The concept of rehabilitation treatment. Medical rehabilitation

The term " rehabilitation" comes from the Latin words "re-" - restoration and "habilis" - ability, i.e. “rehabilis” - restoration of ability (properties).

Rehabilitation is the restoration of health, functional state and the performance of the body impaired by disease, injury or physical, chemical and social factors.

The World Health Organization (WHO) gives a very similar definition of rehabilitation: “Rehabilitation is a set of activities designed to ensure that persons with disabilities due to illness, injury and congenital defects adapt to new living conditions in the society in which they live.” In accordance with the WHO definition, rehabilitation is a process aimed at providing comprehensive assistance to sick and disabled people so that they achieve the maximum possible physical, mental, professional, social and economic usefulness for a given disease.

The above definition reflects the complex nature of rehabilitation, its components, which, in essence, gives grounds to talk about types of rehabilitation. There is no complete unity of thoughts on this issue, which is explained by the lack of a single criterion with the same terminological design.

Thus, rehabilitation should be considered as a complex socio-medical problem, which has several aspects: medical (including psychological), professional (labor) and socio-economic.

Medical (therapeutic) aspect of rehabilitation

Psychological (psychotherapeutic) aspect of rehabilitation

Professional (production) aspect of rehabilitation

The socio-economic aspect of rehabilitation is the return of economic independence and social usefulness to the victim. This is the restoration, and if impossible, the creation of a new position acceptable for a particular person in a family, team or in a larger society. The above problems solve not only medical institutions, but also social security authorities. Therefore, rehabilitation is a multifaceted process of restoring a person’s health and reintegrating him into work and social life. It is important to consider all types of rehabilitation in unity and interconnection. At the same time, in our country and practically throughout the world there is no single service that would ensure the complexity and effectiveness of rehabilitation.

These aspects of rehabilitation correspond to three classes of disease consequences:
1) medical and biological, which consist of deviations from the normal morphofunctional status;
2) decreased performance in different meanings this word;
3) social maladjustment, i.e. disruption of connections with family and society.

The recovery of a patient after an illness and his rehabilitation are not at all the same thing, since in addition to restoring the patient’s health, it is also necessary to restore his working capacity, social status, i.e. return a person to a full life in the family and society, prevent the occurrence of a relapse or new disease.

The term “medical rehabilitation” in the domestic scientific literature refers to the restoration (rehabilitation) of the physical and psychological status of people who have lost this ability due to illness or injury.

The concept of the development of medical rehabilitation should proceed from the theoretical basis of human health protection, based on principles that declare it as a therapeutic process, and non-drug treatment- as an integral part of the prevention and basic treatment of diseases. From this point of view, medical rehabilitation is considered as a differentiated staged system of treatment and preventive measures that ensure the integrity of the functioning of the body, and, as a result, the complete restoration of the patient’s health to the optimal level of performance through the combined, sequential and successive use of methods of pharmacological, surgical, physical and psychophysiological effect on functionally or pathologically altered organs and systems of the body.

Today, medical rehabilitation as a branch of healthcare within the framework of the concept of modern medicine must implement the following main tasks:

1. Maintaining the level of health of people, as well as its restoration in persons who have functional impairments and disorders, distinctive feature which is their reversibility. The object of action here is the reduced reserve regulatory capabilities of the body.

2. Medical rehabilitation of patients who have irreversible morphological changes in tissues and organs. Restorative treatment is aimed here at returning limited legal capacity, compensating for impaired functions, secondary prevention diseases and their complications, elimination of relapses.

The above tasks are implemented through the use of hardware physiotherapy, kinesitherapy (therapeutic gymnastics and physical education, mechanotherapy and physical training), complementary therapy (reflexo-, phyto-, diet therapy, manual therapy, homeopathy), taking medications (supportive, adaptive, anti-relapse pharmacotherapy) and surgical interventions (orthopedic, cosmetic, etc.), which significantly increase the effectiveness and reduce the time of medical rehabilitation.

Sakrut V.N., Kazakov V.N.

