Bulletin of the Russian Society of Professionals in Medical and Social Expertise, Rehabilitation and Rehabilitational Industry

This article presents the results of a study examining the factors that shape the medical and social profile of post-stroke patients newly diagnosed with disability. Disability of patients with the consequences of acute circulatory disorders is one of the main indicators reflecting the quality of medical care in the acute and subacute periods of stroke. The study of the medical and social characteristics of patients due to strokes is an important condition for the formation of comprehensive rehabilitation measures and social support measures. An analysis of the factors forming the medical and social portrait of post-stroke patients showed that among those recognized as disabled for the first time, people with “severe” disabilities predominate: groups II and I (87.0 %), men (63.0 %) over the age of 60 (87.0 %), living in urban areas (51.8 %), having primary and secondary vocational education (66.7 %), living in a family (96.3 %) and being the breadwinners in the family (79.6 %). 100.0 % of all IPI patients had impaired neuromuscular, skeletal, and movement-related (statodynamic) functions due to strokes.; in 81.5 %, disorders of the cardiovascular system and in 74.1 %, disorders of urinary function, less frequent violations of language and speech functions (27.8 %) and mental functions (25.9 %), p < 0.05. The diagnosed priority AES in 100 % of patients with stroke were: the ability to self-care, to move independently and to work, p < 0.05. These findings, reflecting the medical and social characteristics of post-stroke patients newly diagnosed with disability, provide the basis for developing individualized rehabilitation and habilitation programs for this population of disabled people.

Introduction. The article examines modern approaches to remotely controlled rehabilitation, its significance, and its prospects for improving the effectiveness of the national rehabilitation system. Special attention is given to telemedicine technologies and digital platforms that help ensure continuity, consistency, and improved accessibility of rehabilitation. The advantages and challenges associated with mobile and remotely controlled rehabilitation technologies (RCR) are analyzed, along with examples of successful projects and programs implemented in Russia. Issues of regulatory support aimed at developing remote rehabilitation formats are also discussed. Aim. To study the feasibility of developing remote rehabilitation technologies for patients with chronic disorders of consciousness. Methodology and research methods. The article presents the results of a study involving 142 patients with chronic disorders of consciousness at the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology (Moscow region). Results. The findings showed that the first year after the event that caused brain damage is critical: 18 % of patients demonstrated improvement, while more than 60 % did not survive this period. Patient care was mainly provided by relatives, resulting in significant financial burdens and emotional burnout. Most patients did not receive the necessary amount of rehabilitation care. Practical significance. The obtained data highlight the need to develop remotely controlled rehabilitation technologies for this patient group. Implementing RCR can ensure continuity and consistency of rehabilitation and increase its accessibility and quality.

Global demographic dynamics in recent decades have been characterized by rapid population aging and an increasing burden of cardiovascular, cardiometabolic, and cerebrovascular diseases. Against this backdrop, multimorbidity in elderly patients is becoming a key factor in worsening prognosis and increasing mortality and disability. This problem is particularly pressing for resource-limited countries, including the Kyrgyz Republic (KR), where cardiovascular diseases (CVDs) account for more than half of all causes of death. The aim of the study was to investigate the structure and characteristics of multimorbidity in elderly patients, as well as to analyze and evaluate the applicability of international comorbidity and polymorbidity indices (Charlson, Cumulative Incidence Rating Scale (CIRS), Functional Comorbidity Index (FCI)) in the context of multidisciplinary hospitals in Kyrgyzstan, followed by the development of approaches to optimize the management and organization of care for patients with multimorbidity at the primary health care level (PHC).The scientific novelty lies in the primary systemic analysis of multimorbidity in elderly patients in a multidisciplinary hospital and primary health care setting, as well as the analysis and evaluation of international comorbidity and polymorbidity indices in them and their adaptation to local conditions. The methodology includes a retrospective analysis of multimorbidity in elderly patients with a combination of cardiovascular, renal, metabolic, cerebrovascular and cognitive impairments using regional statistical data and clinical information (data from the medical history of 17 785 patients) using three indices and polymorbidity scales. Stratification by age group (up to 60, 60–74, ≥ 75 years) was conducted. The results showed a high frequency of multimorbidity, with cardiorenal and cardiometabolic combinations predominating. The Charlson, CIRS, and FCI indices allowed for quantitative characterization of condition severity; however, limitations of their direct application without adaptation to regional morbidity profiles were identified. Based on the analysis, the development of regionally tailored composite indices was proposed. The practical significance of the study lies in the potential use of the obtained data to adapt international co-morbidity and polymorbidity indices for a multidisciplinary hospital within the national healthcare system and to formulate targeted strategies for strengthening primary health care, optimizing the routing of patients with multimorbidity in geriatrics, and the multidisciplinary management of chronic diseases and training of medical personnel with competencies in the field of geriatrics and multidisciplinary management of chronic patients.

Introduction. The article examines the feasibility of rehabilitation interventions for children who have had community-acquired uncomplicated pneumonia. The study aimed to analyze the functional characteristics of the cardiorespiratory system and assess the ICF domains in convalescent children with uncomplicated community-acquired pneumonia before discharge from an infectious diseases hospital. Materials and methods. A survey of convalescent children (n = 100, aged 14 to 17 years) was conducted before discharge from the hospital in March 2024 after uncomplicated community-acquired pneumonia. All subjects underwent an assessment of structures, functions, activity and participation, and environmental factors in ICF categories. Results and discussion. In all age groups, a decrease in blood oxygen saturation was noted after the 6MWT, low Stange test values were observed before the test of a six-minute walk (6MWT). In response to submaximal exercise, an increase in heart rate (above the physiological norm) was noted, as well as relatively low six-minute walk test values. Patients of all age groups had difficulties performing physical activity in a submaximal mode. The average score on the Borg scale was 19 points. The results obtained were assessed using the ICF. Conclusion. The study found that patients who have had uncomplicated community-acquired pneumonia, at the time of discharge from the infectious diseases hospital, have a number of limitations in life activity associated with the cardiorespiratory system. These patients require rehabilitation aimed at restoring respiratory function and exercise tolerance.

The article presents a comparative analysis the effectiveness of caries prevention in primary school-aged children using fissure sealants and traditional filling techniques. The study included 284 children aged 6 to 9 years who underwent examination and treatment from January 2023 to April 2024 and further monitoring and evaluation of results since April 2024 to September 2025 at the S-Med Scientific and Practical Center in Nalchik. The children undergoing treatment were divided into two groups. The first group included 140 children who underwent traditional dental examinations and caries treatment with fillings. The second group included 144 children who underwent prophylactic fissure sealants on their first permanent molars. The analysis revealed that both groups had poor hygiene at baseline. In the comparison group, an improvement in the hygiene level indicator (a decrease in the Green-Vermillion index) was noted over the observation period from 2023 to 2025 from 72.9 % (102) to 85 % (119). In the study group, positive dynamics in the level of hygiene and a decrease in the proportion of children with a low level of hygiene from 72.2 % (104) to 43.1 % (62) were also noted. The rate of unsatisfactory restorations in the comparison group was 1.5 times higher than in the study group (12.1 % in the first group and 7.6 % in the study group). Similarly, the rate of caries recurrence was three times higher in the comparison group than in the study group (18.6 % in the first comparison group and 6.3 % in the study group).