postoperative rehabilitation
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Relevance. This research is relevant due to ability to help in improving quality of pets life after surgery on the cranial cruciate ligament.Methods. Descriptive (description dynamics recovery various animals), сomparative (comparisons pace recovery various groups of animals applying different metods) methods were used.Results. Applied rehabilitation activities in early postoperative period accelerate recovery, improves muscle tone, keeps joint movements and helps in its stabilization.

Background: The purpose of this study is to assess outcomes in flexor pollicis longus tendon repairs with 6-strand core sutures with and without circumferential sutures. Methods: A 6-strand core suture technique with and without circumferential sutures was used. Thirty-three patients were summarized in the C group (circumferential group) and 16 patients in the NC group (non-circumferential group). After the surgery, the wrist was stabilized with a dorsal blocking splint and a controlled early active motion protocol was applied. At weeks 6, 13, and 26 data on demographics, type of injury, surgery, postoperative rehabilitation, complications such as re-rupture and the following outcome measurements were collected: range of motion and its recovery according to the Tang criteria, Kapandji score, thumb and hand strengths, Disabilities of the Arm, Shoulder and Hand score, and satisfaction. Results: There were no significant differences in range of motion and strength between the 2 treatment groups. In both groups, the outcome measurements increased over time and they expressed similar satisfaction with the surgical treatment. In 4 patients of the C group tendon repair ruptured and in 1 patient of the NC group. Conclusions: Six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries and good results can also be achieved by omitting the circumferential suture.

The concept of a personalized approach is becoming more and more popular in modern medicine. Today it is often understood as a multidisciplinary approach designed to improve therapeutic options, as well as help diagnose diseases at an early stage. In a cardiac surgery clinic, such an approach can take into account not only biological, but also psychological risk factors for the disease, especially its history, clinical condition, mental and psychological status to create an individual route within the framework of medical and psychological support for the patient at the stages of treatment and rehabilitation. The aim of the work was to develop, based on the analysis of the literature and the authors' own work experience, the organizational and psychological foundations for the implementation of a personalized approach in medical and psychological support of cardiac patients. The fundamental principles of support in the work include the following: the principle of accessibility, the principle of openness, the principle of continuity, the principle of complexity, the principle of integrativity, the principle of differentiation, the principle of variability, the principle of participativeness, the principle of awareness, the principle of prevention. In the process of medical and psychological support of cardiac surgical patients within the framework of a personalized approach, the most optimal was the identification of the following clinical stages, different in duration and content, corresponding to the periods of outpatient and inpatient treatment and rehabilitation of patients: preoperative outpatient, preoperative inpatient, early postoperative, postoperative inpatient, postoperative rehabilitation and rehabilitation outpatient stages. For each of the clinical stages of medical and psychological support, a differentiation of goals, objectives, duration and expected results of the impact was carried out, which makes it possible to personalize the programs for accompanying a cardiac patient and individualize the route for each patient, taking into account the specificity and relevance of the influence of biologi cal, psychological and social factors.

Abstract Background: To investigate the effects of dexmedetomidine on perioperative potassium and postoperative rehabilitation. Methods: Totally 124 patients scheduled for elective radical resection of gastrointestinal malignant tumor under general anesthesia were included. and randomly assigned to four groups (n=31): groups D1, D2 and D3 received dexmedetomidine loading dose 1, 1 and 0.5 μg/kg and maintenance dose 0.25, 0.5 and 0.5 μg/kg/h, respectively, group C received normal saline 50 ml/h for 10 min and maintenance dose 10 ml/h. Serum potassium and lactate changes were recorded at 5 min after arteriovenous puncture (T1), 1 h after surgery beginning (T6), surgery ending (T7) and 1 h into the post-anesthesia care unit (PACU) (T10). Serum potassium was examined at 48 h after surgery (T11). Perioperative rehabilitation indicators were recorded.Results: Compared with basal values, serum potassium concentration in groups C, D1 and D2 increased significantly at T11 (P=0.003, 0.002, and ˂0.001, respectively) and at T7 (P=0.008), T10 (P=0.015) and T11 (P˂0.001) in group D3. Serum potassium at T11 in group D2 was significantly lower than group C (P=0.032). Serum potassium at T7 in group D3 was significantly higher than group D2 (P=0.036). There were no significant differences in perioperative rehabilitation indicators in all groups. Conclusions: Dexmedetomidine did not decrease perioperative potassium significantly in patients undergoing radical resection of gastrointestinal malignancy, while its loading dose 0.5 μg/kg and maintenance dose 0.5 μg/kg/h can elevate potassium slightly with no adverse effect on perioperative rehabilitation.Trial registration: This study was retrospectively registered on the clinicaltrials.gov website (registration number: NCT04771637).

