Abstract:BACKGROUND: General injury rates tend to increase in most federal districts of Russia. The patients with fractures of the bones of the lower extremities reaches for 8.525% of the total number of patients with fractures. Fractures of the bones of the lower extremities are characterized by long period of reparation, persistent contractures, a violation of the congruence of the articular surfaces, and changes in the biomechanics of walking. Only full course of rehabilitation can eliminate the these complications … Show more
Relevance. People involved in professional sports quite often encounter injuries. Thus, one of the main problems of modern traumatology and rehabilitation medicine is sports traumatism, which accounts for 2 to 7 % of all injuries.Objective: to analyze the available and modern methods of rehabilitation of athletes with fractures of the bones of the lower extremities.Materials and methods. In the course of the present study, we reviewed the literature data reflecting the current views on the problem of rehabilitation of athletes with fractures of lower limb bones.Results. Successful recovery of athletes and early return to the training process is largely determined by optimally selected rehabilitation measures. There is no unified algorithm in rehabilitation of athletes; the choice of tactics depends on a number of factors, such as localization and severity of the fracture, surgical and conservative treatment performed, individual characteristics of the athlete, and the desired result. The optimal algorithm is a combination of classical rehabilitation measures, which include therapeutic physical training, diet therapy, psychotherapy and physical therapy procedures such as massage, taping, low-frequency magnetic therapy, UHF in low-heat doses, electrophoresis of analgesics, calcium and phosphorus drugs and thermotherapy.Conclusion. All rehabilitation measures are aimed at gradual increase of physical load on the injured limb and strengthening the musculoskeletal system by improving tissue trophism, muscle tone, activation of metabolic processes as well as pain reduction and stimulation of regeneration of injured tissues. The adaptation basis of rehabilitation is the model of control of movements ("control-chaos continuum"), which provides the prevention of complications and re-injuries. Rational nutritional therapy contributes to increasing muscle mass and preventing the accumulation of fat mass. When choosing rehabilitation measures, the nature of the chosen treatment and objectives are taken into account, so that the choice of rehabilitation measures is made on an individual basis, in order to achieve the best possible results in a short period of time. Adequately chosen rehabilitation measures allow athletes to safely return to their original physical performance and reduce the risk of re-injury.
Relevance. People involved in professional sports quite often encounter injuries. Thus, one of the main problems of modern traumatology and rehabilitation medicine is sports traumatism, which accounts for 2 to 7 % of all injuries.Objective: to analyze the available and modern methods of rehabilitation of athletes with fractures of the bones of the lower extremities.Materials and methods. In the course of the present study, we reviewed the literature data reflecting the current views on the problem of rehabilitation of athletes with fractures of lower limb bones.Results. Successful recovery of athletes and early return to the training process is largely determined by optimally selected rehabilitation measures. There is no unified algorithm in rehabilitation of athletes; the choice of tactics depends on a number of factors, such as localization and severity of the fracture, surgical and conservative treatment performed, individual characteristics of the athlete, and the desired result. The optimal algorithm is a combination of classical rehabilitation measures, which include therapeutic physical training, diet therapy, psychotherapy and physical therapy procedures such as massage, taping, low-frequency magnetic therapy, UHF in low-heat doses, electrophoresis of analgesics, calcium and phosphorus drugs and thermotherapy.Conclusion. All rehabilitation measures are aimed at gradual increase of physical load on the injured limb and strengthening the musculoskeletal system by improving tissue trophism, muscle tone, activation of metabolic processes as well as pain reduction and stimulation of regeneration of injured tissues. The adaptation basis of rehabilitation is the model of control of movements ("control-chaos continuum"), which provides the prevention of complications and re-injuries. Rational nutritional therapy contributes to increasing muscle mass and preventing the accumulation of fat mass. When choosing rehabilitation measures, the nature of the chosen treatment and objectives are taken into account, so that the choice of rehabilitation measures is made on an individual basis, in order to achieve the best possible results in a short period of time. Adequately chosen rehabilitation measures allow athletes to safely return to their original physical performance and reduce the risk of re-injury.
Diabetes mellitus (DM) and lower extremity injuries are one of the global health problems. These conditions require rehabilitation measures to restore maximum functionality and quality of life of the patients. The presence of DM aggravates the recovery period after injuries, and also serves as an independent factor in poor outcomes, death, development of early and late trauma complications. In DM patients with injuries of the lower extremities it is required special attention, an integrated approach and the participation of a multidisciplinary team to create an optimal rehabilitation program aimed at prevention of the progression and development of complications, achieving a prompt and complete restoration of functions. Personalized treatment decisions, individually selected therapy methods and the use of modern technologies will help achieve the best results in the rehabilitation of patients with DM and lower extremity injuries. Basic rehabilitation strategies in DM patients with injuries of the lower extremities include: control of glucose levels and metabolic disorders; inspection and care of damaged tissues to prevent the development of ulcers and infections; gradual increase in physical activity; rehabilitation goals must be realistic and take into account the individual characteristics of the patient; the use of physiotherapy methods to improve microcirculation and activate tissue regeneration (transcutaneous electrical nerve stimulation, electrophoresis, magnetic fields, ultratonotherapy, cryotherapy, laser therapy, darsonvalization, pulsed electric fields, ultrasound therapy, ozokerite therapy and peloid therapy); the use of mechanotherapy with biofeedback and robotic systems to increase endurance, strength, improve balance function and form the correct walking stereotype (rehabilitation track with visual feedback about walking C-Mill).
INTRODUCTION. Diabetes mellitus (DM) in patients with lower extremity injuries is a global health problem. The combination of these pathologies in one patient requires rehabilitation measures to restore maximum functional activity and maintain the patients’ initial quality of life. Diabetes as an independent pathology has a negative impact on the patient’s health and also aggravates the recovery period after traumatic bone injury, increasing the risk of adverse outcomes in the early and late postoperative periods.
AIM. To analyze the scientific data of the last ten years on the use of medical rehabilitation methods in patients with lower extremity injuries and diabetes mellitus.
MAIN CONTENT. The search was conducted in Web of Science, PubMed, and Scopus according to PRISMA guidelines and initially identified 181 records. Of these, 45 articles were included in the study with publication periods 2013–2023. Key words used: lower limb injuries, diabetes mellitus, rehabilitation, mechanotherapy, physical therapy, physiotherapy. The literature review analyzes publications on the basis of which a description is made that in case of injuries of the lower extremities in patients with diabetes, the participation of specialists from a multidisciplinary team is necessary to draw up an optimal rehabilitation program aimed at preventing the occurrence of complications and their progression, achieving a speedy and complete recovery of lost functions. A personalized approach, individually selected therapy methods and the use of modern technologies will help achieve the best results in the recovery of patients with diabetes and lower extremity injuries.
CONCLUSION. The review formulated a conclusion about the main objectives of rehabilitation: which include: control of glucose levels and metabolic disorders; examination and care of damaged tissues in order to prevent the development of ulcers and infection of injured skin; gradual increase in physical activity; goals should take into account the individual characteristics of the patient; the use of physiotherapy methods to improve microcirculation and activate tissue regeneration (transcutaneous electrical nerve stimulation (TENS), electrophoresis, magnetic fields, ultratonotherapy, cryotherapy, laser therapy, darsonvalization, pulsed electric fields, ultrasound therapy, ozokerite therapy and peloid therapy); the use of mechanotherapy with biofeedback and robotic systems to increase overall endurance, strength, improve balance function and form the correct walking stereotype (rehabilitation track with visual feedback about walking C-Mill).
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