The expert consensus of the Russian communities discusses the issues of comprehensive medical rehabilitation of patients with coronavirus disease 2019 (COVID-19). COVID-19 is a contagious infectious disease that can cause pulmonary, cardiac, motor, metabolic, neurocognitive and mental disorders, that is, multiple organ dysfunction. COVID-19 survivors, especially after a severe clinical course, face serious psychological and physical problems, posttraumatic stress, cognitive dysfunction, nutritional deficiencies and exacerbation of concomitant chronic diseases. Some patients, regardless of the COVID-19 severity, have a long clinical course of the disease (“chronic-COVID”, “long COVID”). There is evidence of post-acute COVID-19 syndrome. In this regard, patients after COVID-19 will need rehabilitation measures. The expert consensus of the Russian communities presents general principles, stages and aspects of medical rehabilitation after COVID-19, indications and contraindications for rehabilitation interventions. The paper includes recommendations on comprehensive cardiac and pulmonary rehabilitation, as well as specifics of rehabilitation care for different COVID-19 courses within the national three-stage rehabilitation system.
In 40 patients with patellofemoral pain syndrome, before and after the course of treatment, the strength indices of the hip muscles were studied by isokinetic dynamometry, as well as the severity of the pain syndrome in the knee joint and the lumbosacral spine according to the visual analogue scale. The patients of the main group (n = 20) used the technique of complex correction of the pelvic region and lower limb, which was mainly aimed at stabilizing the lumbosacral spine. Patients of the control group (n = 20) performed therapeutic gymnastics aimed at training the muscles of only the interested lower limb. The treatment was performed on an outpatient basis daily for 21 days. After the course of treatment in patients of the main group, the strengths of the quadriceps femoris were significantly higher (p < 0.05), and the degree of pain in the knee joint and lumbar spine was significantly lower (p < 0.05). The obtained data confirm the necessity and expediency of including exercises for stabilization of the lumbosacral spine in the rehabilitation program for patients with patellofemoral pain syndrome.
Abstract:In chronic stage of stroke, it is necessary to pay attention to the complex spatial movements training along with the traditional restoration of balance, strength of particular muscles, and paretic limb joints mobility. The aim of the study was to evaluate the effectiveness of robotic therapy in the recovery of upper limb function in the chronic stage of stroke. The study involved 52 patients with ischemic stroke in the middle cerebral artery. The patients were divided randomly into 2 groups. All patients (5 days/wk × 3 wk) got gymnastics by the standard technique, massage, laser, and pulsed currents therapy. Main group patients (n = 36) extra received complex spatial movements, speed, fluidity, precision and agility training by the robotic electromechanical device Multi Joint System (MJS) (40 minutes, 5 days/wk × 3 wk). Analysis of the results of the study showed a statistically significant difference in improving ROM of the elbow and shoulder joints, speed and accuracy of movement in the main group compared with the control. Hardware recovery of complex spatial upper limb movements in the chronic stage of stroke increases the functionality and independence of the patient's domestic skills.
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