For the first time in clinical conditions a study was carried out for estimation of average amplitude (AA-EMG) and frequency of oscillations repetitions parameters during dynamic and static exercises performance. We found that in healthy individuals EMG amplitude depends on the character of physical exercises performed. The largest EMG amplitude was registered when performing static exercises. It was found that in acute stroke patients, while performing flexion and extension of fingers, low-amplitude EMG activity was registered stretched for entire movement cycle without a clear peak of extremum. When performing static exercises, the amplitude and frequency of EMG oscillations changed significantly in a positive way.

The use of physical rehabilitation methods, in particular respiratory rehabilitation for pneumonia, allows to increase the tolerance to physical activity, improve oxygen consumption and endurance of patients compared to the initial level, reduce the frequency and duration of their hospitalization, as well as significantly improve the effectiveness of drug therapy. In the first stage of assisting patients with pneumonia of various genesis, therapeutic exercises are recommended that improve drainage function of the bronchi and promotes the discharge of bronchial mucous. Prescription of physiotherapeutic methods of treatment, which have a bactericidal, anti-inflammatory, anti-edema and resorption effects, significantly increase the effectiveness of complex therapeutic measures. A comprehensive approach to the treatment of pneumonia can produce better results by using all therapeutic physical exercise and physiotherapy options that have proven effective over many decades.

No abstract

Ankylosing spondylitis is a chronic inflammatory disease from the group of spondylarthritis, characterized by damage to the predominantly axial skeleton, gradual formation of functional disorders of the spine and joints, leading to temporary or permanent disability and poor quality of life for patients, mostly young. In recent years, much attention has been paid to the study of the effectiveness of kinesitherapy in patients with ankylosing spondylitis. Studies have been conducted that confirmed the positive effect on the function of the spine and joints of regular exercises performed at home, regular group exercise and their combination with physiotherapy methods. However, due to the imperfect methodology of conducting these studies and the lack of a standardized approach in evaluating the effectiveness of therapy in these patients, further detailed researches are needed to select the required amount of kinesitherapy for patients with ankylosing spondylitis and develop a standardized assessment of its effectiveness.

Patients with a new coronavirus infection (COVID-19) need rehabilitation. Rehabilitation approaches of patients with another pathology also require to be reviewed under the conditions of the SARS-CoV-2 epidemic. It is necessary to develop clinical recommendations for the rehabilitation care delivery in patients with COVID-19 and other diseases during a pandemic. A group of experts analyzed the data of current reviews on rehabilitation with COVID-19, as well as previous studies on rehabilitation in patients with Post-intensive care syndrome (PICS) and acute respiratory distress syndrome of non-coronavirus etiology, and developed thereupon the main positions of clinical recommendations. We discuss the main rehabilitation problems in patients with COVID-19, in particular structures and functions impairments, leading to limitations and restrictions of self-care, mobility, domestic life, communication, interpersonal interactions and relationships, professional activities and those determining care requirement. The article also provides general recommendations on medical rehabilitation management in a pandemic at all three stages, including patients routing, ensuring the infectious safety of medical personnel and patients. The necessary individual rehabilitation program components for patients with COVID-19 at all stages of rehabilitation have been identified, including patients examination, nutritional deficiency correction, restoration of respiratory function, exercise tolerance, muscle strength, self-monitoring and training in new movement conditions, psychoemotional state disorders and cognitive functions, as well as independence in everyday life recovery. Medical rehabilitation during the COVID-19 epidemic should include all rehabilitation care components and helps to optimize vital functions, to prevent complications and to improve the patients life quality.

The emergence of SARS-CoV-2 and its worldwide spread has become a challenge for healthcare professionals related to rapid diagnosis of infection caused by the new coronaviruses, provision of specialized medical care, rehabilitation and secondary prevention. Currently, there is limited information on primary, secondary prevention and medical rehabilitation of this disease. The most common clinical manifestation of the new variant of coronavirus infection is bilateral pneumonia, with 34% of patients developing acute respiratory distress syndrome (ARDS). Given the unusual pandemic situation and the peculiar COVID-19 pathogenesis, the stereotyped application of generally accepted methods may be unsafe or ineffective. The Union of Rehabilitologists of Russia has prepared Temporary guidelines that are based on the advice on medical rehabilitation of patients with COVID-19 at various stages of special medical care published by WHO specialists, analysis of reports from clinics currently involved in rehabilitation of COVID-19 patients, as well as on the results of clinical studies conducted earlier on the rehabilitation of patients with Post-intensive care syndrome and adult respiratory distress syndrome (ARDS) of non-coronavirus etiology, regulatory documents of the Russian Ministry of Health and Federal Service on Surveillance for Consumer rights protection and human well-being. A syndrome-based approach to the use of means and methods of physical and rehabilitation medicine is also considered. The guidelines are intended for heads of medical organizations and their structural divisions, general practitioners, physicians, infectious disease doctors, pediatricians, emergency physicians of intensive care units in infectious hospitals, physiotherapy and sports medicine doctors, physiotherapists, medical psychologists, physical therapy instructors, nurses and other specialists of multidisciplinary rehabilitation teams working in the field of medical care for patients with COVID-19 at various stages.

