Vol 17, No 4 (2018)

The article describes the experience of the organization of complex treatment and rehabilitation process in the perioperative period after knee replacement. Given the presence of a certain proportion of patients with burdened anamnesis, risk factors for the development of complications and a low rehabilitation potential, the study aims to study the effectiveness of various rehabilitation programs in the early postoperative period, to determine the indications for advanced rehabilitation of patients after knee arthroplasty. The material of the study was patients after knee arthroplasty, conducted in 2017. Patients were divided into 3 groups (accelerated, standard, extended) depending on the rehabilitation potential and peculiarities of the anamnesis. Different clinical approaches were applied to the management of patients in groups. In the «expanded» group, emphasis was placed on an individual approach and additional activities at the stages of preparation for and rehabilitation after surgery. The effectiveness of rehabilitation was assessed at admission, on 1 day after surgery and at discharge, as well as at the stage of catamnesis 1, 3 and 12 months after surgery on standard functional scales. Comparative evaluation of the results showed that if after the first stage of rehabilitation the indicators of its effectiveness in the «extended» group lag behind the standard group, by the end of the third stage the patients of the «extended» group achieve positive dynamics in rehabilitation on an equal basis with the standard group. Extended rehabilitation is a good potential for improving the quality of life of patients after knee arthroplasty.

Low back pain (LBP) is a serious medical problem, which is observed in 50-85% of the world population. The evaluation of muscle strength is an important indicator for patients with neurological and musculoskeletal diseases. For an objective analysis of the functioning of the spine muscles, 3D isometric and isokinetic testing using the Bionix Sim3 Pro (Belgium) is used, which allows to evaluate the static and dynamic forces of the muscles in three planes. The article presents the results of examination and treatment of 60 patients with myofascial pain syndromes of lumbosacral localization. Taking into account the results of testing on the Bionix apparatus, individual gymnastics for patients was developed, which increased the effectiveness of treatment and rehabilitation.

On the basis of a complex of clinical data and the results of radiation diagnosis of 84 patients', it was shown that in case of minimally invasive osteosynthesis of acetabulum fractures, rehabilitation measures should be started from the first days after the operation. The system-forming principle of the rehabilitation program is a long-term axial unloading of the damaged limb for at least 6 months with adequate training of the periarticular muscles. The long-term results in terms of up to 10 years in 42 patients were studied. The results were evaluated on the Harris scale and amounted to 85.5±4.2 points. In 19% of cases after 5 years, aseptic necrosis developed, which became the basis for endoprosthesis.

The expediency and effectiveness of application of turpentine baths in patients with COPD of mild and moderate course, in the phase of complete and incomplete remission, in the presence of respiratory insufficiency of I and II st. According to the data obtained, the use of white turpentine baths is advisable for proximal airway obstruction, mainly due to discrepancies and evacuation disorders. The basis for choosing yellow turpentine baths is the presence of bronchial obstruction associated with a slow inflammatory process in the respiratory system against the background of hemodynamic disorders in the system of the small circulation. Mixed turpentine baths can be prescribed for a mild course of COPD.

Improving the quality of predicting motor outcomes in premature infants in order to form a unified approach to the ablution of this category of patients at all stages of nursing can be realized by developing methods for assessing the functioning of the spinal-stem level of the movement construction according to N.A. Bernstein. In this article, for the first time, clinical data reflecting disturbances in tone regulation, abnormalities in the unconditioned reflex sphere, the quality of postural control and control of arbitrary movements with the help of the corresponding domains of neuromuscular, skeletal and motion-related functions from the positions of The International Classification of Functioning, Disability and Health. In children receiving a disability for the first year of life, a dysfunction of the spinal-stem level of the construction of movements was detected. The severity of this dysfunction is higher in children born premature than in full-term children, with the same frequency of detected violations, which determines the need to develop and apply appropriate methods of habilitation.