Physical and rehabilitation medicine, medical rehabilitation

2019 ◽  
2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 838.2-838
Author(s):  
L. Marchenkova ◽  
V. Vasileva

Background:There is a high prevalence of osteoporosis (OP) among patients of the older age undergoing rehabilitation. Therefore, it is obvious that physicians working in the field of physical and rehabilitative medicine should be well oriented in this medical problem.Objectives:to study the relevance of the problem of osteoporosis (OP) for physicians working in the field of physical and rehabilitation medicine, their awareness of the main methods of diagnosis, treatment and prevention of this disease, as well as the frequency of their use in daily clinical activities.Methods:A cross-type study was carried out using a questionnaire survey. The study included 157 doctors (M-34, F-123) of 8 medical specialties working in 27 specialized medical institutions on the profile of “medical rehabilitation. The questionnaire for doctors consisted of 21 items of special questions.Results:90.45% of the surveyed doctors believed that the problem of OP is relevant for their clinical activities, 100% of the respondents indicated that the presence of OP significantly affects the rehabilitation prognosis and 95.54% - on the degree of effectiveness of medical rehabilitation. According to the respondents, patients with OP make up on average 30.0% [20.0; 50.0] (0-90) of the total flow of patients. 92.36% (145/157) of doctors indicated that they know the risk factors for OP, 98.73% (155/157) - methods for diagnosing OP, 68.79% (108/157) - methods for treating OP, 80.25 % (126/157) - methods of preventing OP, 47.13% (74/157) - what is FRAX. However, 35.01% (55/157) of the respondents considered their level of awareness of the problem sufficient for managing patients with OP. Diagnostic procedures for OP are recommended by all endocrinologists (100%) and the majority of traumatologists (72.73%), gynecologists (66.67) and cardiologists (64.28%), as well as on average half (50%) neurologists and therapists. Endocrinologists (100%), gynecologists (66.67%) and therapists (60%) are mainly involved in the treatment of OP. 32.48% (51/157) of physicians have ever referred their patients to a bone mineral density assessment.Conclusion:Conclusion. The problem of OP is relevant for the clinical activities of specialists in physical and rehabilitation medicine, and there is the need for advanced training on the problem of OP among these specialists.Disclosure of Interests:None declared.


2019 ◽  
Vol 1 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Iuly Treger ◽  
Lena L Lutsky

A definition as stated by the American Academy of Physical Medicine and Rehabilitation in 1975 is: "Medical rehabilitation services can be defined as a coordinated multi - disciplinary approach to disability under a qualified physician who directs a plan of management for one or more of the categories of chronic disabling diseases or injuries, specifying realistic goals for maximal recovery". The Main rehabilitation principles include patient and family centeredness, a multidisciplinary approach and holistic attitude towards physical and mental health. From early in its development and until today, rehabilitation is represented as the third phase of medical care - after diagnosis and treatment. Physical and Rehabilitation Medicine (PRM) is a growing and a developing discipline. Gutenbrunner et al wrote: "Various societal and medical trends, including the ageing of populations, the increasing number of people with functional limitations due to improving survival rates in different disease entities (e.g. stroke, spinal cord injury, multiple trauma) and the need of elderly workers to remain integrated in the workforce despite the presence of chronic illnesses, call for an increasing importance of rehabilitation in the future".