кресло-коляска с ручным приводом для перемещения дома, инвалидное кресло-коляска с ручным приводом для перемещения на улице, противопролежневая подушка, кресло -стул с санитарным оснащением, адсорбирующие средства, впитывающие пеленки, ортопедическая обувь с жестким задником, жесткий тутор с фиксацией нескольких суставов, ходунки, противопролежневая подушка, кресло -стул с санитарным оснащением, адсорбирующие средства, впитывающие пеленки, ортопедическая обувь с жестким задником, жесткий тутор с фиксацией нескольких суставов и др.; при умеренных нарушениях функций (25-49%) -трость 4-х опорная с широким основанием, костыли подмышечные с устройством противоскольжения, бандаж на плечевой и коленный сустав, тутор на кисть, стоподержатель и др.; при легких нарушениях функций (5-24%) -трость одноопорная, функциональный бандаж на плечевой и голеностопный сустав и др.Ключевые слова: МКФ, ограничение жизнедеятельности, медицинская реабилитация, технические средства. ABSTRACTThe international classification of functioning, disability and health (ICF)is a classification of health components, allows to objectively determine the health status of patients, make a forecast of impaired functions and helps to assess the effectiveness of rehabilitation activities.The article describes the approach to the choice of technical means of rehabilitation with the help of ICF. UF allows you to objectively determine the health status of patients and to choose technical means of rehabilitation depending on the degree of disability: if an absolute dysfunction (96-100%) -functional beds, anti-bedsore mattress, gel cushion, wheelchair with headrest and armrests, the absorbent means absorbent diaper, chair -chair with sanitary equipment, a rigid splint with fixation of multiple joints, etc.; in severe functional disorders (50-95%) -anti-bedsore mattress, wheelchair with manual drive to move at home, wheelchair with manual drive to move on the street, anti-bedsore pillow, chairchair with sanitary equipment, adsorbing agents, absorbent diapers, orthopedic shoes with a hard back, hard splint with fixation of several joints, walkers, anti-bedsore pillow, chair -chair with sanitary equipment, absorbent means absorbent diaper, orthopedic shoes with a hard heel, a hard splint with fixation of multiple joints, etc.; at moderate impairments (25-49%) -cane 4-point with a wide base, the axillary crutches with the device anti-skid bandage on the shoulder and the knee joint, the splint on the hand, stopiteration, etc.; in milder disorders (5-24%) -cane single-bearing alternator, the functional brace with shoulder and ankle etc.

В современных работах по лечению и реабилитации пациентов с инсультом описывают преимущества и эффективность отдельных видов медицинской реабилитации, но этих данных недостаточно для оценки эффективности реабилитационной системы в целом. Целью нашего исследования было изучить эффективность пациент-центрированной проблемно-ориентированной мультидисциплинарной трехэтапной системы медицинской реабилитации пациентов с инсультом. В исследовании принял участие 1021 пациент старше 18 лет с ОНМК по ишемическому или геморрагическому типу в острейшем периоде. Все пациенты имели ограничение жизнедеятельности на момент поступления (без стойкой инвалидизации в анамнезе). Проводили сравнение двух моделей реабилитационных мероприятий, которые осуществляли в две последовательные фазы. В фазе 1 реализовывали преимущественно модель линейной формы оказания реабилитационной помощи, а в фазе 2 — мультидисциплинарную модель. Состояние пациентов оценивали по модифицированной шкале Рэнкина (mRS) в конце курса реабилитации. Сравнение результатов, полученных в первую и вторую фазы исследования, показало, что количество пациентов с оценкой по шкале mRS 0–1 балл в фазе 2 было на 18% меньше. Доля пациентов, имевших положительную динамику, также была значимо выше в фазе 2, чем в фазе 1 (16 и 30% соответственно). Пациентов, продемонстрировавших улучшение на 1–4 балла, в фазе 2 было значимо больше. Таким образом, применение мультидисциплинарной модели по сравнению с линейной моделью реабилитации обеспечивает значимое улучшение.