Rehabilitation is a process aimed at achieving certain goals in an individual who has suffered an injury, illness, or debilitating condition. R. assumes that this individual was previously able to function adequately in those areas of activity in which activity was weakened; R.'s goal is a return to the previous state or previous ability to function. R. as a concept is relatively new in humans. stories. Scott Allan reminds us that in most cultures, people who became disabled were ostracized or killed. Although we now have a more humane view of disability, many others. people continue to react to disabled people with intense disgust. Now, for example, it is often difficult to establish certain rehabilitation centers in populated areas, since the administration is concerned about the negative impression that disabled people will make on local residents. As Gerald Kaplan argues, successful disability programs must begin with the prevention of disability. Kaplan's three-step prevention model includes first, health education and physical changes. environment to prevent illness; secondly, early identification and treatment to prevent permanent disability and, finally, treatment and rehabilitation to prevent further deterioration and ensure possible restoration functions. Rehabilitation centers are focused mainly on solving the problems of the third stage of prevention according to Kaplan. The beginning of rehabilitation in the USA is associated with the interest of private groups, which saw this problem in society and were looking for ways to solve it. Shriners Centers, for example, were organized to help children - physical. disabled people Sometimes rehabilitation efforts were part of larger reforms. For example, the Salvation Army paid attention to depressed people, especially those with alcohol problems. Phys. and mental R. gained great importance against the backdrop of two world wars. Improving the quality and increasing the capabilities of honey. assistance led to the fact that people with the most severe injuries were saved, but only to become severely disabled. This fairly large contingent of disabled people had to be returned to society, which put the United States in a difficult position. The rehabilitation process begins with the assessment and treatment of the disease, injury or condition. In addition, an assessment must be made of any deficits remaining after treatment and its impact on social, psychological and psychological factors. and professional skills of the individual. Treatment of the condition in the acute period is focused on the injury or disease that leads to disability. on the contrary, it focuses on preserved skills and those that can be formed on the basis of the patient’s reserve capabilities. The term "rehabilitation center" refers to the various types of services offered. There are rehabilitation centers for most types of physical. and mental pathological conditions, as well as personality disorders. Rehabilitation centers for physical Disabled people are probably the largest of the existing institutions, in which interdisciplinary teams provide a wide range of services. This is due both to the diversity of skills required to effectively treat existing disorders and to the trend towards specialization in medicine as a means of optimizing healthcare. Rehabilitation centers in special problem areas are for the most part monodisciplinary institutions, or the services of representatives of other medical specialists. professions are used there as additional treatment to a limited extent. However, the broader the treatment approach, the more interdisciplinary the therapeutic team should be. Rehabilitation center treatment programs must be specific enough to effectively address the client's underlying dysfunction and at the same time broad enough to address the problems associated with the disability. In some cases, some services may not be available at this center. In such situations, they turn to institutions of the appropriate profile to provide the necessary specialized assistance. In the absence of such assistance, the overall result of rehabilitation will be low, despite some successes achieved in this center in other areas. Rehabilitation center programs vary from region to region, even for the same disorder. This is due to a number of factors, including. financial considerations, size of service contingent, availability qualified specialists and public attitudes towards rehabilitation. In addition, there are significant differences, caused by disagreement in the opinions of specialists regarding which treatment methods are the most effective. In fact, it is most likely that the series common approaches suitable for most patients, while certain conditions require the use of some specific methods. Rehabilitation center staff typically consist of professionals, paraprofessionals, and administrative staff. Financial considerations sometimes force us to rely mainly on paraprofessional help. However, the use of paraprofessionals is advisable if they have experience working with this type of disability and are proficient in various rehabilitation techniques. See also Health Services, Humanitarian Model of Health R. Kappenberg

Definitions, meanings of words in other dictionaries:

Psychological Encyclopedia

(Latin re - again, habilis - comfortable, adapted). Complex, targeted use of medical, social, educational and labor measures in order to adapt the patient to activities at the highest possible level for him (WHO definition). Basic...

Psychological Encyclopedia

(aftercare) - long-term observation as an auxiliary or additional remedy for the treatment of chronically ill or disabled patients, including those with mental illness and those with birth defects. includes the provision of special assistance...

A powerful impetus for the development of physiotherapy, physical therapy and occupational therapy came at the beginning of the last century. World War, then World War II completed the formation of a new discipline dealing with restorative treatment - rehabilitation.

Further rapid socio-economic development of the world led to the emergence of new military conflicts, man-made accidents and disasters, natural disasters with the emergence of large heterogeneous groups of people (physically disabled and people with mental disorders).

Only a very rich country can afford to limitlessly increase the number of disabled and socially dependent people, therefore rehabilitation is not a luxury, but an important practical task of healthcare in any civilized country.

IN modern conditions Due to changes in the demographic situation in the world, an increase in average life expectancy, an aging population and changes in the structure of morbidity (injuries, cancer, and cardiovascular diseases are taking the leading positions), patients with severe chronic diseases, the disabled, the elderly and the elderly are accumulating in society.

The well-being of the elderly can easily be undermined not only by acute or chronic disease, but also by economic or social, constantly operating factors.