Author(s):  
Марина Михайловна Романова ◽  
Алексей Викторович Чернов

Активная деятельность ВОЗ по распространению и применению Международной классификация функционирования, ограничений жизнедеятельности и здоровья (МКФ) приводит к изменению законодательной базы, стандартов систем медицинской и социальной реабилитации с учетом положений МКФ. Во всем мире и в нашей стране продолжается развитие такого важного направления медицины как медицинская реабилитация, физическая и реабилитационная медицина. Среди актуальных аспектов можно отметить проблему полиморбидности патологии у одного пациента, а также объективизации диагностики нарушения отдельных функций, системы объективизации контроля и оценки эффективности реабилитационных мероприятий, в том числе с включением физических и физиологических методов контроля в контексте дальнейшего совершенствования системы физической и реабилитационной медицины. Статья посвящена результатам исследования по изучению возможностей применения хронобиологического подхода к оценке функционирования систем адаптации у пациентов при наличии полиморбидности. Применялся метод суточного мониторирования вариабельности сердечного ритма, электрокардиограммы, артериального давления. Полученные данные обрабатывали статистически с применением косинор-анализа. Результаты исследования свидетельствуют о достоверных нарушениях циркадианного ритма вариабельности сердечного ритма у больных при сочетании метаболического синдрома и заболеваний верхних отделов желудочно-кишечного тракта. Хронобиологический подход в оценке показателей суточного мониторирования вариабельности сердечного ритма является одним из объективных методов интегральной оценки адаптационно-восстановительных резервов организма, что следует учитывать при организации и проведении диагностических, лечебных, профилактических мероприятий, в восстановительной, физической и реабилитационной медицине Who's active work on the dissemination and application of the International classification of functioning, disability and health (ICF) leads to changes in the legal framework, standards of medical and social rehabilitation systems, taking into account the provisions of the ICF. All over the world and in our country, the development of such an important area of medicine as medical rehabilitation, physical and rehabilitation medicine continues. Among the relevant aspects, we can note the problem of polymorbidity of pathology in one patient,as well as the objectification of diagnostics of violations of individual functions, the system of objectification of control and evaluation of the effectiveness of rehabilitation measures, including the inclusion of physical and physiological methods of control in the context of further improvement of the systemof physical and rehabilitation medicine. The article is devoted to the results of a study on the possibilities of applying a chronobiological approach to assessing the functioning of adaptation systems in patients with polymorbidity. The method of daily monitoring of heart rate variability, electrocardiogram, and blood pressure was used. The obtained data were processed statistically using cosinor analysis. The results of the study indicate significant violations of circadian rhythm and heart rate variability in patients with a combination of metabolic syndrome and diseases of the upper gastrointestinal tract. Chronobiological approach to the assessment of indicators of daily monitoring of heart rate variability is one of the objective methods of integral assessment of adaptive and recovery reserves of the body, which should be taken into account when organizing and conducting diagnostic, therapeutic, preventive measures, in rehabilitation, physical and rehabilitation medicine


2019 ◽  
Author(s):  
Gennadiy Ponomarenko ◽  
Inna Lavrinenko ◽  
Anna Isaeva ◽  
Vadim Akhmedov

The practical guide presents the organization of specialized care for medical rehabilitation, physiotherapy, therapeutic physical culture and Spa treatment. The procedures and stages of assistance, job descriptions of employees, the device and equipment of units, sanitary and epidemic regime, quality control and safety of medical activities are considered. It is addressed to the heads of medical organizations and health resorts, doctors of medical rehabilitation, physiotherapists, doctors of physical therapy, secondary medical personnel.


2020 ◽  
Vol 97 (3) ◽  
pp. 14-21 ◽  
Author(s):  
A.A. Shmonin ◽  
M.N. Maltseva ◽  
E.V. Melnikova ◽  
I.E. Mishina ◽  
G.E. Ivanova

Coronavirus infection causes lung damage and leads to the development of disabling conditions. The development of the Covid-19 pandemic leads to a one-stage increase in the number of patients who need assistance not only from infectious disease specialists and intensive care specialists, but also from rehabilitation specialists. However, patients suffering from other non-infectious conditions need rehabilitation despite the pandemic. Thus, rehabilitation specialists are faced with new tasks to organize rehabilitation in the epidemic for both patients with Covid-19 and patients at high risk of infection, but without coronavirus infection, to develop specific programs for pulmonary rehabilitation, data collection on the nature of disability, organization of outpatient programs and telerehabilitation.


A definition as stated by the American Academy of Physical Medicine and Rehabilitation in 1975 is: "Medical rehabilitation services can be defined as a coordinated multi - disciplinary approach to disability under a qualified physician who directs a plan of management for one or more of the categories of chronic disabling diseases or injuries, specifying realistic goals for maximal recovery". The Main rehabilitation principles include patient and family centeredness, a multidisciplinary approach and holistic attitude towards physical and mental health. From early in its development and until today, rehabilitation is represented as the third phase of medical care - after diagnosis and treatment. Physical and Rehabilitation Medicine (PRM) is a growing and a developing discipline. Gutenbrunner et al wrote: "Various societal and medical trends, including the ageing of populations, the increasing number of people with functional limitations due to improving survival rates in different disease entities (e.g. stroke, spinal cord injury, multiple trauma) and the need of elderly workers to remain integrated in the workforce despite the presence of chronic illnesses, call for an increasing importance of rehabilitation in the future".


2021 ◽  
Vol 24 (2) ◽  
pp. 41-46
Author(s):  
Alexander N. Sereda ◽  
Sergey N. Puzin ◽  
Servir S. Memetov ◽  
Vyacheslav V. Kim ◽  
Ruslan G. Ilyukhin

