюшина А.Е. Лечебная физическая культура. Наука-2020. 2020; 7 (23): 69–72 [Babicheva K.D., Ilyushina A.E. Therapeutic physical culture. Nauka-2020. 2020; 7 (23): 69–72 (in Russ.)].
  32. Лихограй Л.И. Физическая реабилитация при ожирении. Бюллетень медицинских интернет-конференций. 2019; 9 (5): 194 [Likhogray L.I. Physical rehabilitation in obesity. Bulletin of medical Internet conferences. 2019; 9 (5): 194 (in Russ.)].
  33. Васильева В.А., Марченкова Л.А. Реабилитация пациента с острым инфарктом миокарда на фоне сахарного диабета 2 типа и ожирения. Российский кардиологический журнал. 2021; 26 (S5): 57 [Vasilieva V.A., Marchenkova L.A. Rehabilitation of a patient with acute myocardial infarction against the background of diabetes mellitus type 2 and obesity. Russian Journal of Cardiology. 2021; 26 (S5): 57 (in Russ.)].
  34. Сулейманова Р.Р. Биоимпедансометрия как метод оценки реабилитации детей с ожирением. Бюллетень медицинских интернет-конференций. 2018; 8 (10): 498 [Suleymanova R.R. Bioimpedance measurement as a method of assessing the rehabilitation of children with obesity. Bulletin of medical Internet conferences. 2018; 8 (10): 498 (in Russ.)].
  35. Хань Х.Ч., Ахтямов И.Ф. Хирургическое лечение пациентов с повышенным индексом массы тела при травме проксимального отдела бедренной кости. Политравма. 2023; 2: 53–63 [Han H.H., Akhtyamov I.F. Surgical treatment of patients with increased body mass index in proximal femural injury. Polytrauma. 2023; 2: 53–63 (in Russ.)]. doi: 10.24412/1819-1495-2023-2-53-63

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Pathways of obesity-related kidney disease

Download (305KB)

Copyright (c) 2025 Russkiy Vrach Publishing House