Medical and Social Expert Evaluation and Rehabilitation

Peer-review quarterly medical journal.


Journal founders

  • Izdatelstvo "Meditsyna"
  • Eco-Vector Publishing Group



The journal is intended for practitioners and specialists involved in disability issues.

It covers the following topics:

  • theoretical and practical aspects of prevention and prevalence of disability;
  • medical and social evaluation;
  • medical, vocational, and social rehabilitation of people with disabilities;
  • legal, regulatory, and economic issues relating to disability;
  • the training of, and refresher courses for, specialists from institutions for medical and social evaluation;
  • and rehabilitation of people with disabilities.

The journal disseminates information on the current state and future of Russia’s social policy for people with disabilities, the practices of Russian regional and territorial agencies working in the field of social protection, and modern approaches to solving the problems of disabled people in other countries. Special attention is devoted to original research focused on new promising methods of diagnosis and treatment of disabling conditions.

Types of accepted articles

  • reviews
  • systematic reviews and metaanalyses
  • original research
  • clinical case reports and series
  • letters to the editor
  • short communications
  • clinical practice guidelines


  • in English and Russian
  • quarterly, 4 issues per year
  • continuously in Online First
  • with Article Submission Charge (ASC)
  • distribution in hybrid mode - by subscription and/or Open Access
    (OA articles with the Creative Commons Attribution 4.0 International License (CC BY-NC-ND 4.0))


  • Russian Science Citation Index (Web of Science)
  • Russian Science Electronic Library (
  • Google Scholar
  • Ulrich's Periodicals directory
  • WorldCat
  • Crossref


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Vol 25, No 4 (2022)

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Assessment of disturbed functions in patients with chronic heart failure using International classification of functioning ICF categories
Stolov S.V., Makarova O.V., Vladimirova O.N., Privalov K.A.

BACKGROUND: The evaluation of impaired functions in patients with cardiac diseases is traditionally based on the clinical signs of the disease and instrumental hemodynamic parameters, without affecting all other disorders that occur with this pathology. The International classification of functioning is based on the functioning of the patient in his/her environment; therefore, a consistent assessment of the entire complex of impaired functions of the patient is appropriate, allowing for a more accurate formulation of the goals of rehabilitation and controlling the main stages of rehabilitation.

AIM: To evaluate the International classification of functioning for assessing all impaired functions in patients with chronic heart failure.

MATERIALS AND METHODS: The study included 68 patients with decompensated chronic heart failure. The analyzed sample included patients with chronic heart failure stages 2B and 3 (NYHA classes III–IV). The average patient age was 63.9 years, and the average disease duration was approximately 7 years. The sample was predominantly men (66.5%). The etiology of chronic heart failure was represented by uncontrolled arterial hypertension (92%), post-infarction cardiosclerosis (74%), ischemic cardiomyopathy (25%), and chronic obstructive pulmonary disease (12%). Radiation diagnostic methods were used to confirm the severity of cardiac decompensation. The study assessed impaired functions in accordance with the domains of the International classification of functioning, mainly in “functions of the cardiovascular system”.

RESULTS: In this study, 68 patients had decompensated chronic heart failure stages 2B and 3 (NYHA classes III–IV). Group 1 included 40 patients, and group 2 included 28 patients. The instrumental examination revealed a more pronounced decrease in left-ventricular ejection fraction in group 1 compared with group 2 (42.8±4.4 and 49.2±5.6, respectively), showing a significant difference (p <0.05). Other hemodynamic parameters did not differ significantly in the groups. In the analysis of a basic set of the International classification of functioning domains for patients with chronic heart failure, the following domains turned out to be the most significant: heart function (b410), forced myocardial contraction (b4102); heart rate (b4100); blood supply to the heart (b4103); blood pressure functions (b420): increase (b4200), decrease (b4201), maintenance (b4202); functions of the respiratory system (b440) including the “respiratory rate” (b4400); additional functions and sensations from the cardiovascular and respiratory systems (b450-469); exercise tolerance functions (b455); water balance (b5450), including “water retention” (b45500), characterizing the presence of edematous syndrome; and muscle strength functions (b730). The indicated domains were also supplemented with Section d (activity and participation) — walking long distances (d4501) and doing housework (d640); and Domain e (environmental factors), i.e., help from the next of kin (e310).

CONCLUSIONS: A set of domains of the International classification of functioning for patients with decompensated heart failure has been developed and proposed, which makes it possible to more effectively identify the key problems of people with disability and more objectively form a plan for complex rehabilitation, which largely determines the prognosis in these patients.

Medical and Social Expert Evaluation and Rehabilitation. 2022;25(4):211-218
pages 211-218 views
Profile of a disabled person with HIV/AIDS 18 years and older from the standpoint of the International Classification of Functioning
Ugleva E.M.