Abstract Background Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity. Objective The aim of this study was to assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy. Methods An electronic database search was performed in the MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPCs and postoperative morbidity, in-hospital mortality rate, length of hospital stay (LOS) and health-related quality of life (HRQoL). Results Seven randomized controlled trials (RCTs) and seven cohort studies assessing prehabilitation totaling 960 patients, and five RCTs and five cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien–Dindo score ≥ II). No difference was observed in functional exercise capacity and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, shorter LOS, and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue, and pain scores. Conclusion This meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative periods. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which patient subgroup will gain the maximal benefit.

Cancer of the lower jaw is one of the most common causes of the development of total defects. There are many indices and indicators to assess the quality of life of patients with this pathology, but they do not fully describe the features of their postoperative rehabilitation. The question of developing an evaluation criterion for the introduction of a special device in patients with subtotal defects of the lower jaw remains open.Material and methods. In the period from 2010 to 2021, 100 patients with subtotal defects of the lower jaw, aged 30 to 65 years old, who are being treated in the Department of Maxillofacial Surgery at the Department of Maxillofacial Surgery of the GBUZ SKKKB, were interviewed. All patients were divided into 2 groups of 50 people each. In the main rehabilitation was carried out using a special device to optimize the biomechanics of the lower jaw, in the control group, rehabilitation was carried out without one. The article presents the results of assessing the quality of life, which were carried out using a special questionnaire.Conclusions. This questionnaire makes it possible to assess the standard of living of patients using a special device at the stages of rehabilitation.

Abstract Background Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns. Methods Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up. Results During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (p < 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (p < 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level. Conclusions Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice. Level of evidence Prospective cohort study, 2.

The aim of research was to study the effect of the abdominal wall injuries and ascorbic acid (AA) on morphometric parameters of the somatosensory cortex.Material and methods. The density of the arrangement of neurons, sizes of nuclei and perikaryons of neurons, density and area of blood vessels in the somatosensory cortex were detected in guinea pigs after simulation of the abdominal wall injury. The process was accompanied by the parenteral administration of AA.Results. Simulation of the abdominal wall injury in guinea pigs resulted in a decreased thickness of the somatosensory cortex and a decreased density of neurons arrangement (on average by 32-37%). In 7 days after the operation, the exposed animals demonstrated a decreased density of blood vessels by 14–18%, the size of blood vessels also decreased by 27–46%; the fact evidencing a deterioration in the blood supply to the somatosensory cortex in the postoperative period. The effect of AA was mainly manifested in the increased size of the nuclei and perikaryons of neurons (by 20–40%); this evidencing activation of their metabolic activity. The most significant changes in the studied parameters were observed in the outer granular and, to a lesser extent, in the pyramidal and inner granular cytoarchitectonic layers.Conclusion. Experimental abdominal surgical interventions resulted in a decreased size and density of blood vessels in the somatosensory cortex. The results obtained can be used to develop methods of postoperative rehabilitation with the inclusion of drugs that improve blood supply and metabolism of the brain neurons. AA potentiates some of the effects of surgery on the somatosensory cortex; currently, there are no sufficient data to recommend it as a neuroprotective agent in the postoperative period.