Algorithm for physical rehabilitation of patients with multiple sclerosis: practical experience

Tatyana A. Kuzminova, Yana V. Fedorenko, G. Ivanova, Sergey A. Ryabov, O. Boyko, A. N. Boyko
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Abstract

BACKGROUND: Multiple sclerosis is a pressing problem of modern society and healtcare. The high risk of disability of the able-bodied population, together with the observed trend of increase in morbidity and decrease in the age of onset of the disease, create a number of economic and social difficulties. It is well known that current medical treatment of multiple sclerosis is most effective in reducing the frequency of exacerbations and disability progression, but does not affect the already established residual manifestations, indicators of disability progression objectified by magnetic resonance imaging data. AIM: Evaluation of the effectiveness of using the algorithm for choosing a method of physical rehabilitation, according to the selected models of patients with multiple sclerosis. MATERIALS AND METHODS: The medical histories of patients aged from 31 to 58.8 (average age 48.9±8.6) years who were in hospital treatment were analyzed (n=504; men — 34%, women — 66%), of which 56% had no disability, 11% had disability group I, 25% had disability group II, and 8% had disability group III. RESULTS: An algorithm for working with patients in this category was developed from the perspective of functioning in the categories of the International Classification of Functioning, Disability and Health, and Assessment of Impairments, which is a huge part of the medical rehabilitation protocol for patients with multiple sclerosis. CONCLUSION: The proposed models of patients, including pronounced disorders, make it possible to systematize and standardize the process of rehabilitation measures, improve the quality of provided medical services and provide the population with qualified rehabilitation care.
多发性硬化症患者的物理康复算法:实践经验
背景:多发性硬化症是现代社会和医疗保健领域的一个紧迫问题。健全人群致残风险高,加上发病率呈上升趋势,发病年龄呈下降趋势,给经济和社会带来了诸多困难。众所周知,目前对多发性硬化症的药物治疗最有效的是减少病情加重和残疾进展的频率,但并不影响已经形成的残留表现,即磁共振成像数据所确定的残疾进展指标。目的:根据多发性硬化症患者的选定模型,评估使用算法选择物理康复方法的有效性。材料与方法:对住院治疗的 31 至 58.8 岁(平均年龄为 48.9±8.6)岁患者的病史进行分析(n=504;男性占 34%,女性占 66%),其中 56%无残疾,11%为 I 类残疾,25%为 II 类残疾,8%为 III 类残疾。结果:从《国际功能、残疾和健康分类》和《损伤评估》的功能分类角度出发,制定了与这类患者合作的算法,这是多发性硬化症患者医疗康复方案的重要组成部分。结论:所提出的患者模型(包括明显的障碍)可以使康复措施的过程系统化和标准化,提高所提供医疗服务的质量,并为人们提供合格的康复护理。
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