Vol 5, No 3 (2023)

Currently, each rehabilitation institution solves the problem of registration of rehabilitation medical records empirically, based on the existing realities of a particular institution.

The study examined the development of a medical history template for the in- and outpatient medical rehabilitation of patients with peripheral nervous system (PNS) and musculoskeletal system (MSA) dysfunction.

The medical history template corresponded to the currently approved forms 003/y (“Medical record for inpatient care”) and 025/y (“Medical record for outpatient care”) but supplemented with chapters, allowing entry of information in accordance with the requirements of the Ministry of Health of the Russian Federation Order for medical rehabilitation of adults (No. 788n dated July 31, 2020). Additional chapters, forms, and appendices designed to include specific information about the rehabilitation process included the physical and rehabilitation medicine doctor examination list, multidisciplinary rehabilitation team members, examination lists, rehabilitation routing scale blank, list of MDRC discussions, individual patient management forms, standard rehabilitation discharge form, and list of rehabilitation quality criteria for adult patients with MSA/PNS dysfunction. Validated scales and test forms were also included.

The unification of rehabilitation medical records for patients with MSA/PNS impairment makes it easier for the staff of the rehabilitation departments and centers to file medical records in accordance with the current legislation.

BACKGROUND: Currently, the incidence of developmental disorders and the level of disability in premature infants, especially those born with a low and extremely low body weight, remain high, that determines the relevance of habilitation methods.

AIM: to develop and evaluate the effectiveness of the early habilitation complex in premature infants with a perinatal brain damage when transferring to the stage III of rehabilitation.

MATERIALS AND METHODS: The study included 86 patients born with a very low and extremely low body weight, who had a hypoxic-ischemic or hemorrhagic brain damage and were observed at the Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan during the first three years of life. A comparative analysis of the development and functional outcomes of the disease was carried out for children of two groups. The first group, when transferred to the stage III of rehabilitation, was assigned a complex of early sensorimotor habilitation, developed on the basis of N.A. Bernstein’s concept to be carried out at home for three months after an appropriate training. The second group was not prescribed such a complex.

RESULTS: The effect of the early sensorimotor rehabilitation complex on the functional (motor, speech and cognitive) outcomes in prematurely born patients was evaluated and described. In the first group with an assigned complex of sensorimotor exercises, despite the absence of a significant effect by the age of 6 months, it was found by the age of one and a half years, that the average indices of the development of large (p=0.022) and fine motor skills (p=0.023), expressive speech (p=0.006) and cognitive functions (p=0.040) were higher, while, by the age of three years, the differences in speech (p=0.001) and cognitive (p=0.001) outcomes retained their statistical significance compared to the development indicators in children who did not receive the same early habilitation complex.

CONCLUSION: It was found that premature infants who received the early habilitation complex had better speech and cognitive outcomes by the age of three, compared to patients who did not receive the complex. The significance of the positive influence on the ontogenesis of motor skills persists during the second year of life.

In the last decade, the healthcare system has been undergoing reforms to ensure the effective use of budgetary resources given the steady increase in spending on the maintenance of medical institutions and implementation of state policy in healthcare. Improving the payment methods for medical care is one of the main tasks for the healthcare system.

Medical care payment in a clinical hospital is made using clinical and statistical groups. The work based on the Federal Center of Brain Research and Neurotechnologies of Federal Center of Brain Research and Neurotechnologies of Federal Medical and Biological Agency of Russia of Russia with clinical and statistical groups within the framework of medical insurance has been implemented since January 2021.

In total, 2,973 medical records of inpatients treated under medical insurance were analyzed for 2021. Special attention is paid to the analysis of the use of clinical and statistical groups for the profile “Medical rehabilitation.” The patterns that allowed increasing case efficiency have been identified. These measures helped optimize the expenses of the medical institution for the provision of medical care and preserve all opportunities for long-term growth and development.

This article is the second part of a literary review of the most common and difficult to differentiate between visual–spatial disorders, namely, homonymous hemianopia and unilateral spatial neglect, which occur after a right hemisphere stroke. In the first part of the review, the phenomenology of these disorders, diagnostic methods, and criteria for their difference were comprehensively explored.

The second part highlights modern methods of rehabilitation based on the recommendations of the World Federation for Neurorehabilitation. For the rehabilitation of homonymous hemianopia, the following interventions are recommended: saccadic training, hemianopic reading training, restorative visual field training, etc. For the rehabilitation of the neglect syndrome, the following interventions are encouraged: visual scanning training, optokinetic/smooth pursuit therapy, prism adaptation, eye patching, noninvasive brain stimulation, etc.

Recommendations on the methods and timing of their implementation are presented, and modern clinical studies are highlighted. In addition, the innovative methods of eye tracking and virtual reality are described.

The information presented herein is sent to rehabilitation medicine specialists.