The development of rehabilitation at the present stage is one of the priorities in the field of health and social development. Not only medical organizations, but also other organizations can take part in carrying out medical rehabilitation activities. A prerequisite for the implementation of rehabilitation activities is the availability of a license for medical activity with an indication of medical rehabilitation work. Of great concern is the issue of staffing of medical organizations, especially primary care, by such specialists as a doctor of physical and rehabilitation medicine, a doctor of medical rehabilitation, a medical speech therapist, an ergorehabilitation specialist, etc. In the absence of these specialists in medical organizations, it is impossible to form interdisciplinary rehabilitation teams, and in their absence, the solution of medical rehabilitation issues is questionable. The article contains an analysis of the current legal framework for medical rehabilitation. The stages of medical rehabilitation in medical organizations are reflected in accordance with the scale of rehabilitation routing. Four groups of medical organizations carrying out medical rehabilitation have been identified. The shortcomings of the current legal framework for medical rehabilitation are indicated, since a comprehensive rehabilitation system is currently being formed in the Russian Federation. For its successful development and implementation in the practical activities of medical organizations and social institutions, a regulatory and legal framework is being developed and improved. The approved Procedure for the organization of medical rehabilitation will allow to systematize and organize this work at a qualitatively new level.


2019 ◽  
Vol 21 (4) ◽  
pp. 8-13
Author(s):  
V E Yudin ◽  
A M Shchegolkov ◽  
V P Yaroshenko ◽  
I G Ovechkin ◽  
E S Kosukhin

Improving the system of medical rehabilitation in the Armed Forces of the Russian Federation is carried out in accordance with the trends of civilian health care, with an emphasis on the specifics of military medicine. It is stated that medical rehabilitation should be carried out by specialists of the multidisciplinary team - a functional association of medical and non-medical professionals in the course of providing assistance in the field of medical rehabilitation. In the future, the activities of the multidisciplinary team will include the definition of a rehabilitation diagnosis using the international classification of functioning. Changing the nomenclature of specialties will require organizing the training (retraining) of specialists in the specialty «Physical and Rehabilitation Medicine» in educational institutions of the Russian Ministry of Defense.


2017 ◽  
Vol 15 (1) ◽  
pp. 13-20
Author(s):  
Anna Cabak

Background: Understanding the expectations of patients seems to be an essential complement to medical diagnosis and an aid in ordaining the healing process. The aim of this study was to assess and analyse the expectations of patients who are re ferred to physical and rehabilitation medicine doctors as a result of various musculoskeletal diseases. Material/Methods: 90 patients were tested, including 34 males and 56 females, ranging in age from 22 to 88 years (mean age 52.5 ± 19.54), who go to see a doctor predominantly because of back pain. As adopted by Juczyński, the questionnaire assessing patients’ expectations “Patients’ Request Form (PRF), was em ploy ed for statistical analysis, the Mann-Whitney U, Kur skala-Wallis and chi-square tests were also used. Results: It has been shown that primarily all patients await the diagnosis of their disease and then information about further examination and treatment. Expectation of any emotional support was at the lowest rate, though it did increase with age and was higher in women than in men (p <0.05). The majority of respondents express a wish to take advantage of supplementary physiotherapeutic consultations, ones specially targeted for interim aid, especially when the waiting time for any assigned rehabilitation is two-months and longer. Conclusions: Further research on patients’ expectations towards medical rehabilitation specialists should be conducted, and its results should be taken into account in the treatment process in order to improve the efficiency and quality of medical services as well as the entire, long-lasting therapy process.


2021 ◽  
pp. 134-141
Author(s):  
L. A. Marchenkova

Introduction. The special rehabilitation programs are often required for patients with osteoporosis (OP). So physicians working in the field of physical and rehabilitation medicine should be well-versed in this problem.Aims. To study the awareness of doctors of rehabilitation medicine in the field of diagnosis and treatment of osteoporosis and their activity in providing medical care to patients with OP.Materials and methods. A questionnaire survey of 157 doctors (M-34, F-123) of 8 medical specialties working in 27 specialized medical institutions on the profile of “medical rehabilitation” was carried out. The questionnaire for doctors consisted of 21 items of special questions.Results and discussion. In the sample of rehabilitation doctors, 90.45% of the interviewed doctors believed that the problem of OP is relevant for their clinical activities, 100% of the respondents indicated that the presence of OP significantly affects the rehabilitation prognosis and 95.54% - on the degree of effectiveness of medical rehabilitation. According to the respondents, patients with OP make up on average 30.0% [20.0; 50.0] (0-90) of the total flow of patients. Endocrinologists (all surveyed doctors - 100%), obstetricians - gynecologists (66.67%) and therapists (60%) are mainly involved in the treatment of OP. Most often, specialists from rehabilitation institutions recommend zoledronic acid (23.57% of doctors indicated in this aspect), preparations of vitamin D (23.57%) and calcium (14.65%), various methods of physical therapy (14.65%) and parenteral form of ibandronic acid (12.74%).Conclusions. The presence of OP significantly affects the rehabilitation prognosis and the effectiveness of medical rehabilitation. 23.57% of specialists in the field of rehabilitation medicine prescribe treatment for OP to patients, giving preference to parenteral bisphosphonates, vitamin D, calcium and physical exercises.


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