Vol 18, No 2.1 (2016)



Ivanova G.E.


Одним из приоритетных проектов в области здравоохранения является развитие медицинской реабилитации как органичной составляющей оказания первичной, специализированной, в том числе высокотехнологичной, медицинской помощи.
Consilium Medicum. 2016;18(2.1):8
pages 8 views

Medical rehabilitation in Russia. Development prospects

Ivanova G.E.


The paper presents the basic concept of the development of medical rehabilitation in the Russian Federation, the main documents regulating the work of medical rehabilitation of the subjects of the Russian Federation, the purpose, objectives, principles, target indicators, separation of powers of public health officials and health care organizations that provide health care. The model of development of medical rehabilitation.
Consilium Medicum. 2016;18(2.1):9-13
pages 9-13 views

The biopsychosocial model of the patient stroke: the role of environmental factors in rehabilitation

Shmonin A.A., Maltseva M.N., Melnikova E.V., Ivanova G.E.


The article describes the biopsychosocial model of stroke. The advantages of this model are evidence. In the article,we demonstrate the importance of environmental factors that determine the activity and participation. As the tool is proposed to use the international classification of functioning for the implementation of the biopsychosocial model of stroke (ICF). We present a set of the most important domains of ICF, which are used in the rehabilitation of stroke patients.
Consilium Medicum. 2016;18(2.1):14-19
pages 14-19 views

Medication support of the rehabilitation process in acute cerebral circulatory disorders

Ivanova G.E., Melnikova E.V., Shmonin A.A., Shamalov N.A., Stakhovskaya L.V., Meshkova K.S.


The article is a review of medical support in the rehabilitation process. The main groups of drugs used in rehabilitation: secondary prevention, neuroprotection, treatment of anxiety and depression, spasticity therapy, cognitive impairment, pain, thrombolysis. Multidisciplinary rehabilitation team can increase the effectiveness of drug therapy.
Consilium Medicum. 2016;18(2.1):20-24
pages 20-24 views

The basic principles of managing the patients with impaired tone after focal brain damage

Khatkova S.E., Orlova O.R., Botsina A.Y., Shikhkerimov R.K., Kovalenko A.P.


According to current data, not less than 1/3 of patients with focal brain injury, stroke, or traumatic brain injury, early in the recovery period of the disease is formed by focal or multifocal spasticity. This syndrome is significantly impairs vital functions of patients, limiting active and passive limb motor function, the possibility of rehabilitation, causing pain. Today, the specific treatment for focal or multifocal spasticity having a high level and the class of evidence is Botulinum, which is a regular injection of botulinum toxin type A into the muscles that shape an individual spastic pattern. Botulinum should be included in the complex of programs for the rehabilitation of patients with focal brain damage.
Consilium Medicum. 2016;18(2.1):25-33
pages 25-33 views

Cognitive disorders in medical rehabilitation

Krasnov V.S., Shmonin A.A., Maltseva M.N., Melnikova E.V., Ivanova G.E.


The article is a review of the literature on the role of cognitive impairment (CI) in patients receiving rehabilitation. Cognitive disorders are a common type of problem in patients with different pathologies. The article presents the main causes of CI, discusses the differential diagnosis between CI is impaired function or activity limitation and participation. That is, discussing the possibility of working with CI using the International Classification of Functioning. The article provides rules and guidelines for communicating with patients having CI.
Consilium Medicum. 2016;18(2.1):34-38
pages 34-38 views

The multidisciplinary approach in treatment of the poststroke cognitive impairments

Prokopenko S.V., Mozheyko E.Y., Koryagina T.D., Bezdenezhnih A.F., Shvetsova I.N., Dyadyuk T.V., Anay ool T.S.


The analysis of own research data and modern domestic and foreign publications devoted to multidisciplinary rehabilitation of cognitive impairment after a stroke was the purpose of the work. There are definitions of the poststroke cognitive impairments and vascular cognitive impairments and vascular dementia are formulated in present article, modern data on diagnostics of the cognitive impairments including which are followed by speech pathology are provided. Data of the neuropsychological status, the most characteristic for the poststroke of cognitive impairments are provided. The modern principles and methods of impact on poststroke cognitive deficiency, including medicinal therapy and methods of cognitive rehabilitation are covered in the section treatment.
Consilium Medicum. 2016;18(2.1):39-44
pages 39-44 views

Urinary dysfunction in patients with cervical spinal cord injury

Salukov R.V., Kolmakov A.S.


