The pandemic caused by the novel coronavirus infection COVID-19 dramatically increased the burden on healthcare, which led to the repurposing and limitation of the bed stock in rehabilitation centers. That served as the basis for the search for new approaches to the treatment and routing of patients, including using remote-controlled rehabilitation. The aim of the study was to evaluate the effectiveness and safety of motor rehabilitation in patients after hip replacement with the use of telerehabilitation technologies. Materials and methods: In a retrospective study, 32 patients aged 40 to 75 years who underwent rehabilitation after hip replacement using telemedicine technologies were examined. After discharge from the surgical hospital, all patients were offered a link to receive a program of motor rehabilitation, including exercise therapy complexes and a video clip on the technique of performing these exercises. In addition, online classes with a physical therapy instructor were conducted for patients with technical capabilities. The rehabilitation program started from the first day after surgery and lasted 90 days. To assess the effectiveness of rehabilitation, all patients underwent testing, including questionnaires and mobility tests, which were conducted on the second day and 3 months after surgery. Results: Rehabilitation with the use of telemedicine for patients after hip replacement demonstrates a positive clinical effect, assessed by mobility tests (TUG and the 6‑minute walk test), the EQ-5D quality of life scale, the SF-36 questionnaire and State-Trait Anxiety Inventory test. Conclusion: The criteria for patient inclusion developed by us, special physical therapy programs, and a routing model with remote rehabilitation treatment can become an effective alternative to the full-time rehabilitation, in case of paramedical difficulties for its implementation.
Medical rehabilitation is now a priority of the Russian Healthcare [Skvortsova V.I., 2012]. Rehabilitation centers are usually located in big cities and are not available for most patients. Therefore, one of the modern trends in the development of rehabilitation is a distantly controlled rehabilitation. We have developed a program of distant rehabilitation in Russia, based on our own achievements and experience of foreign colleagues. The article provides an overview of methods according to world literature studies. The survey shows that the problem of distant rehabilitation is relevant in our time, and requires additional clinical research and technological development.
Disorder of the swallowing act occurs in 25-50% of patients in the acutephase of stroke. The presence of dysphagia in a patient notonly can develop life-threatening complications, such as aspiration pneumonia, exhaustion and dehydration, but al so significantly reduces the quality of life of patients. Thus, the correction of thes wallowing act disorders after brain damage is a quite significant challenge for neurorehabilitation. For a long time logopedic correction remained the only method of rehabilitation inneurogenic dysphagia, and now different stimulation techniques such as surface and intra pharynx electro stimulation are widely used. Evaluation of swallowing by scintigraphy indicates that each patienth as a unique pattern of disorders of the swallowing act. Depending on which elongation phase of swallowing is essential, we have developed an individualized approach to there habilitation of patients with dysphagia, which improves the efficiency of there habilitation process.
The article presents the current data on the importance of applying a multimodal approach including hardware techniques with biofeedback in restoring fine motor skills of the hand in patients after ischemic stroke in the early recovery period. The results of the combined use of peripheral magnetic stimulation (Magstim Rapid) with active training on the Hand Tutor device with biofeedback are described on the example of a clinical case. The efficiency of the complex approach was evaluated according to basic scales of neurological deficit: the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale, the Barthel Index for Activities of Daily Living, the Rivermead Activities of Daily Living Scale, the Montreal Cognitive Assessment Scale (MoCA). We also performed a quantitative assessment of motor deficits in the affected limb before and after application of the technique, using the MediTutor software. Based on the results of the study, a decrease in both neurological and motor deficits in the affected limb was revealed; however, further study of the effectiveness of the method with the selection of parameters and duration of therapy is necessary.
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