Problems of orthotics in patients with flaccid paresis/palsy of the upper limbs

Authors:

Nikolaev Veniamin Fedorovich — PhD in Medical sciences (Cand. Med. Sci.), Deputy Director of the Institute of Prosthetics and Orthotics, Albrecht Federal Scientific and Educational Centre of Medical and Social expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: doc.nikolaev@mail.ru; http://orcid.org /0000-0001-6601-2678.

Shcherbina Konstantin Konstantinovich — Grand PhD in Medical sciences (Dr. Med. Sci),Deputy Director General — Director of the Institute of Prosthetics and Orthotics, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street 50, 195067 St. Petersburg, Russian Federation; е-mail: shcherbina180@mail.ru; http://orcid.org/0000-0001-7579-0113.

Andrievskaya Alla Olegovna — PhD in Medical sciences (Cand. Med. Sci.), Associate Professor; е-mail: alandrievskaya@yandex.ru; http://orcid.org /0000-0003-2245-5711.

Chernikova Marina Vladimirovna — Head of the Design Department of Institute of Prosthetics and Orthotics, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; postgraduate student of Department of Automation and Control Processes, Saint Petersburg Electrotechnical University, 5 Professora Popova Street, 197022 St. Petersburg, Russian Federation; e-mail: chernikovamarinavl@gmail.com; https://orcid.org/0000-0002-3881-7521.

Fogt Elizaveta Vladimirovna — Head of the Department of Biomechanical Studies of the Musculoskeletal System of Institute of Prosthetics and Orthotics, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; postgraduate student of Department of Biomedical Engineering, Saint Petersburg Electrotechnical University, 5 Professora Popova Street, 197022 St. Petersburg, Russian Federation; e-mail: fogtlisbet11@yandex.ru; https://orcid.org/0000-0002-1017-6179.

Ivanova Natal’ya Viktorovna — Head of the Department of scientific activity organization, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: nivanova2504@yandex.ru.

Annotation:

Introduction. Upper flaccid mono/paraparesis (paralysis) is the leading clinical syndrome of a heterogeneous group of diseases with different etiologies. The upper limb accounts for a huge share of human motor activity, without its participation, home life, self-service, industrial and daily activities are impossible, the quality of life deteriorates, there is a need for social protection. In the pathology under study, the disabled are shown the use of assistive products in order to fix, unload, correct, activate and, ultimately, to restore or replace the impaired functions of the upper extremities and life limitations. However, specialists often have difficulties when making a decision on choosing the right product for the patient.

Aim. To study the features of orthosis of patients with the syndrome of flaccid paresis/paralysis of the upper extremities in order to increase the effectiveness of rehabilitation in this pathology.

Material and methods. Special literature, current Russian regulatory documents, national standards, methodological materials, nomenclature of manufactured products, data from archival materials. Research methods: retrospective analysis of the problem, theoretical method, including analysis, synthesis and analogy, method of system analysis.

Results. The data of 51 medical records of disabled people with the syndrome of flaccid paresis/paralysis of the upper limb, who applied to the MTC of the Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, were analyzed. 48 (94.1 %) of the examined patients were of working age. Among the main nosologies that caused sluggish paresis/paralysis of the upper extremities, a high frequency of injury consequences was noted.The main types of orthoses recommended for the above syndrome have been identified. It is established that the studied contingent is not fully provided with orthoses prescribed to compensate for impaired function.

Discussion. Studies of specialists confirm that the consequence of the syndrome of sluggish paresis/paralysis of the upper extremities in patients is a significant deterioration in the quality of life. Insufficient specification of recommendations, limited and disparate knowledge of specialists make it difficult to decide when selecting the necessary product for the patient, which ultimately adversely affects the results of rehabilitation.

Conclusion. A comprehensive approach is needed to identify the needs and choose the design of upper limb orthoses. The presented methodology for determining the need for upper limb orthoses and recommendations for the appointment of TSR will contribute to the successful rehabilitation of patients with the syndrome of flaccid paresis/paralysis of the upper limbs.

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