Medical and Social Expert Evaluation and Rehabilitation

ISSN: 1560-9537 (Print) ISSN: 2412-2092 (Online)

Mediko-Sotsyal’naya Ekspretiza i Reabilitatsiya
Launch Year: 1998
Frequency: 4 issues per year

Subscripition:
«Rospechat» – 47281
«Pressa Rossii» – 27883

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.

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Vol 23, No 4 (2020)

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Экспертиза и реабилитация
Rehabilitation after viral pneumonia, including those caused by coronavirus infection
Mironova-Khodorovich A.Y., Kiseleva E.V.
Abstract

Pneumonia caused by a new type of coronavirus, or coronavirus pneumonia — is a type of acute respiratory infectious disease with a strong degree of infection, widespread, seriously threatening the health and safety of the population.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):4-7
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Results of the study of medical and social consequences of hearing impairment in children with disabilities from the position of the international classification of functioning
Goryainov I.V., Vladimirova O.N., Bondarev S.A., Goryainova M.V.
Abstract

Background. Hearing impairment in children has not only medical, but also social significance, since it significantly affects the communication processes and the development of the child’s speech and can lead to social maladjustment to one degree or another. Aim: to study the functions and life of disabled children with hearing impairment from the perspective of the International Classification of Functioning, Disabilities and Health (ICF). Rehabilitation expert diagnostics and questioning of 181 children were carried out according to a specially developed methodology taking into account ICF domains and the WHO DASH questionnaire of the World Health Organization. As a result of the study, impairments of various functions of varying severity were revealed in children with disabilities, which determines the characteristics of medical and social rehabilitation of this category of patients. Conclusion. A detailed description of the factors affecting the disability of children with hearing impairments makes it possible to develop algorithms for rehabilitation and expert diagnostics and targeted medical and social rehabilitation for the development of a comprehensive rehabilitation system in the constituent entities of the Russian Federation, as well as standard rehabilitation programs in institutions that are direct executors of individual rehabilitation programs and habilitation of disabled children with hearing impairments.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):8-14
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Features of interhospital transportation of patients requiring prosthetics of vital functions (on the example of the federal research and clinical center of intensive care medicine and rehabilitology)
Laykovskaya E.E., Vladimirova O.N., Afonina K.P., Zlokazov A.V., Liubushkina T.L.
Abstract

Background. In the Sverdlovsk Region in 2017–2018, a pilot project was implemented to develop approaches to the formation of a comprehensive rehabilitation and habilitation system for people with disabilities, including children with disabilities. To assess the starting positions of the regional system of rehabilitation and habilitation of disabled people, including disabled children, a SWOT analysis was carried out. Based on its results, platforms have been developed to solve the identified problems: conceptual, regulatory, resource, organizational and technological and digital (information and analytical). Aim: analysis of the results of the formation of a comprehensive rehabilitation and habilitation system based on a comparison of the initial state of the system and its characteristics after transformation within the framework of a pilot project. The work used SWOT analysis. In assessing the results, the method of comparative analysis of the system before the implementation of the change and after the pilot project was used. The results of SWOT analysis of the system of rehabilitation and habilitation of disabled people in the Sverdlovsk region at the beginning of 2017 made it possible to objectify the state of systemic factors influencing the formation of a system of comprehensive rehabilitation and habilitation of disabled people in the region, and to outline the directions of transformation. The final assessment of the system of comprehensive rehabilitation and habilitation of disabled people in the Sverdlovsk region showed an increase in indicators from 7.1 to 8.9 points, which reflects a qualitative shift in the system - from the need to form a regional system (less than 7.2 points) in 2018 to the formation of a system and the need its improvement (from 7.2 to 13 points) in 2019, respectively. Conclusions. Significant positive results have been achieved not only in an increase in the number of organizations participating in the system, in the formation of human resources, but also in an innovative, technological and methodological breakthrough in all areas of rehabilitation, as well as in the formation and establishment of new mechanisms of interdepartmental interaction.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):15-22
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Features of interhospital transportation of patients requiring prosthetics of vital functions (on the example of the federal research and clinical center of intensive care medicine and rehabilitology)
Haritoshkin D.V., Yakovlev A.A., Yakovleva A.V., Loginova T.G., Sidorova E.E.
Abstract

