Vol 3, No 2 (2021)

Radical surgical treatment, adjuvant chemotherapy and postoperative radiation therapy, used in the complex and combined treatment of breast cancer, inevitably lead to serious functional and psychosomatic disorders. One of the most common complications of breast cancer treatment is postmastectomy syndrome (PMES). That is why the study of the latter and the development of modern methods of rehabilitation of patients with an established diagnosis of PMES remain extremely relevant. To date, the pathogenetic mechanism of the development of upper limb edema and a huge range of possible methods of prevention and treatment have been described in detail. However, the choice of a rehabilitation method requires a personalized approach based on a specific clinical case, and special attention to the psychoemotional status of the patient.

The mechanical properties of tendons are thought to be affected by different loading levels. Changes in the mechanical properties of tendons, such as stiffness, have been reported to influence the risk of tendon injuries chiefly in athletes and the elderly, thereby affecting motor function execution. Unloading resulted in reduced tendons stiffness, and resistance exercise exercise counteracts this. Transforming growth factor-β1 is a potent inducer of type I collagen and mechanosensitive genes encoding tenogenic differentiation markers expression which play critical roles in tendon tissue formation, tendon healing and their adaptation during exercise. In recent years, our understanding of the molecular biology of tendons growth and repair has expanded. It is probable that the next advance in the treatment of tendon injuries will result from the application of this basic science knowledge and the clinical solution will encompass not only the the best postoperative rehabilitation protocols, but also the optimal biological modulation of the healing process.

This article gives an overview of medical rehabilitation in the Netherlands. It shows that Dutch rehabilitation is based on the International Classification of Functioning, Disability and Health (ICF) and organized in three different levels: rehabilitation medicine, geriatric rehabilitation, and monodisciplinary therapy. The author describes these three levels in their distinctive scopes and numbers. Together they operate as a coherent rehabilitation service system that reflects an important characteristic of the system of health care in the Netherlands: decentralized if possible and centralized if necessary. The system is accessible for all and it is organized in a way that simple medical problems can be dealt with close to home, whereas specialized treatment is concentrated in rehabilitation centers spread over the country. The rehabilitation facilities are embedded in the general health care system: it is easy for hospitals as well as general practitioners to refer patients to rehabilitation. In conclusion, the possibilities of further improving the system of medical rehabilitation and the application of Dutch experience in other countries are considered.

In this paper, we consider a hardware-software complex based on virtual reality and a non-invasive EEG neurocomputer interface, designed to restore motor functions of the limbs in patients with the consequences of severe acquired brain lesions through ideomotor training. The complex is a flexible system that allows to train any movements of both the upper and lower extremities in any virtual environment with varying degrees of immersiveness. The proposed method for assessing desynchronization of the sensorimotor rhythm during imagining movements and the developed algorithm for ideomotor training have been successfully tested on healthy volunteers.