. As the practice of the Federal Scientific-Clinical Center for Resuscitation and Rehabilitation (FNKC RR) confirms, working with relatives is of paramount importance in the rehabilitation of patients with brain injuries, including those with impaired consciousness, since the main rehabilitation work is carried out in family-home conditions, and In addition, the emotional component of successful rehabilitation of this category of patients is shifted to loved ones. The technology of the School of Relatives involves a combination of collective (training seminars) and individual working methods (consultations of specialists of all profiles, of which the speech therapists consultations are especially important in the face of complex tasks of rehabilitation work). With a competent and systematic approach associated with comprehensive training and subsequent information and consulting support for relatives of the rehabilitated patient, it is possible to achieve significant progress in rehabilitation work, as evidenced by an analysis of the experience of organizing the School of Relatives in the FNKC RR. The introduction of telemedicine tools contributes to increasing the success of the functioning of the School of Relatives, which is important not only in the context of the continuity of interaction between relatives and specialists in ordinary conditions, but also ensuring continuous interaction in the context of restrictions on social contacts, including the provision of various types of medical care, in the context of a new pandemic coronavirus COVID-19.

Among the innovative technologies of medical care for citizens with impaired consciousness, a special place is occupied by the technology of mobile rehabilitation service (MRS), with the help of which a wide range of patients are served at home, and their relatives and friends receive extensive counseling. The practice of the Federal State Budgetary Institution Federal Scientific and Clinical Center for Resuscitation and Rehabilitation indicates the high efficiency of mobile rehabilitation in this category of patients. Positive experience can be developed, incl. due to the use of telemedicine after completion of the main rehabilitation course. The methodology, in which online sessions and consultations are conducted using video conferencing technology, can significantly increase the territorial coverage of MRS patients, and ensure the continuity of rehabilitation. A special place is given to the interaction of a speech therapist with patients and their relatives, in the framework of which the course of medical and social rehabilitation is continuing. It is stated that the use of telemedicine contributes to the development of remote rehabilitation of handicapped patients with impaired consciousness at home. The accumulated experience allows us to recommend the extensive use of a combination of technologies of MPC and telemedicine, thereby greatly expanding the rehabilitation potential of a significant number of patients at home. It seems expedient to scale up and replicate the experience of MRS FNKC RR within the framework of medical rehabilitation institutions in the country, as well as to raise discussion about the possibilities of expanding the practice of distance counseling and receptions to other stages of mobile rehabilitation.

In the last decade, considerable attention has been paid to the development of medical and social services including rehabilitation services, for citizens at home. Particularly noteworthy are patients with impaired consciousness, high-quality rehabilitation and social work with which at home has not been carried out before. According to the research materials, the creation of the Mobile Rehabilitation Service (MRS) in the Federal State Budgetary Institution Federal Scientific and Clinical Center for Reanimatology and Rehabilitation has allowed to accumulate and actively practice the unique innovative experience of mobile rehabilitation of clients with impaired consciousness. The data on the served contingent and the indicators of the effectiveness of the rehabilitation, convincingly confirming the need and high medical and social significance of the innovative technology the mobile rehabilitation service. The experience of MRS FNKC RR seems appropriate to scale and replicate in the framework of medical rehabilitation institutions in the country.

Background: Dysphagia of various origins is widespread. There is a high risk of developing formidable complications: malnutrition, dehydration, weight loss, airway obstruction, aspiration pneumonia. The product Softia S is used to solve the problems of swallowing liquids. The Ministry of Agriculture, Forestry and Fisheries of Japan financed this study within the framework of the 8-Point Cooperation Plan presented by the Prime Minister of Japan S. Abe to the President of the Russian Federation V.V. Putin in May 2016. Aims: assessment of the efficacy and safety of NUTRI's Softia S product for patients with dysphagia of various origins. Materials and methods: Complex assessment of dysphagia included speech therapy, video fluoroscopy and video laryngoscopy with assessment of swallowing function (Rosenbek (PAS) and FEDSS scales). Patients were divided into 2 groups (experiment and control). The study lasted 14 days. Examination by a speech therapist and a nutritionist was carried out daily. On the 1st and 14th days, laboratory parameters were monitored, and the patient's body weight was determined. Results: The study included 30 patients with mild dysphagia. By the end of the study, 8 people in the experimental group showed a restoration of the swallowing function, residual effects in the form of choking persisted in 7 people. In the control group, a slight improvement was observed in 2 patients, 13 had no changes. The most significant changes were found in the experimental group for the indicators "Time of eating " ("Breakfast", on average, 3.7 minutes, P = 0.0033; "Lunch", on average, 6.9 minutes, P0.0001); "The number of chokes after hydration" ("Breakfast" by an average of 7.0, P0.0001; "Lunch" by an average of 8.1, P0.0001; "Dinner" by an average of 6.8, P 0.0001); "The number of chokes during hydration" ("Breakfast" by an average of 8.8, P0.0001; "Lunch" by an average of 12.1, P0.0001; "Dinner" by an average of 8.7, P0.0001). The number of dysphonia cases with sputum significantly decreased only in the experimental group. Conclusions: Softia S can be used in complex therapy for dysphagia by reducing the amount of choking after and during hydration and time of eating and dysphonia cases with sputum.

A clinical example shows the role of a speech therapist in communication between doctors and patients with severe brain damage. An individual approach to the provision of speech therapy to patients in intensive care units significantly increases the effectiveness of rehabilitation.