The spread of HIV infection continues not only in the Russian Federation, but throughout the world. With the onset of secondary lesions in HIV infection, patients develop persistent dysfunctions of various organs and body systems, leading to a limitation in the main categories. The International Classification of Functioning and Disabilities and Health ICF, as a tool for describing the life of an individual, is gradually being introduced into medical practice, most often used to assess the effectiveness of the rehabilitation process. By now HIV infection/AIDS does not have a basic comprehensive description in terms of the ICF. The authors, in the article, provide an analysis of the existing problems from the standpoint of the ICF in patients and disabled people with HIV infection/AIDS. As a result of the analysis, the authors propose a set of domains that correspond to the most common disorders in patients and disabled people with HIV infection and characterize limitations in daily activities (self-service and domestic life) and in the main areas of life (education, work and employment).

Medical and Social Expert Evaluation and Rehabilitation. 2022;25(4):219-229
pages 219-229 views
Using the International classification of functioning, disability and health to describe children with Down syndrome
Kolcheva J.A., Nepomnyashchaya S.A., Adrianov A.V.

BACKGROUND: Down syndrome is a widespread, but still insufficiently studied genetic pathology, leading to early disability of the child population.

Complex habilitation using transcranial micropolarization according to the method of N.Yu. Kozhushko can effectively compensate for impaired cerebral functions. The article deals with the question of the expediency and relevance of the application of the International classification of functioning, disability and health ICF in the complex habilitation in Down syndrome in children, as an international language intended for a comprehensive description of the components of human health.

AIMS: studding the possibilities of transcranial micropolarization in the correction of neurological deficit in children with Down syndrome based on the principles of the ICF, designed to comprehensively describe the biopsychosocial status of a child.

MATERIAL AND METHODS: The study involved patients (n=55) with Down syndrome aged 3 to 5 years without severe concomitant decompensated pathology from other organs and systems. All cases of the disease were genetically confirmed: all had complete trisomy on the 21st chromosome. The main group included 40 children, the control group — 15. In addition to the complex psychological and speech therapy support, the habilitation program for the children of the main group included the method of transcranial micropolarization according to the method of N.Yu. Kozhushko, the use of which can significantly improve the existing cerebral dysfunction in Down syndrome. All children were categorical ICF profiles, taking into account the most sensitive and informative in this disease.

RESULTS: According to the results of testing on a 10-point scale for assessing speech function, 6 months after the procedures, there was a significant improvement in the indicators of expressive and impressive speech, speech attention, as well as positive dynamics in the formation and improvement of neatness skills.

At the same time, the ICF made it possible to form a categorical profile of a child with Down syndrome, visually assess the influence of environmental and personal factors in each specific case, objectify changes in health disorders during habilitation, which is especially important in assessing the patient’s condition, developing a treatment plan, and analyzing the results obtained.

CONCLUSIONS: The method of transcranial micropolarization adapted by N.Yu. Kozhushko, can be recommended for complex habilitation for patients with Down syndrome. The use of the ICF for a comprehensive assessment of the functioning of a child with a hereditary disease makes it possible to take into account the strengths and weaknesses of the individual, correct environmental factors, which is especially important in achieving results in hereditary diseases accompanied by cerebral deficiency.

Medical and Social Expert Evaluation and Rehabilitation. 2022;25(4):231-239
pages 231-239 views
To the question of the relevance of the organization of comprehensive rehabilitation of adolescents in difficult life situation
Karpatenkova O.V., Karasaeva L.A., Goryainova M.V.

BACKGROUND: The relevance of the study is determined by the high number of crimes committed by minors. including serious and especially serious, the need for timely medical, social and psychological rehabilitation of children with deviant behavior. The purpose of the study: to form the main directions of the comprehensive rehabilitation of adolescents who find themselves in a difficult life situation and are in the Center for the temporary detention of juvenile offenders based on the study and analysis of the medical and social parameters of their life.

MATERIALS AND METHODS: The materials and methods of the study included a statistical analysis of the results of medical and social indicators of 204 adolescents who were in the Temporary Detention Center for Juvenile Offenders in St. Petersburg and the Leningrad Region at the age of 14 to 18 years.

RESULTS: Among juvenile offenders, males prevailed (76.0%), aged 16 to 18 years (58.0%) and 14 to 15 years (42.0%), brought up in relatives, complete (45.7%) or incomplete (39.2%) families. The majority (72.0%) of adolescents presented neurological complaints in the form of: sleep and wakefulness disorders (22.2%); abdominal and headaches (14.8% and 11.1%, respectively), tremor (14.8%) people, periodic palpitations (4.7%), seizures (11.1%), back pain (3.7%). Acute injuries were stated in 88.9% of cases, poisoning — in 55.6%, panic attacks — in 33.3%, episodes of uncontrolled aggression occurred in 18.5%, suicides — in 7.4% of adolescents, syncope — in 3.7%.

