Purpose: to investigate the dynamics of restoration of the amplitude of motion in the ankle joint, the quality of life and to assess the effects of the breakdown of the Achilles tendon. Material: patients (n=59, of which n=30-the main group and n=29-the control group) were examined at 4, 8 and 16 weeks after surgery. Indicators registered with the help of: goniometry; the Achilles tendon Total Rupture Score; the scale of an assessment of consequences and results of Leppilahti implications. Results: the decrease of the total amplitude of the motion in the ankle joint takes place due to the deficiency of the amplitude of the dorsal flexion. At the end of the study the dorsal flexion rates were significantly better among the patients of main group. In particular, its deficit was 3.2 ± 1.85° in the main group and 6.8 ± 2.06° in the control group. The final total score Me (25; 75) was also better according to the questionnaire of the Achilles tendon Total Rupture Score: 82 (78; 84) points against 74 (72; 77) points (p <0.01). An assessment of consequences according to the Leppilahti score was 83.8 ± 8.58 points in the main group and 70.7 ± 10.58 points in the control group (p <0.01). Conclusions: means of physical rehabilitation help recover the amplitude of movement in the ankle joint, improve the quality of life and the effects after the rupture of the Achilles tendon. The correct methodological approach and combination of tools further improves the results.

IntroductionThe study aim was to analyse the justification of limitations in physical therapy and activities of daily living in patients after cardiac surgery via sternotomy.MethodsA narrative review design was followed. This study is the result of analysing and comparing the data obtained through investigating sternal closure stability after sternotomy, the load on the sternum during physical therapy, activities of daily living and coughing, as well as the effectiveness of sternum external fixation.ResultsSternum closure stability after sternotomy and the force of the load on the sternum during cough are greater than when performing upper extremity movements and most of the activities of daily living. The benefits of using sternum external fixation are not marked. Mathematically, most of the presented statistical benefits of sternum external fixation were achieved owing to the large number of individuals in the samples. Therefore, it is important to analyse such statistical indicators as odds ratio, attributable risk, the number needed to treat in terms of such a ‘harmful factor’ as lack of sternum external fixation. The use of sternum external fixation should be biomechanically grounded.ConclusionsConventional restrictions and recommendations for patients after cardiac surgery via sternotomy lack theoretical justification and research to confirm their necessity.

Introduction:The assessment of patient satisfaction with the received physical therapy (PT) is a necessary part of PT system analysis. The purpose of the study was to investigate the effect of incentive spirometry on pulmonary function recovery and the level of satisfaction with PT in patients undergoing cardiac surgery.Materials and methods: 70 patients of both sexes were randomly divided into сontrol group (CG) and training group (TG). Both groups received standardized PT (early mobilization, therapeutic exercises, coughing). TG patients also used Tri-Ball breathing exerciser (flow-oriented incentive spirometry). Outcome Measures: the indicators of pulmonary function and satisfaction with PT results on the 7th postoperative day.Results: Pulmonary function results were statistically the same in CG and TG both before the surgery and on the seventh postoperative day. According to the results of the assessment of patient satisfaction with PT, none of the groups showed advantages in any of the seventeen items. Both groups of patients showed high scores in all items of PT satisfaction questionnaire. The overall score had no statistical difference in the groups as well: 82.5 (79; 85) points in CG and 80.5 (74.75; 85) points in TG (p = 0.315) out of a maximum of 85 points.Conclusions: The investigation of pulmonary function and patient satisfaction with the received physical therapy did not confirm the effect of flow-oriented incentive spirometry included in the physical therapy program on the level of satisfaction and pulmonary function test results.

<p><strong>Objective</strong>: to identify the main approaches in the management and motivation of the staff of the center to improve the effectiveness of physical therapy in orthopedic disorders, to form ways to take these features into account in managing the process of physical therapy.</p><p><strong>Methods</strong>: theoretical analysis and generalization of literary sources, method of systematization of scientific information.</p><p><strong>Results</strong>. It is advisable to use a fairly wide range of management techniques in the management of staff to provide physical therapy services, since it is about the impact on a rather complex system - the team of physical therapists, which in turn have a controlling influence on the not less complex systems - patients. The use of management methods can potentially contribute to a number of positive changes in the activities of the staff of physical therapists. The additional impact of these methods will be directed at the patient, in particular, in improving the quality of services. The work of a physical therapist is rather debilitating both from the physical side and from the psychological one. Therefore, the motivation of the staff is important in the management of physical therapists, as well as other employees of the Center for the provision of physical therapy services to patients with orthopedic profile. The study of the problem of motivation has a significant theoretical and practical significance, since the most valuable resource in the current conditions of the market of physical therapy services is personnel, not equipment. Therefore, the responsibility of the leader of a successful center for the provision of physical therapy services is that the motivational goals of the employees are largely correlated with the interests of the center and led to the final result to success, which can be characterized as achieving a useful result immediately to all participants in the system " the head is a physical therapist - a patient. " In a team of physical therapy center, as in any enterprise, there are different types of workers, and the choice of one concept of motivation is mainly determined by the majority of employees of a certain type in the team. The paper outlines the features of the selection and use motivational concepts for the staff center physical therapy. The theory of motivation is considered. Economic and non-economic motivational factors are allocated within the framework of the center for providing physical therapy services, the model of motivation of the personnel is given.</p><p><strong>Conclusio</strong><em>n</em>. The quality and performance of physical therapists in today's market conditions depends not only on professionalism and competence, but also on management, motivation, satisfaction of their needs and loyalty.</p>