Despite the emergence of new, often expensive treatments, there has been no significant increase in life expectancy for people suffering from common diseases. Lately chronic non-communicable diseases, in particular heart disease, malignant neoplasms, joint diseases, diabetes. In addition, the rapid development of the technical equipment of medicine leads to a breakdown in the interaction between the doctor and the patient, to the danger of irrational instrumental research -

If treatment does not increase the patient's life expectancy, will it lead to an improvement in its quality? The established traditional criteria for the effectiveness of treatment and disease outcomes, based primarily on traditional indicators - average life expectancy, overall mortality, mortality from certain causes and others - have ceased to satisfy doctors. To do this, a certain concept is necessary, broad enough, which can assess the physical and mental health of a person, determine the characteristics of a particular individual in connection with external environment. Such a concept is quality of life, interest in which has increased unusually recently. This concept includes a person’s physical health, his psychological status, level of independence, and characteristic features of the environment.

In this regard, at present, it is advisable to evaluate the effectiveness and cost-effectiveness of various treatment methods not only by the criteria of survival and life expectancy, but also by indicators quality of life, increasingly used in practice and included in special techniques.

One of the main goals of rehabilitation of patients with various diseases is improving quality of life, which includes the patient's assessment of his physical, mental and social well-being.

Thus, we can say that such a well-known and widespread concept as rehabilitation is closely related to the medical, sociological and philosophical concept of quality of life.

Rehabilitation, according to WHO, in the broadest sense of the word can have a very large impact on a person’s quality of life.

Quality of life can be used to evaluate the effectiveness of various treatments and the adoption of various medical programs. This is especially important for people with disabilities who have low quality of life indicators. These indicators, along with psychological and social-labor readaptation, can be used as a true criterion for the rehabilitation of disabled people.

Medical science has long been engaged in the study and elimination of structural and functional disorders in the human body that arise under the influence of one or another pathological process.

Under the influence of various theoretical movements, the concept of “personality and illness” arose and began to attract more and more attention, which allowed us to take a different look at these concepts. Disease is understood as processes of disorganization of the body, accompanied by violations of the biological and social properties of the individual. The purely biological model of the disease has been replaced by the so-called mixed model, which assumes the interaction and complementarity of the biological and psychosocial. The biological in a person is always mediated by the social, and a person’s personality as a holistic, integral concept directly forms the connection between the biological and the social. Thanks to the so-called ecological orientation of modern social and natural sciences, including medicine, the style of thinking is changing towards a broader evolutionary-population concept, where the organism is considered in living connection with the environment.

The very goal of treatment ultimately comes down not only to ridding the body of the destructive effects of the pathological process, but also to preventing fatal outcome, restoration of functions or prolongation of life with a previously known fatal outcome. The patient should be able to live a full life, maintaining human dignity, and not just exist.

Rehabilitation is concerned with restoring the status of the individual from a philosophical point of view. Rehabilitation is a direction of modern medicine, which in its various methods relies primarily on the patient’s presence, actively trying to restore the person’s functions impaired by the disease, as well as his social connections. There is no true rehabilitation without addressing the patient’s personality, without perceiving the person in inextricable connection with the environment. The success of rehabilitation measures can be lasting only when harmony is established between the body and the environment.

Rehabilitation- the final stage of the overall treatment process, where it is very important to evaluate the effectiveness of treatment and its effect on the body, primarily in terms of restoring the patient’s personal and social status.

The correct, rational combination of physical and mental methods of influence on a particular patient directly affects the success in the treatment of common severe chronic diseases, including full or partial restoration of working capacity. Rehabilitation is based on the partnership between the doctor and the patient, the diversity of efforts and influences aimed at different areas of life, the unity of biological and psychosocial methods of influence and the gradation of influences. For example, according to many researchers, rehabilitation can prevent rapid aging and stimulate the restoration of lost functions in accordance with age. Timely and systematically carried out rehabilitation measures often lead to functional restoration of the body of old people, sufficient for self-care or requiring minimal outside assistance. Rehabilitation of the elderly and elderly, as defined by a number of authors, means a restructuring of the mental, psychological and physical condition, impaired by illness, especially chronic. The purpose of rehabilitation in in this case there must be a reactivation of the personality for a more independent life of the elderly person in the family and society.

In medical and biological meaning, rehabilitation is therapeutic and restorative measures. Its main component is medical rehabilitation, which involves the use of a system of medical-biological and medical-social measures aimed at preventing loss of ability to work, the speedy restoration of impaired functions, the prevention of complications and relapses of the disease, and an early return to society and work.

The concepts of “treatment” and “rehabilitation” should not be confused, since rehabilitation is considered as an integral part of the treatment process and is characterized by an early and special focus therapeutic measures, ensuring improved function of body systems and the most complete restoration of the patient’s ability to work. Rehabilitation is not after-care either, since it begins at the earliest stages of the pathological process, although its methods are most actively used at the final stages of treatment - after the patient’s clinical recovery until his ability to work is restored.

The term “rehabilitation” is often replaced by the narrower concept “ rehabilitation treatment “, which is acceptable only for certain types of pathology that are not associated with medical and social consequences.

