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A definition as stated by the American Academy of Physical Medicine and Rehabilitation in 1975 is: "Medical rehabilitation services can be defined as a coordinated multi - disciplinary approach to disability under a qualified physician who directs a plan of management for one or more of the categories of chronic disabling diseases or injuries, specifying realistic goals for maximal recovery". The Main rehabilitation principles include patient and family centeredness, a multidisciplinary approach and holistic attitude towards physical and mental health. From early in its development and until today, rehabilitation is represented as the third phase of medical care - after diagnosis and treatment. Physical and Rehabilitation Medicine (PRM) is a growing and a developing discipline. Gutenbrunner et al wrote: "Various societal and medical trends, including the ageing of populations, the increasing number of people with functional limitations due to improving survival rates in different disease entities (e.g. stroke, spinal cord injury, multiple trauma) and the need of elderly workers to remain integrated in the workforce despite the presence of chronic illnesses, call for an increasing importance of rehabilitation in the future".

The advances of modern medicine, prolonging the average life-span, and especially the recognition of medical rehabilitation as a vital part of the medical process, have created rapid development in the field among most of the countries worldwide. The dynamic process of the development in the fields of medical rehabilitation in Russian healthcare, has brought up questions about different outlooks, principles and processes of quality assessment in medical rehabilitation. Taking into consideration the differences in the organizational structures and professional tendencies applying the indicators of quality into rehabilitation practice can prove to be challenging. In the last years the Israeli health system has gained much experience working with different rehabilitation structures. The Obligatory State Insurance of the Israeli health system forced Health Funds to developed optimal indicators for the evaluation of the professional quality in rehabilitation. The accumulated knowledge can help in creating a system for the quality assessment in Russian Federation. Rehabilitation is characterized by a long list of professional performance aspects which are exposed to quality control. That is why it is common to define indicators separately for the structures, processes, and results. In different countries dissimilar aspect of quality are defined as indicators, but all of them are built on similar principles which focus on the simplicity and objectiveness of information gathering, minimal dependency on the character of the auditor, combining different forms of internal and external examination, and including systems of quality control by gathering questionnaires from the patients and their family members. The chosen quality indicators of the rehabilitation process need to reflect on the different sides of the professional treatment, stimulating a constant increase in quality on account of organizational activities in the industry in general and in separate departments in particular. The International Classification of Functioning (ICF) is widespread over many countries and constitutes the accepted paradigm in the field of medical rehabilitation, and with time may become the optimal platform for developing a system of quality control worldwide.

Background/Aims Diabetic patients with peripheral vascular manifestations often develop foot ulcers and sometimes have to undergo lower extremity amputation. This retrospective study investigated leg dominance and laterality of lower extremity amputation in diabetic, dysvascular amputees. Methods All patients who met the inclusion criteria had their medical records reviewed for their dominant side and a correlation with a side of amputation was analysed. This information is routinely obtained as part of the admission history. For the literature review, PubMed, Google Scholar, ScienceDirect and Cochrane Library were searched with no date restriction until February 2018. Relevant studies were included and analysed. Results Of all the patients (n=27), 16 had diabetes and of these, 12 (75%) had their dominant leg amputated. Conclusions The data and literature analysis suggest that diabetic, dysvascular patients' dominant legs may be at higher risk for amputation than the non-dominant side. Larger studies are needed to clarify the relationship between leg dominance and laterality of lower extremity amputation.

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