CONCLUSION: Based on the analysis, a comprehensive program for the rehabilitation of juvenile offenders has been drawn up and is being implemented, including medical, psychological and pedagogical measures, socio-cultural and environmental rehabilitation. This methodological approach made it possible to form groups of adolescents with their active involvement in the rehabilitation process and increasing motivation for social adaptation.

Medical and Social Expert Evaluation and Rehabilitation. 2022;25(4):241-248
pages 241-248 views
Medical and sociological research of persons elderly and senior age receiving medical and social assistance in stationary conditions and at home
Karasaeva L.A., Timerbulatov I.F., Kondratyeva J.E., Puzin S.S.

BACKGROUND: Assessment of the need for medical and social and long-term care for elderly and senile people serves as the basis for improving organizational approaches to improve the quality of medical and social services provided.

AIMS: Determination of the needs of elderly and senile people in the provision of medical and social assistance.

MATERIALS AND METHODS: For the study, a representative selective set of 400 elderly respondents is determined, of which 280 (70.0%) respondents lived at home (I group) and 120 (30.0%) — under the stationary conditions of the gerontological center (II group). The study was conducted by interviewing based on a specially designed questionnaire and «Loneliness» by Svetlana G. Korchagina. Statistical processing of the received data was carried out using the Microsoft Office Excel 2013 and statistical package Statistica 12.

RESULTS: The average age of the respondents was 72.9±7.96 years (p >0.05). The presence of polymorbidity was noted by every third respondent (33.0%), of which 2–3 diseases had 26.0%, 4 or more — 7.0%, with a prevalence in the structure of the incidence of diseases of the cardiovascular system. 53.0% of people are in need for medical and social home care. 31.0% of people were satisfied with medical care, 41.0% of people consider social assistance available. A high prevalence of the state of loneliness in elderly and senile people was established: 94.0% in group I, 99.0% in group II, with a progressive increase in the rate as the age of the elderly increases.

CONCLUSIONS: With increasing age, the subjective self-assessment of health worsens, associated with an increase in polymorbidity (mainly age-associated diseases) and the presence of disability; the decrease in the possibility of self-care increases the need for the elderly for assistance and care. The high prevalence of self-assessment of «loneliness» among the elderly and senile causes an increased need for older people in psycho-corrective measures.

Medical and Social Expert Evaluation and Rehabilitation. 2022;25(4):249-257
pages 249-257 views
Algorithm for the classification of phases and stages of sleep in patients with chronic disorders of consciousness based on logical artificial intelligence
Nekrasova Y.Y., Borisov I.V., Kanarsky M.M., Pradhan P., Mayorova L.A., Redkin I.V., Sorokina V.S.

BACKGROUND: The analysis of sleep patterns in patients with chronic disorders of consciousness is attracting increasing attention in terms of diagnosis, prognosis, and treatment of severe brain damage. The study describes a software package based on an artificial intelligence (AI) expert system designed to classify the phases and stages of sleep, taking into account the characteristics of impaired cortical rhythm in such patients.

AIM: To develop a specialized AI-based software package focused on patients with chronic impairment of consciousness for automatic classification of sleep phases and stages, with an emphasis on identifying sleep spindles and non-rapid eye movement (REM) and REM sleep phases.

MATERIALS AND METHODS: To ensure the correct operation of the software package, receiver operating characteristic (ROC) curves were analyzed considering the binary classification of slow sleep, REM sleep, and wakefulness.

RESULTS: The average sensitivity and specificity of the algorithm were 87.9 and 70.1, respectively. The average area under the ROC curve was 0.790. The algorithm for determining the REM phase demonstrates low specificity with high sensitivity, and its graph was similar to that of wakefulness, as well as the irregularity of the presence of REMs in the REM sleep phase in patients with CNS and the frequent presence of nystagmus in the waking state. Information about the presence of nystagmus, entered at the start of the program, allowed us to slightly increase the efficiency of the algorithm; however, this aspect probably needs further improvement.

CONCLUSION: A software package that takes into account the features of electroencephalography of patients with chronic disorders of consciousness and analyzes sleep and wakefulness automatically is not only useful as a diagnostic tool for neurologists and somnologists but also contributes to a wider dissemination of this technique in clinical practice.

Medical and Social Expert Evaluation and Rehabilitation. 2022;25(4):259-270
pages 259-270 views

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