International Medical Journal, Vol. 27., Iss. 3, 2021, P. 53−59.
MANAGEMENT OF REHABILITATION MEASURES FOR PATIENTS WITH SPINAL CORD INJURY (Part I)
Kharkiv Medical Academy of Postgraduate Education
Ukrainian Scientific and Research Institute of Prosthesis, Construction of an Artificial Limb and Restoration of Work Capacity, Kharkiv, Ukraine
Spinal cord and its injuries are the main problems in neurosurgery, traumatology and neurorehabilitation, that is associated with a big number of complications, concomitant spinal cord injuries, gross functional disorders, resulting in limited self−care and movement, loss of pelvic control and high levels of disability, social and psychological maladaptation of patients. Rehabilitation of patients with spinal cord injuries is relevant, that is associated with an increased frequency of this category of injuries and depends on the basic principles of this process, i.e. the stage and sequence of measures. According to the degree of loss of basic motor functions, there are four stages of motor rehabilitation, which are aimed to maximally compensate the disorders. After studying the motor system and assessing the degree of loss of support and movement functions, the task of each of the rehabilitation and measures stages to address them has been set. The tasks of the first stage were the preparation of functional systems of the body for training loads, physical therapeutic measures were involved. The task of the second stage was to restore the ability of standing and moving using the technical means. The third stage comprised assimilation of walking without devices, its correction, high−quality and quantitative improvement. The condition for this stage is the presence of moderate spastic hemiparesis and mild paraparesis, stable fixation of motor skills, systematic loading of the limbs in a vertical position, which contributes to the development of a spastic reflex of knee closure. The fourth stage is social and labor adaptation. The expediency of a comprehensive approach to the rehabilitation of this category of patients with the involvement of modern training and work equipment creates the preconditions not only for providing them with high−performance support products, but also for their social adaptation.
Key words: spine, spinal cord, rehabilitation, maladaptation, neurosurgery, traumatology.
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