The development of a system of staged medical care for the medical rehabilitation of children with spinal dysraphism is an important and urgent task of pediatrics.
Spinal dysraphism is accompanied by flaccid paresis or paralysis of the lower extremities, as well as a violation of the function of the pelvic organs. In most cases, various deformations of the feet are observed, congenital dislocations of the hip are often found.
Medical rehabilitation begins immediately after surgical treatment in intensive care units and specialized departments. At the first stage, one of the important tasks is the correction of pelvic disorders. For this purpose, electrical stimulation, drug electrophoresis, magnetotherapy are used depending on the type of neurogenic bladder dysfunction. Currently, the effectiveness of high-intensity pulsed magnetotherapy in children with areflex bladder has been proven. The second stage of medical rehabilitation should be carried out if available in rehabilitation departments, medical rehabilitation centers and aimed at correcting motor impairment. Along with instrumental physiotherapy, modern technologies of physiotherapy exercises are actively introduced, aimed at strengthening the muscles of the lower extremities, preventing muscle atrophy.
The third stage of medical rehabilitation is the longest, carried out on an outpatient basis and includes various health technologies, such as aeroionotherapy, halotherapy, balneotherapy, and mud therapy.
Timely implementation of rehabilitation measures with the inclusion of physical factors in the early postoperative period and the consistent expansion of physiotherapy and kinesitherapy technologies at all stages of medical rehabilitation significantly increases the effectiveness of rehabilitation of patients with spinal cord injuries and improves their quality of life.
The pandemic of the novel coronavirus infection COVID-19 has led to a public health emergency. The feature of the course of the novel coronavirus infection is the fact that even patients who have had the disease in mild or moderate to severe forms develop various functional disorders, the symptoms of which significantly worsen their functional state in the short and long term, indicating the need for rehabilitation treatment. To ensure the continuity of medical care for patients with COVID-19 at different stages of medical rehabilitation, a standardized assessment of the functional state with the development of a rehabilitation protocol is necessary.
In the article it is discussed about the approved methods of using physical therapy on patients with different forms of COVID-19 at the stage of inpatient treatment. The study involved 86 patients with varying degrees of lung tissue damage (CT2CT4), the main group included 49 patients, and the control group included 37 patients. A scheme of rehabilitation measures that can be used in patients with SARS-CoV-19 is proposed. Methods of therapeutic and respiratory gymnastics for both passive and active work with patients to restore muscle strength, improve sputum outflow, prevent deep vein thrombosis and bedsores with various degrees of lung tissue damage are described. The importance of performing physical therapy techniques in the early stages, when the patient is still in bed, is shown. Using the modified Questionnaire "quality of life" (GAD-9), the effectiveness of respiratory and therapeutic exercises was confirmed.
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