Vol 14, No 1 (2015)

This article reports about the legislative and methodological prerequisites for organization department of mobile rehabilitation in a rehabilitation center for disabled. Describes the organization of the activities of mobile rehabilitation section and procedure of comprehensive rehabilitation at home. Represents by social- demographic characteristics of the service contingent in dynamics of a two-year work. We give data about the types and amount of services rendered, the methods of assessment of efficiency of mobile rehabilitation section. Indicates promising directions of activities for mobile rehabilitation section.

In this article we present the results of a research work dedicated to the assessment of the impact of an original method of gait stereotype correction in patients with the syndrome of central hemiparesis in the rehabilitation period of stroke. We compared the efficiency of rehabilitation between two groups of patients. The study group received standard medical treatment, apparatus physiotherapy, massage and the proposed original method of gait stereotype correction. The idea of the original method is the activation of the moment, when the paretic leg lifts from the support surface, the activation of the posterior foot impulse by means of mechanic stimulation. The patients of the control group received standard medical treatment, apparatus physiotherapy, massage, kinesiotherapy, training in the costume «Adeli» for propriocorrection. Research methods were: neurological examination, objective assessment of balance function using the Computer Stabilometry (CS), objective assessment of gait using «laser analyzer of kinematic parameters of gait» (LA-1), clinically balance function was assessed using the Berg Balance Scale, gait function was assessed using the Dynamic Gait Index. Results: In the I group after the course of treatment was a statistically significant decrease in the data of computer Stabilometry (area, length, velocity of displacement of the center of gravity, the shift of center of gravity in frontal plane), LA-1 data change (increase stride length of paretic limb, reducing the time of step in intact limb), positive dynamics of the results Berg Balance Scale and Dynamic Gait Index. In the II group also noted a positive trend in data of computer Stabilometry (displacement of the center of gravity in the frontal plane) and functional scales. The results of the study allow us to conclude that the efficiency of the method is comparable to the traditional methods of movement rehabilitation. The patients showed improved stability during standing and walking, which facilitates the formation of a new movement stereotype and lowers the risk of falling.

Based on a survey of 62 patients with ischemic stroke who received course continued rehabilitation in neurology Department clinic «Ivanovo State Medical Academy», the analysis of the effectiveness of four modern and traditional physiotherapeutic measures: vasoselective stimulation, alternating electrostatic field of the high voltage low frequency, pneumomassage and magnetic therapy pulsed magnetic field. The parameters of physical therapy effects (time, frequency, power, current) were selected individually taking into account the functional defect and comorbidity of the patient. All subjects were patients of the Department received only one type of physical therapy effects. Assessment results use of these methods relative to motor, cognitive and somatic spheres. Evaluation of the effectiveness of the treatment was carried out on the basis of the two parts of the International classification of functioning, disability and health (ICF): «Damage to body functions and activity limitations, and participation». It was found that patients in the early rehabilitation period of ischemic stroke treated in the complex rehabilitation of physical therapy showed positive points, characterizing the degree of severity of paresis and spasticity muscle groups, all groups improved indicators on mobility, self-care, including activity, and participation, as well as under section d1 is the Ability to learn and apply knowledge. The groups of patients treated in the complex rehabilitation treatment vasoselective electrical stimulation from the apparatus Body Drain, according to the International classification of functioning, disability and health, improved indicators of participation in the exercise of the functions of the walk; and in patients who have undergone a course of treatment with application of an alternating electrostatic field apparatus «Hivamat 200», improved characteristics of cardiac function. The marked advantage of modern methods of physiotherapy treatment in comparison with the previously widely used (pneumomassage with apparatus «Pneumomassage» and magnetotherapy with «Almag»).

The article presents the results of research on the effectiveness of complex restorative treatment of athletes with posttraumatic knee chondropathy using chondroprotectors (chondroitin sulfate). A greater efficacy of treatment in combination with chondro-protective therapy according to changes in the parameters of the questionnaire KOOS

The results of motor rehabilitation in patients undergoing reconstruction of the anterior cruciate ligament of the knee joint, parallel-group using the method of functional orthotics were studied. An assessment of clinical, biometric and functional outcomes, resulting in faster recovery noted knee function, the optimal parameters of quality of life, as well as subjective perception of treatment outcome in patients of the main group. Morphological substrate of recovery of motor activity is the mechanical strength of the graft achieved intraoperatively, as well as adequate parameters of muscle tone. Rigid fixation is optimal for osseointegration in the channels of the femur and tibia, but contributes to muscular atrophy of the lower extremities, which in turn may underlie the instability of the operated joint. Functional orthotics allows metered volume limit movement in the joint, thus ensuring the optimum conditions for regeneration medium structures synovial joint, at the same time, allows the strain on the dosage painless extremity in the range that does not cause clinically significant muscular atrophy, thereby improving parameters of motor rehabilitation and quality of life of patients in the postoperative period. Thus, the comparative analysis of the method of motor rehabilitation in the postoperative period proved the advantages of functional latch HKS - 375 brand «Orlett». Were marked by positive results on subjective symptoms in patients of the main group compared with the control group, in particular, revealed earlier pain relief in conjunction with the restoration of quality of life (Fig. 7) that this was confirmed by objective evidence, namely the angles of flexion in the knee joint (Fig. 5) and stabilometry parameters (Fig. 6). Based on these results we can recommend the use of products HKS-375 brand «Orlett» as an effective, easy-to-use and secure resources in the comprehensive rehabilitation of the pathologies of the knee joint in the perioperative period. Functional orthotics modern means of external immobilization provides optimal conditions for the regeneration of bone tissue in the femoral channel and the tibia, at the same time does not lead to muscular atrophy, as evidenced anthropometric data, in particular the dynamics of the lower thigh circumference, stabilometry parameters, and subjective perception of patients the results of surgical reconstruction.

The analysis of treatment outcome in 680 wounded limb injured in counter-terrorism operations was done. 138 people (42%) of them were found to partially fit for military service, 125 people (38%) - unfit for military service, and 67 (20%) - fit for military service with minor restrictions. A retrospective analysis showed that treatment outcomes are depend on three factors: 1) the severity of injury; 2) defects in the treatment during medical evacuation; 3) incorrect assessment of the health status of injured military medical commission premature to draw conclusions about unfit for military service. It was found that, regardless of the nature and cause of the injuries, the lower stages of medical rehabilitation of injured and runs faster than it comes in a specialized medical facility, the less the period of his stay in hospital and better treatment outcomes.