One of the important features of patients in chronic critical illness is their need for prosthetics of vital functions. The provision of specialized medical care to all patients in need is impossible without resolving the issues of transportation to a specialized medical center. Inter-hospital transportation of resuscitated patients is one of the tasks of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology. The greatest difficulty is the transportation of patients with unstable hemodynamics. The transportation service created in the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology is engaged in the development of issues of safe transport, including this category of patients by attracting organizational resources, forming a specialized team and equipping it. Medical and diagnostic, additional assessment of the patient’s condition on the spot. This approach makes it possible to increase the efficiency of intensive care during transportation and to eliminate mortality in this category of patients during transportation. Our experience of inter- and intra-hospital transportation of resuscitation patients was widely discussed at conferences, congresses and today is used in the work of mobile resuscitation teams.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):23-27
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Standartization of medical and social rehabilitation services in perm region
Bronnikov V.A., Skliannaia K.A., Grigoreva M.I.
Abstract

Background. The process of rehabilitation services of disabled people in Russia began in 90s, when National standards (GOSTs) were developed on the basis of ISO international quality standards, however, the issue of the availability of standards is still relevant. The aim: development of approaches to the formation of a system of comprehensive rehabilitation and habilitation of disabled people, including disabled children, in the Perm Region during the implementation of a pilot project in 2017–2018. Materials and methods. During the process of implementation in the Perm region in 2017–2018 a pilot project the group of experts had to implement the methodological materials of the Ministry of Labor of the Russian Federation including standards of rehabilitation and habilitation of disabled children and adults. Two groups of disabled people of working age were selected for testing – one is with motor disorders (n = 21) and other is with mental disorders (n = 25). Evaluation using standardized diagnostic scales was carried out at the beginning and at the end of the rehabilitation course, when each client filled out a client feedback questionnaire, and specialists — a specialist feedback questionnaire. The duration of the rehabilitation course was 21 days. Results. Comparison of the results obtained with the data on the effectiveness of clients’ rehabilitation according to the existing rehabilitation programs showed the advantage of the developed standards, which was expressed by a significant improvement in the assessed indicators, as well as more accurate assessment of the rehabilitation results. Conclusions. The results of the standards development and implementation showed the possibility of creating medical and social services in rehabilitation that would make possible to put into practice the idea of a biopsychosocial model of rehabilitation through the use of the International Classification of Functioning, Disabilities and Health (ICF) as a methodology.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):28-38
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Научный обзор
Orthotics lower limbs in children with spastic forms of cerebral palsy: (literature review)
Dzhomardly E.I., Koltsov A.A.
Abstract

Background. Cerebral palsy (CP) is an important medical and social problem due to the high frequency of childhood disability and a significant prevalence of the disease. One of the features of cerebral palsy is the formation of secondary orthopedic complications, for the correction of which, along with surgery and botulinum therapy, technical rehabilitation devices and orthoses in particular are used.

Aim: To analyze world experience in orthotics in children with cerebral palsy. World literature review in open electronic databases PubMed and Elibrary for the last 30 years. The most of publications focuses on ankle-foot orthoses as the most commonly used in foreign clinical practice. A minimal number of papers cover the problem of orthopedic footwear, despite on its prevalence in Russia. There are no works analyzing the frequency characteristics of orthoses used, including the likelihood of their reuse and rejection. There is no unified, generally accepted terminology and classification of orthoses. We found no articles covering the effectiveness of combined use of several types of orthoses. To date, no clinical guidelines for orthotics in children with cerebral palsy have been developed; therefore, in many cases, orthoses are prescribed empirically.

