Review article

Special Features in Physical Rehabilitation Program Compiling during Primary Prosthetics in Patients with Traumatic Amputation of the Lower Limb

1,2 ORCIDDenis D. Bolotov

1 Federal Bureau of Medical and Social Expertise, Moscow, Russian Federation
2 Russian Medical Academy of Continuing Professional Education, Moscow, Russian Federation


Abstract:

Patients with traumatic amputations of the lower limbs have a number of typical dysfunctions and complications. Optimal results ofprosthetics are achieved when the quality of the stump formation corresponds to the capabilities of the prosthesis and an adequaterehabilitation program in terms of goals and objectives. At the same time, the rehabilitation program affects both the quality of theformation 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 ofcomplications.Medical rehabilitation expert diagnostics is both the basis in compiling rehabilitation programs, allowing to achieve their personalizednature, and an assessment tool of rehabilitation measures effectiveness. Counseling is an important preparatory part of therehabilitation 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 completeadaptation in the prosthesis-limb-organism system both in the short and long term periods. Preparation of a limb for prosthetics oftenone of the longest, occupying and significant sections of preparation for the restoration of static-dynamic function, associated with thelargest number of complications; where the use of physical rehabilitation technologies allows the prevention and correction of suchcomplications. Preparatory work in accordance with the general algorithm for conducting rehabilitation measures, taking into accountthe individual characteristics of the patient, the continuity and regularity of rehabilitation measures allows to achieve the greatestpossible result.Teaching the use of the prosthesis. Starting from the sequential mastering of all the basic elements with the subsequent transition toperforming complex coordinated movements with the help of the prosthesis and only then working out the walking options directlyon 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 andconsolidation of irrational patterns when walking, which in turn is fraught with a violation of the correct walking pattern, an increase inits 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 primarilyon the observance of a clear algorithm of sequential actions in conjunction with an individualized selection of rehabilitation means.

Keywords: traumatic amputations of the lower limbs, prevention of complications, preventive technologies, therapeutic exercises, walking restoration

For citation: Bolotov D.D. Special Features in Physical Rehabilitation Program Compiling during Primary Prosthetics in Patients with Traumatic Amputation of the Lower Limb. Bulletin of Rehabilitation Medicine. 2022; 21(2): 27-36. https://doi.org/10.38025/2078-1962-2022-21-2-27-36



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