Application of suspension systems with rigid elastic elements in the physical rehabilitation of patients with amputation defects of the lower extremities

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Abstract

BACKGROUND: Exercise on suspension systems (gravitational neuromuscular activation) is a highly effective means of physical rehabilitation for patients with various pathologies. Modernization of these products through the use of rigid elastic slings or equipping standard simulators with elastic elements expands the capabilities of this type of equipment, allows you to master new types of exercises, positively affecting the strength, tone and endurance of muscle groups.

AIMS: to study the impact of the inclusion of suspension systems with rigid elastic elements (slings) in physical rehabilitation programs for patients with amputation stumps at the hip level.

MATERIAL AND METHODS: Twelve patients were tested before and after repeated prosthetics in the conditions of the FB MSE Clinic, which, due to the use of suspension systems, including elastic elements, not only increased strength, endurance and coordination relationships of muscles, but also changed the structure of their walking. The active part of the course of physical rehabilitation with the inclusion of suspension systems with elastic elements was less than two weeks. Setting the patient the task of increasing the speed of movement on the prosthesis in the long term, in the near future we focused exclusively on the correctness of the step structure and subjective sensations.

RESULTS: The technical improvement of suspension systems due to elastic elements increases the convenience of their use, the speed of mastering by patients and the degree of efficiency, determining a high percentage of achieving the planned result. Inclusion in the course of training on the simulator with the use of elastic slings allows the patient to master and confidently perform various complexly coordinated movements, including squats, to participate in new types of game activities, which contributes to an increase in his adaptation and socialization in society. Subjectively, patients note greater strength of muscle groups that have undergone additional stress on these systems, improved coordination of movements and endurance when walking on a prosthesis as a whole, as well as a sense of "correctness" of walking, which is confirmed by clinical examination methods and the results of biomechanical tests (increased pace and speed of walking with a decrease in the duration of the step cycle).

CONCLUSIONS: Suspension systems are most useful for the prevention and elimination of atrophy of the muscles that support the movement of the pelvic girdle, in comparison with conventional dynamic training and walking on a prosthesis. Modifications of suspension systems by including elastic elements in them allow functional training not only using static, but also dynamic exercises, expanding their application possibilities in medical and complex rehabilitation, adaptive physical culture and adaptive sports.

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About the authors

Denis D. Bolotov

Federal Bureau of Medico-Social Examination; Russian Medical Academy of Continuing Professional Education

Author for correspondence.
Email: bolotov_d@mail.ru
ORCID iD: 0000-0003-1320-0960
SPIN-code: 8846-6802

MD, Cand. Sci. (Med.), Associated Professor

Russian Federation, Moscow; Moscow

Sergey M. Starikov

Medical Institute of Continuing Education of the Moscow State University of Food Production

Email: bolotov_d@mail.ru
ORCID iD: 0000-0003-4915-6164

MD, Cand. Sci. (Med.), Associated Professor

Russian Federation, Moscow

Yana N. Zakharova

Federal Bureau of Medico-Social Examination

Email: bolotov_d@mail.ru
ORCID iD: 0000-0003-3345-0828
Russian Federation, Moscow

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Supplementary files

Supplementary Files
Action
1. Fig. 1. Practicing squats with the use of elastic slings by a patient with post-traumatic amputation of the left lower limb at the level of the middle third of the thigh with a uniaxial hydraulic knee module that allows you to control the phases of transfer and support.

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2. Fig. 2. The possibility of performing a movement that is qualitatively new for this patient — squats — under the complicated conditions of using the Bosu balancing platform. Side view.

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