Cervical spinal cord injury (CSCI) is characterized by severe motor and sensory impairments and pelvic organs dysfunction, among which urinary dysfunction (UD) has a special place. The pathogenesis of UD associated with impaired communication between spinal and pontine micturition centers. The article presents the experience of observation of 112 patients with CSCI in the medical center of the III rehabilitation phase. The duration of observation ranged from 3 to 7 years. All patients passed complex urological examination every 1-2 years. Despite of the same level of SCI, clinical picture of urination disorders was different. Neurogenic detrusor overactivity was found in 55 (49.2%) of patients; 46 (41.2%) patients had a detrusor-sphincter dyssynergia with different degrees of voiding dysfunction; 8 (7.1%) patients had voluntary micturition; 3 (2.7%) patients had decreased urinary bladder capacity. The examination included urodynamic study and radiological examination; 83 (74.1%) patients had a stable clinical picture of urination disorders in the first year after the injury. The aim of urological rehabilitation included reduction and prevention of high detrusor pressure, adequate emptying of the bladder by periodic clean intermittent catheterization, prevention and treatment of urinary tract infection. The main criterion for the effectiveness of urological rehabilitation was improvement of quality of life, which was observed in 83% cases. Thereby, patients with cervical spinal cord injury require regular urological rehabilitation, which includes not only correction of urinary dysfunction but also monitoring and prevention of urological complications.
Consilium Medicum. 2016;18(2.1):45-47
pages 45-47 views

Metabolic control and nutritional support in the rehabilitation of patients with ITP syndrome

Leiderman I.N., Belkin A.A., Rakhimov R.T., Davydova N.S.


Development of critical care medicine s has led not only to improve the results of treatment of patients in the intensive care units, but also gave rise to new pathological syndromes, namely,PICS-post intensive care syndrome. One of the most important components of this syndrome is a protein-energy malnutrition.Hypercatabolism, hypermetabolism, inadequate support nutitivnaya lead to the formation of severe hospital malnutrition.Severe weight loss, muscle massdepletion in a patient with PICS syndrome violate the processes of recovery after critical illness.Implementation of metabolic control in terms of early recovery makes it possible to more reliably estimate the true energy of the patient to mobilize that allows adequate nutritional support. Metabolic monitoring can be considered as a method of monitoring the mobilization of the patient endurance, along with Doppler and hemodynamic monitoring. Conducting nutritional support (enteral nutrition), given the increasing energy needs of the patient during rehabilitation procedures to determine the target level of energy needed to achieve the targets of rehabilitation in patients with PICS syndrome.
Consilium Medicum. 2016;18(2.1):48-52
pages 48-52 views

The basic feeding principles in cases of neurogenic dysphagia

Avdyunina I.A., Grechko A.V., Bruno E.V.


The basic principles of feeding arrangement for patients with neurogenic dysphagia which provide safe and effective intake of food and fluid are discussed: diet modification; thickening of fluids; modification of eating behaviour, including compensatory techniques; artificial accesses for fluid and nutrients delivery.
Consilium Medicum. 2016;18(2.1):53-58
pages 53-58 views

Occupational therapy for rehabilitation of neurological patients

Maltseva M.N., Shmonin A.A., Melnikova E.V., Ivanova G.E.


The article gives a general idea of occupational therapy. Occupational therapy - is an interdisciplinary method of normalization of the patient's life. Occupational therapists analyze activity and violations of patient involvement, environmental factors impact on his daily life, using the patient's daily activities for rehabilitation or adaptation. Occupational therapy can be applied at all stages of rehabilitation.
Consilium Medicum. 2016;18(2.1):59-60
pages 59-60 views

Vertigo in peripheral vestibular disorders: etiology, diagnosis and management

Guseva A.L., Levina Y.V.


The most common peripheral vestibular disorders, followed by vertigo, are summarized in the article. The pathophysiologic mechanisms, diagnosis and treatment of benign paroxysmal positional vertigo, Ménière's disease and vestibular neuritis are thoroughly described. Acute management and further rehabilitation procedures in case of these vestibular disorders are analyzed.
Consilium Medicum. 2016;18(2.1):61-67
pages 61-67 views

Clinical and psychological diagnosis and clinico-psychological rehabilitation of patients with memory impairments in cerebral injuries

Akhutina T.V., Varako N.A., Zinchenko I.P., Krotkova O.A., Mikadze Y.V., Fufaeva E.V.


Участие в реабилитационной работе и оценка различных параметров психической деятельности в связи с проводимым лечением и восстановительными мероприятиями относятся к числу основополагающих практических задач, которые призваны решать медицинские психологи в клинике в соответствии с действующими не только в нашей стране, но и во всем мире профессиональными стандартами. Участие в решении этих задач отвечает запросам, формулируемым со стороны практической медицины. Достижение целей реабилитации и решение поставленных задач предполагают необходимость учета ряда методологических принципов, соблюдение которых и обеспечивает возможность удерживать в фокусе внимания как когнитивную сферу пациента, так и его личность, его индивидуально-типологические особенности, ценностно-смысловые образования и комплекс отношений: к себе, болезни, окружающему миру. Все сказанное с необходимостью предполагает разработку системы реабилитации, соответствующей требованиям, выдвигаемым современной наукой и направленным на формирование у пациентов сознательного и активного участия в реабилитационных мероприятиях.
Consilium Medicum. 2016;18(2.1):68-81
pages 68-81 views

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