Currently, shoulder arthroplasty is being actively introduced into surgical practice, indications for operations are expanding, and the number of patients operated with severe injuries and diseases of the proximal humerus and shoulder joint is growing. The decrease in the effectiveness of restoring the painless functioning of shoulder, household independence and quality of life of patients after surgery may be due not only to the severity of damage to the shoulders joint structures of the before surgery, shortcomings in surgical techniques and the development of postoperative complications, but, possibly, the imperfection of medical rehabilitation programs for these patients. To date, the content of the rehabilitation protocol for the early postoperative period has not been sufficiently substantiated, the need for strict immobilization of the operated joint, as well as the long-term benefits and effectiveness of early rehabilitation remains unclear. The article attempts to summarize the available data on the physical rehabilitation of patients after shoulder joint replacement with various types of endoprostheses in the early and late postoperative periods.

BACKGROUND: Over the past years, injuries have been consistently included in the first seven leading classes in the structure of general morbidity, and in the distribution of the number of people aged 18 years and over who were first recognized as disabled, they are included in the first six causes of disability. AIM: to study the clinical efficacy and safety of the author's technique, in patients after injuries of the lower and upper extremities at the second stage of medical rehabilitation. MATERIALS AND METHODS: The study included 105 patients who had suffered injuries. 37 (35.2%) men, 68 (64.8%) women. The patients were randomly divided into 2 observation groups: the main group (n=53), whose patients, in addition to the standard rehabilitation program, were trained on the biofeedback simulator Tergumed Pegasus 3D (Germany), a course of 710 procedures, and the control group (n=52), whose patients underwent a course of medical rehabilitation only according to the standard program of the 2nd stage, lasting 1014 days. The complex rehabilitation treatment of patients included standard drug therapy, massage courses, physiotherapy, group exercise therapy. Treatment outcomes were assessed using the VAS (Visual Analog Scale), HAQ (Health Assessment Questionnaire), Lequesne index, and 20-m walking time scales. Data analysis included comparison of dependent series of variables and descriptive statistics methods. The type of data distribution (parametric or nonparametric) was assessed using the ShapiroWilk and KolmogorovSmirnov tests. The statistical significance of differences between dependent groups was assessed using the Wilcoxon and MannWhitney tests. The value of p=0.05 was taken as the level of statistical significance. RESULTS: All measured indicators improved significantly (p 0.001). In the main group, compared with the control group, there was a statistically significant increase in walking speed, and there was a tendency to a more pronounced positive change in the Lequesne and HAQ indices, the level of pain according to VAS, compared with the control group. CONCLUSION: Our proposed method of training with the participation of antigravity muscles trunk is effective for patients after limb injuries at the 2nd stage of medical rehabilitation.