Vol 13, No 1 (2014)

The article presents the main normative documents-laws and by-laws, resolutions of the Government of the Russian Federation governing the provision of assistance to the Russian Federation in medical rehabilitation. Its organizational basis, funding for the health system as a whole.

The article contains the information about the Moscow Center of medical-social rehabilitation, successfully implementing the program of assistance to young people with disabilities. A combination of medical, social, psychological, professional aspects of rehabilitation improves the efficiency of rehabilitation measures, to decrease the percentage of disability, to achieve maximum integration of the disabled into society.

For balance dysfunction assessment in rehabilitation practice three main methods are used: clinical, clinical scales and objective instrumental methods. Clinical scales are easy to use and does not require additional equipment. However, their value is relatively small. Instrumental methods provides diagnosis as well as differential diagnosis, including early and even preclinical forms of diseases. Appropriate standards for practical work are reviewed.

The totality of limiting everyday life of the patient somatoneurologic consequences of a stay in the Intensive Care Unit (ICU) in the united syndrome (PICS - Post Intensive Care Syndrome). The bed-rest is recognized as the main pathogenetic factor of PICS-syndrome Combined with aggressive methods of intensive therapy (sedation, myoplegia) it promotes the development of immobilization syndrome. There are two main mechanism of this syndrome: muscle inaction and orthostatic failure (core). In a series of special studies have shown that this condition occurs in all patients with acute cerebral insufficiency with the first day in the ICU. The main strategy of prevention and treatment of PIT syndrome is expected early kinesiotherapy, in particular, plumbing and passive cycle velobike training.

The paper analyzes the findings of a comprehensive survey of 628 patients (346 men and 282 women, average age 51,4 ± 1,23 years) with ischemic stroke in the middle cerebral artery, which were used in the rehabilitation of locomotor robots - Erigo and Lokomat. Complex clinical and neurophysiological (TMS and EP) survey conduction whether the 6th , 21th and 42th day of stroke and in the long term - 6 months. It was estimated, that the main predictors of the effectiveness of robotic mechanical therapy for stroke is stroke severity, severity of paresis and the activity of the motor cortex at TMS forecast with accuracy from 68 to 96%. The proposed integrated clinical and neurophysiological approach can be used to determine the rehabilitation potential of patients with ischemic stroke.

A new technique of rehabilitation of patients with neurological disorders was developed. The method involves the use of a new type of prosthetic joints. The advantage of this compensation method: simplicity of the method associated with the use of special orthopedic shoes , increasing the efficiency of parallel ongoing rehabilitation therapy, reduction (disappearance) posturological pathological patient’s disorders related to the presence of lower limb length difference and (or) installation equinus foot(s).

Objective: to assess the effectiveness of rehabilitation programs for patients with movement disorders in cerebral accident. Material and methods. We examined 997 patients 23-84 years old who have undergone extended rehabilitation at the clinic Medical University TMGI Health Ministry. There were conducted a comprehensive survey of patients. Results. Rehabilitation process include diagnostic and rehabilitation units. In assessing the effectiveness of rehabilitation course obtained improvement of the cardiovascular and respiratory systems, blood , blood pressure , attention, sleep , emotions , as well as activity and participation in the parameters of interpersonal interactions and relationships ( p <0.05). Improved ability to use upper extremities, personal hygiene (p < 0.05). Stabilometry and complex Primus RS allowed to objectify increased resistance and an increase in muscle strength of the extremities. Conclusion. Using the complex rehabilitation of patients improves performance of the cardiovascular and respiratory systems, the emotional-volitional and cognitive function , as well as activity and participation in interpersonal interaction, the use of hands , the implementation of personal hygiene.

In the article with the pathogenetic positions analyzes the efficiency of application of photophoresis пантовегина combined with пелоидотерапией. It is shown that корригирующий effect of the combined effects of factors is a variant of additive interaction, implemented through common points of regenerative activity of mud applications, and metabolic potentials пантовегина, reinforced by the influence of the infrared laser. Application photophoresis пантовегина in the complex of peat with «TOMED-APPLICATE» accompanied by growth regulator-the metabolic capacity of the organism, providing persistent clinical effect. Used it is a very effective method of regenerative correction of patients suffering from chronic inflammation of the gum tissues, creating favourable conditions for the relief of inflammation and regeneration of gum tissue.