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.
Aim. To study the physical activity in disabled patients who underwent an amputation of the lower limb in a late period of rehabilitation and prosthetics. Methods. The study included patients with structural and functional disorders of limbs. 308 patients aged 18 to 66 years were randomly selected to participate in the study as they were referred to Prosthetic and orthopedics center «Reabilitaciya invalidov», Kazan, Russia from 2008 to 2010. Patients were allocated to five age groups: 19 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years old and older than 60 years. Activity level, depending on the motor capacity was investigated in 308 patients who were offered prosthetics according to the classification subdividing locomotor activity on five levels. SF-36 questionnaire (quality of life), Spielberger-Hanin reactive and personal anxiety scales, Beck Depression Inventory, the Mehrabian Achieving Tendency Scale, Smisek-Leonhard characterological test were administered. Quality of lower limbs prostheses were assessed by «TWO LEGS» prosthesis evaluation questionnaire on a 5-point scale. Results. The majority of patients who were at the remote stage of rehabilitation after prosthesis had high level of physical activity - 141 (45.7%) patients, average activity level - 81 (26.2%) patients, reduced level of activity - 63 (20.5%) patients. High level of physical activity, depending on the locomotor activity, was more typical for the second (20-29) and third (30-39 years) age groups - 60 and 54%, respectively. Very high and high levels of physical activity was equally observed in patients with one and both amputated both lower legs: 8.4 and 7%, respectively. Conclusion. Level of amputation, age and psychological characteristics, as well as prosthesis quality and the term of prosthesis use were essential for motor activity, quality of life and functional independence of the disabled with structural and functional of the lower limb disorders.
Aim. To study the quality of life, characteristic traits and emotional features in disabled patients with functional and structural damage of limbs. Methods. Disabled patients with functional and structural damage of limbs who addressed to the center of prosthesis and ortopedy for limb prosthesis were studied. 318 patients (males - 267 (83.3%), females - 51 (16.7%), aged 18 to 66 years) with limb stumps (including congenital limb defects) who addressed to the centre since 2008 to 2010 were randomly picked out to be included in the trial. The complex study of the following context factors included in the International Classification of Functioning, Disability and Health: quality of life, individual psychological traits, emotional sphere and motivation, social, cultural and nature environment. Patients were divided into 5 groups: aged 19 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, over 60 years of age. Results. In the group of patients aged 19 to 29 years, the most intimately related to the quality of life were: situational anxiety and pedantic types demonstrative and of accentuated personality. In the group of patients aged 30 to 39 years the limitations due to amputations increased the influence on depression formation. In the group of patients aged 40 to 49 years the conjugacy of patients’ emotional and personal traits with the quality of life strengthened. Meanwhile, the influence of depression on patients’ quality of life and personality increased. n the group of patients aged 50 to 99 years the most influential was the triad of situational anxiety, personal anxiety and depression. In patients over 60 years of age quality of life was strongly related to patient’s psychologic and emotional condition, especially with situational anxiety. Conclusion. Different age groups of the patients who underwent a limb amputation, need an individualized and specialized rehabilitation programs, considering the interrelation between emotional, individual and psychological personal traits and parameters of quality of life.
The problems of healthcare system formation and management for physical culture and sports are discussed within the framework of prevention and rehabilitation areas development in the Republic of Tatarstan. The 2013 Summer Universiade is acknowledged as the largest event in the international sports, involving 13 000 sportsmen participating in 27 different summer sports. Physical culture and sports healthcare is known to be the one of the most crucial factors influencing sporting achievements. Since 2013 the Centre for Medical Prevention has started to create the informational and analytical system required for integral, in-depth and systemic image of physical culture and sports healthcare status and problems in the Republic of Tatarstan. A multi-layer matrix of the data gathering within the healthcare system, including the elements of physical culture and sports healthcare. We offer to create a national program the basing on the modern methodology of science for studying and solving complex social problems. The development of the local program devoted to physical culture and sports healthcare improvement can be a model of similar methodology-based program formation with a wider coverage, allowing to provide the preventive and rehabilitation healthcare for the whole population.
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