Российская медицинская академия непрерывного профессионального образования Минздрава России, Москва, Россия
Patients with traumatic amputations of the lower limbs have a number of typical dysfunctions and complications. Optimal results of prosthetics are achieved when the quality of the stump formation corresponds to the capabilities of the prosthesis and an adequate rehabilitation program in terms of goals and objectives. At the same time, the rehabilitation program affects both the quality of the formation of the stump and the functional reserves of the body, which ultimately affects the choice of prosthesis joints. Aim. To clarify the approaches on making up physical rehabilitation programs, taking into account the prevention and correction of complications. Medical rehabilitation expert diagnostics is both the basis in compiling rehabilitation programs, allowing to achieve their personalized nature, and an assessment tool of rehabilitation measures effectiveness. Counseling is an important preparatory part of the rehabilitation program for prosthetics, the theoretical foundations for the prevention of complications for the disabled. Prosthesis manufacturing. When knowing prosthesis manufacturing stages, it is possible to create conditions for the most complete adaptation in the prosthesis-limb-organism system both in the short and long term periods. Preparation of a limb for prosthetics often one of the longest, occupying and significant sections of preparation for the restoration of static-dynamic function, associated with the largest number of complications; where the use of physical rehabilitation technologies allows the prevention and correction of such complications. Preparatory work in accordance with the general algorithm for conducting rehabilitation measures, taking into account the individual characteristics of the patient, the continuity and regularity of rehabilitation measures allows to achieve the greatest possible result. Teaching the use of the prosthesis. Starting from the sequential mastering of all the basic elements with the subsequent transition to performing complex coordinated movements with the help of the prosthesis and only then working out the walking options directly on the prosthesis, allows to master the correct technique from the outset. It means that training to master walking on a prosthesis canalso be represented as a sequence, an algorithm of actions. Stepping away from the required sequence may lead to the appearance and consolidation of irrational patterns when walking, which in turn is fraught with a violation of the correct walking pattern, an increase in its energy intensity and pronounced difficulties in its correction in the future. Conclusion. The complication prevention in the implementation of prosthetics with the help of physical rehabilitation is based primarily on the observance of a clear algorithm of sequential actions in conjunction with an individualized selection of rehabilitation means.
traumatic amputations of the lower limbs, prevention of complications, preventive technologies, therapeutic exercises, walking restoration
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