Conclusion. Thus, further research of the role of orthotics in the medical rehabilitation of children with cerebral palsy appears to be an urgent task.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):39-46
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Medical and social rehabilitation for new coronavirus infection (covid-19). temporal methodological recommendations of the Russian Federation and European countries (literature review)
Lapina E.Y., Yakushev A.A.
Abstract

At the end of 2019, the People’s Republic of China (PRC) faced an outbreak of a new coronavirus infection, the causative agent of which was given the name 2019-nCoV. Subsequently, the World Health Organization (WHO) on February 11, 2020 gave the official name of the infection COVID-19 (Coronavirus disease 2019). The International Committee for Taxonomy of Viruses has named the causative agent SARS-CoV-2. The virus quickly spread throughout the world and acquired the status of an epidemic. It was necessary to develop algorithms for rapid diagnosis, provision of specialized medical care, as well as rehabilitation and prevention of recurrence. At the moment, all data is accumulated in real time. And the information on rehabilitation and prevention of re-infection is completely minimal.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):47-52
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Практическому врачу
Features of the organization of complex medical and social rehabilitation of patients with diabetes in the rehabilitation center
Syrnikova B.A., Storozhenko D.V., Storozhenko E.E., Temirov K.V., Sokolov G.E., Nekrasov I.O., Puzin S.S.
Abstract

The prevalence of diabetes is high and continues to grow. Patients with diabetes make up 3.12% of the population of Russian Federation. Economic losses from diabetes accounted for 1.8% of the world’s gross domestic product. There are no effective treatments for diabetes. The goals of patient care are control homeostasis indicators and prevent complications. The Russian Federation has created a multi-level system of care for patients with diabetes. Social protection institutions take part in comprehensive rehabilitation of patients with diabetes. In 2015–2019 years the state budgetary institution of the city of Moscow “Scientific and practical rehabilitation center” conducted inpatient rehabilitation of 10.4 thousand disabled people. The prevalence of diabetes among them was 19.5%. Rehabilitation of patients with diabetes in the rehabilitation center has a number of features: planned nature, the possibility of individual and group work of doctors with patients, the state of physical and psychological comfort of patients, the use of climate therapy.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):53-57
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Technology of early intervention in a preventionof chilfren disability in perm region
Bronnikov V.A., Grigoreva M.I., Serebryakova V.J.
Abstract

This article is devoted to the development of early intervention in the Perm region as a measure for the prevention of child disability in the system of complex rehabilitation and habilitation of disabled people (disabled children). The article presents the level of disability among the child population in modern Russia; the theoretical and methodological foundations of the provision of early comprehensive intervention to children with special needs and their families are considered; the relevance of the development of early intervention at the federal and regional levels as a strategically significant area of modern social policy in the country, the creation of a unified system of early intervention, taking into account the characteristics of the regions of the country. The authors presented results of the study reflect the experience of organizing an early intervention service in the system of comprehensive rehabilitation and habilitation of disabled people (disabled children) in the Perm region over the past few years. The early intervention system in the Perm region is constructed at three levels. At the macro level, the activity of the region is analyzed within the framework of the implementation of the Pilot Project to develop approaches to the formation of a system of comprehensive rehabilitation and habilitation of disabled people; the specifics and content of the created mechanisms of interdepartmental interaction are disclosed; the problems and prospects of their implementation are identified, the experience of organizing early intervention as a public service is studied. At the meso-level, the structure of early intervention services created at institutions of various departmental affiliations is presented; disclosed the activities of the early intervention service, created at the departments of social service institutions of the Perm region; describes the procedure for providing early intervention services to children and their families. The provision of early intervention services to a child and his family is presented as a micro level; disclosed the content of early intervention technology in the early intervention service; describes the stages of providing early intervention services, forms and methods of work used. The prospects for the development of early assistance in social service institutions, new forms of providing early intervention services in modern conditions are determined.

Medical and Social Expert Evaluation and Rehabilitation. 2020;23(4):58-67
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