Vol 16, No 4 (2017)

The article discusses diagnostic procedures in children with spinal pathology. These procedures also include stabilometric examination. 201 children with spinal pathology (studied group) were examined in the Clinical and Research Institute of Urgent Pediatric Surgery and Trauma and in the municipal pediatric polyclinic № 133; 39 healthy children were taken as controls. Average age was 15.2 ± 1.9. All children had a complete clinico-instrumental examination. Stabilometric parameters were analyzed in both groups. A sympatocomplex of postural disorders in various pathology has been defined.

Analyzing the worldwide experience of the exoskeleton's application and own results in the Pirogov Center during the period from 2015 till 2017 years, it was noted that the priority areas for the exoskeleton's application are military industry and medicine. It should be noted that analyzed papers of the exoskeleton's application in medical rehabilitation of patients with spinal cord injury were differed in the length of the course, the number and type of training, characteristics and number of patients. Despite of this, most of the studies has been confirmed positive role in improving of motor control using of the exoskeletons - improving muscle activation pattern and movement coordination. Important positive results of the exoskeleton's application are: reduction of secondary complications of immobility, decreasing spasticity and pain, increasing of bone density, strengthening of the trunk and extremities muscles, increasing exercise tolerance, and in some cases, self independent walking. The advantage of the exoskeleton training was walking on the unmoving surface using the physiological pattern and significant decreased work of the physiotherapists with heavy patients. The experience of the exoskeleton's application has been analyzed in the Pirogov Center too, and it coincides with the data of the leading rehabilitation centers on the whole. The aim of our research was evaluation of the safety and effectiveness of the synchronized application of the exoskeleton ExoAtlet ® with FES in the complex rehabilitation of the SCI patients. Significant changes in the neurological status were not revealed after rehabilitation course. BP values were changed by not more than 15% from baseline, HR values were within acceptable values. ECG monitoring excluded significant cardiac pathology during walking. We had increasing tolerance to physical stress and reducing energy consumption in vertical direction during walking, increasing in the amplitude of the angular movements of the leg's joints. It was objectively noted improvements in back muscles control and muscle's maximum electrical activity, walking became more stable about the transverse and sagittal axis. This review leads to the conclusion on the possibility of the exoskeleton's application in rehabilitation of the patients with spinal cord injury.

Introduction. Currently the effect of rehabilitation programs for the patients after decompression and stabilization surgeries in the spine is undergoing the intensive study. Materials and Methods. The study was performed in 222 patients divided into 3 groups. The 1st group included 72 individuals prior to operative treatment, the 2nd group involved 69 patients after operative treatment and exercise therapy course in in-patients conditions and the third group included 81 case after operative treatment with the course of early functional and psychomotor rehabilitation. The following methods were used: Russian version of SRS-22 questionnaire, Oswestry questionnaire (ODI) and Wong-Baker Pain Rating Scale (2011). Psychological assessment of adaptive behavior was performed in 39 patients according to the E.Heim technique of coping behavior study. 38 Технологии восстановительной медицины и медицинской реабилитации Вестник восстановительной медицины № 4^2017 Results and discussion. During clinical examination of the patients in the 2nd group in mean 4 months after operation ODI index increased but pain syndrome was kept at the same level. Regardless this fact the satisfaction with the treatment (SRS-22) was above the mean one (3.6 points). The analysis of the psychological status revealed moderate changes in the domains of self-perception and mental health (SRS-22) with low correlation dependence on functional status and pain. The changes of the structure and type of rehabilitation measures in 3.2 months after operation allowed improving functional status of the patients in the 3rd group - ODI index decreased by 8% comparing with pre-op level and by 12% comparing with the patients of the 2nd group. According to pain scale VAS was reduced by 15% in comparison with the results of the 1st and 2nd group. Satisfaction of the patients with the treatment results was up by 5%. The reduction of correlation relations of self-perception and mental health domains and criteria of the functional status of the patients can be considered as indirect criterion of psychoemotional state of the patients. Conclusions Within 3.2-4 months after operative invasion in the spine the pain syndrome and physical dysfunction were still observed. The system of early functional rehabilitation of the patient after spinal operations is developed on the basis of the life quality changes and allows improving functional and psychological status of the patients after invasion providing earlier social and labor integration of the patient. It is necessary to continue the study in order to evaluate long-term efficiency of this program.

The article is devoted to the development and analysis of a complex postoperative rehabilitation program for children with patellar instabiliiy. Various rehabilitation methods are reviewed, depending on different approaches to surgical treatment. The study is based on clinical material that includes 117 children with patellar instability treated at our institute. The results of the study were evaluated according to a modified grading scale, developed by us in collaboration with S. P Mironov and A. K. Orletskiy (1999). The proposed program is divided into three distinct postoperative periods (immobilization, early postimmobilization, and late postimmobilzation) and has led to effective restoration of joint function.

Secondary stroke prevention and optimization of follow-up care are important strategies in reducing morbidity and mortality of patients. Telephone interviews can serve as remote monitoring method of stroke patients in outpatient clinics. Aims and objectives of the research. This paper aims to assess effectiveness of the rehabilitation potential indicators in stroke patients living in Krasnoyarsk, depending on the number of completed stages using the telephone interview method in 90 days after hospitalization. Materials and Methods. A total of 163 cases of stroke were registered. On each of the three rehabilitation stages at admission and discharge the analysis of the rating scales indicators was made and in 90 days after the admission a remote monitoring of patients was performed by telephone interviews. Statistical processing of material was carried out with the use of applied programs Statistica 10. Results. At different stages of the rehabilitation process three groups of patients were observed. By the telephone interview method in 90 days after admission it was revealed that 96% of patients could move independently, 37% of patients returned to usual daily activities, 62% of patients did not experience difficulties in self-care and 28% had some problems with washing and dressing. A majority of the patients (57%) did not experience anxiety or depression and 35% had a moderate degree of anxiety-depressive syndrome. Conclusion. Telephone interviews can be used as an affordable and effective method for remote monitoring of stroke patients in the outpatient stage of treatment.