The pandemic caused by the novel coronavirus infection COVID-19 dramatically increased the burden on healthcare, which led to the repurposing and limitation of the bed stock in rehabilitation centers. That served as the basis for the search for new approaches to the treatment and routing of patients, including using remote-controlled rehabilitation. The aim of the study was to evaluate the effectiveness and safety of motor rehabilitation in patients after hip replacement with the use of telerehabilitation technologies. Materials and methods: In a retrospective study, 32 patients aged 40 to 75 years who underwent rehabilitation after hip replacement using telemedicine technologies were examined. After discharge from the surgical hospital, all patients were offered a link to receive a program of motor rehabilitation, including exercise therapy complexes and a video clip on the technique of performing these exercises. In addition, online classes with a physical therapy instructor were conducted for patients with technical capabilities. The rehabilitation program started from the first day after surgery and lasted 90 days. To assess the effectiveness of rehabilitation, all patients underwent testing, including questionnaires and mobility tests, which were conducted on the second day and 3 months after surgery. Results: Rehabilitation with the use of telemedicine for patients after hip replacement demonstrates a positive clinical effect, assessed by mobility tests (TUG and the 6‑minute walk test), the EQ-5D quality of life scale, the SF-36 questionnaire and State-Trait Anxiety Inventory test. Conclusion: The criteria for patient inclusion developed by us, special physical therapy programs, and a routing model with remote rehabilitation treatment can become an effective alternative to the full-time rehabilitation, in case of paramedical difficulties for its implementation.

Relevance: The effectiveness and validity of rehabilitation after endoprosthetics of the lower limb joints is beyond doubt. However, the workload of operating surgeons and the high demand for rehabilitation hospitals and outpatient care limit the possibility of rehabilitation treatment, which impairs the final result of the operation. Taking into account active development of technologies, the introduction of remote-controlled rehabilitation and online questionnaires to assess the effectiveness of postoperative recovery and the quality of life of patients can be considered a promising direction for the organization of a continuous approach to rehabilitation treatment. The aim of the study was to evaluate the effectiveness of the remote rehabilitation forms and the developed questionnaires to determine the routing of patients after hip replacement. Materials and methods: The retrospective study included 30 patients aged 40 to 75 years after total hip replacement surgery. In the surgical hospital, all patients were offered the opportunity to take a survey according to the questionnaire developed by us in order to determine the group and further routing after surgery. The patients of the main group (n=15) who had the technical capabilities to engage in rehabilitation remotely were offered a link to exercise therapy complexes and a video clip on the technique of performing these exercises; online classes with a physical therapy instructor were also conducted. The rehabilitation program started from the first day after surgery and lasted 90 days. The patients of the control group (n=15) underwent classical rehabilitation in a hospital lasting 10–14 days, after which they were discharged with recommendations for outpatient follow-up. To assess the dynamics and satisfaction with postoperative recovery, all patients underwent remote testing to evaluate the quality of life and psycho-emotional state, which was carried out on the second day and 3 months after surgery. Results. The use of remote rehabilitation methods for patients after hip replacement has a positive clinical effect and is characterized by high satisfaction with the outcomes of postoperative recovery. Remote monitoring of the recovery dynamics and the creation of a database contribute to assessing the effectiveness of the treatment. Conclusion. The developed online questionnaires allow determining further routing of patients for rehabilitation treatment after surgery and evaluating the effectiveness of rehabilitation, including by means of remote rehabilitation methods. In case of paramedical difficulties in conducting full-time rehabilitation, a model of using various forms of remote rehabilitation is proposed.

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BACKGROUND: All over the world, osteoarthritis is a common disease and accounts for 10% of all diseases in the population, and therefore, the frequency of large joint arthroplasty continues to increase, which determines the need to develop new methods of complex treatment in the rehabilitation of patients after arthroplasty operations. AIM: Scientific substantiation of the expediency of the complex use of a stabilometric multifunctional platform with biofeedback and light therapy in patients after arthroplasty of the joints of the lower extremities to improve the quality of life in the late recovery period. MATERIAL AND METHODS: 60 patients were examined three months after total joint replacement of the lower limb at the age of 55 to 75 years. All patients were randomly divided into three groups of 20 people comparable in terms of clinical and functional characteristics. Patients of the main group were exposed to monochromatic polarized incoherent light and underwent physical training using a stabilometric complex with biofeedback COBS (mtd-Systems, Germany), in the comparison group, patients received therapeutic exercises on a stabilometric simulator with biofeedback, patients the control group received only a standard rehabilitation complex and drug therapy, which served as a background in the main group and the comparison group. RESULTS: Prior to the start of treatment, when analyzing the indicators of static and dynamic stabilometric studies, an uneven distribution of the load was established during tests with a preponderance towards the healthy leg. After a course of treatment, patients of all groups showed statistically significant positive results, however, a more pronounced improvement in indicators was observed in patients of the main group, less pronounced, but statistically significant results were obtained in the comparison group, and insignificant positive dynamics was noted in patients of the control group. When studying the quality of life and the effectiveness of treatment according to the EQ-5D questionnaire in the examined patients in the initial state, the indicator averaged 6.60.8 points. After the course of treatment, patients of the main group showed a statistically significant decrease in the scores of the EQ-5D questionnaire from 6.70.9 points in the initial state to 4.20.9 (p 0.001), which lasted up to 6 months. In patients of the comparison group, in all periods of observation, a decrease in the indicator was also noted, but less pronounced, in patients of the control group ― only a positive trend. The findings were supported by the results of the Hospital Anxiety and Depression Scale (HADS). CONCLUSION: The use of a comprehensive rehabilitation program with the inclusion of a stabilometric platform with biofeedback and polarized light "Bioptron" contributes to a marked improvement in the state of balance, balance and coordination abilities of patients, normalization of muscle tone, a significant reduction in anxiety and depression and can significantly improve the quality of life of patients with endoprostheses in the late recovery period.

BACKGROUND: Total knee arthroplasty is one of the most common surgical interventions in the world and the Russian Federation. Endoprosthetics of the knee joint occupies a leading place in the structure of surgical methods for the treatment osteoarthritis. AIM: of the study was to scientifically substantiate the feasibility of the complex use of electrical stimulation and therapeutic exercises in patients after total knee arthroplasty. MATERIALS AND METHODS: We examined 60 patients who were admitted 3 months after TCS and were randomized into 2 groups. In the first group, 30 subjects received electrical stimulation of the quadriceps muscles and underwent therapeutic exercises, for a course of 10 procedures. The subjects of the second group, 30 people, had only physiotherapy exercises. RESULTS: The use of electrotherapy and physiotherapy exercises, in the complex treatment of patients after total knee arthroplasty, improves the function of joint mobility. This is confirmed by the improvement in the functional activity of the operated joint according to the KSS scale (Кnee Society Scores), the improvement in the state of microcirculation and the positive dynamics of the pain syndrome according to the VAS (Visual Analog Scale). The obtained data of the HAQ (Health Assessment Questionnaire) questionnaire testify to the expansion of the possibilities for performing most of the activities in everyday life. However, more statistically significant results were obtained in patients after a course of quadriceps electrical stimulation and therapeutic exercises compared with the use of therapeutic exercises alone. CONCLUSION: The complex of rehabilitation of patients after total knee arthroplasty presented by us, including electrostimulation and therapeutic gymnastics, is scientifically sound, effective and can be implemented into the basic scheme of outpatient and sanatorium treatment of this category of patients.