Rehabilitation I Rehabilitation (French réhabilitation, Latin re- again + habilis comfortable, adapted)

a combination of medical, social and government activities carried out with the aim of maximizing compensation (or restoration) of impaired or lost body functions and social readaptation (or adaptation) of sick, injured and disabled people. According to the WHO Expert Committee on Medical Rehabilitation (1970), this concept is defined as “the combined and coordinated use of medical and social measures, education and vocational training or retraining, aimed at providing the patient with the highest possible level of functional activity.”

At the present stage of development of medicine, R. is a coherent system of scientific knowledge and methods, the implementation of which in practice is carried out by many doctors in various rehabilitation institutions of the inpatient, outpatient, and sanatorium-resort type. The cardinal task of R. is the normalization of impaired or lost function due to replacement hyperfunction or qualitative change functions of organs and physiological systems not damaged by the pathological process. is either a complete restoration of function, or such a redistribution of function in the entire organism with an active restructuring of physiological systems, motivational incentives and behavior that provide the maximum possible social and biological readaptation for a given individual. Since clinical or noticeable improvement of impaired function always precedes reparative processes, R.’s tasks include restoring not only the impaired function, but also the structure of cells, tissues and organs damaged by the pathological process. In pathological regeneration, R. consists of preserving the achieved functional compensation for as long as possible, preventing complications of the underlying disease that initially caused dysfunction of the body, and timely treatment of all accompanying pathological processes.

A special report of the WHO Expert Committee (1983) identified the following pathological conditions requiring rehabilitation measures: dysfunction - any loss of psychological, physiological or anatomical structure or function; - limitation or deficiency (due to dysfunction) to carry out activities in the form or volume that is considered normal for a person; physical and other defects - a deficiency or of a given individual arising from a dysfunction or disability that limits or prevents the performance of a role that is normal (taking into account age, gender and social and cultural factors) for that individual. In this regard, R. includes all measures aimed at reducing the impact of disabling factors and conditions leading to physical and other defects, as well as providing opportunities for people with disabilities to achieve social integration. From this definition follows the provision on three levels of disability prevention (Disability): at the first, a set of measures is implemented to reduce the frequency of dysfunction; on the second - a set of measures that help limit the degree or reverse the development of disability; on the third - a set of measures to prevent the transition of disability into physical and other defects. At the same time, the tasks of R. include not only disabled people to adapt to the environment, but also intervention in their immediate environment and society to promote their social integration. Social inclusion means the active participation of people with disabilities in the life and activities of society.

The ultimate goal of rehabilitation measures is a return to socially useful, active work in accordance with the functional capabilities of sick, injured and disabled people. The optimal solution to this problem is considered to be the resumption of previous professional activity in full by a person who has undergone R. If such a task is impossible in conditions of pathological regeneration, R. performed can be considered effective in restoring the disabled person’s ability to self-service and, even more so, to self-sufficiency with subsequent financial independence .

The following main types of R. are distinguished: medical, professional and social. Medical R. is the entire complex of therapeutic effects (medicinal, surgical interventions, instrumental procedures, reflexology, sanatorium-resort, therapeutic physical education), carried out from the moment of illness or until final recovery or the formation of a chronic pathological process requiring maintenance therapy.

There are R. cardiological (covering all those suffering from heart disease, as well as persons who have undergone cardiac surgery), neurological (which is also needed by persons who have undergone neurosurgical intervention), psychiatric, traumatology and orthopedic, etc.

Regardless of the type and nature of the disease or injury, physical and mental R. is indicated for all patients and victims. The main tasks of physical R. are to accelerate regeneration, minimize the degree and volume of functional and structural disorders, intensify compensatory processes (Compensatory processes) and facilitate readaptation to environment with irreversible organic changes.

Necessity of compliance bed rest and the loss of habitual, everyday contacts in connection with the emerging pathological process often contribute to the development of a depressive or subdepressive state in the patient. The more sudden the onset and more severe the course of the pathological process and the longer it is, the more pronounced it is, preventing compensatory-adaptive reactions and resocialization of the patient or victim. Therefore, mental R., which takes into account the internal picture of the disease, the leading psychopathological syndrome and the patient’s personality characteristics, should begin simultaneously with the physical one. Full contact medical personnel with the patient should be considered in this case not only in terms of deontological relations, but also as the most important means mental R., and reassuring information received by the patient about his condition and prognosis of the disease - as required condition systematic mental rehabilitation. The problems of medical rehabilitation can be considered solved with stabilization somatic condition the patient and restoration of his individual and social status.

Professional R. provides the following opportunities: at the previous workplace; in a new workplace with changed working conditions, but at the same enterprise, readaptation to a new workplace in conditions close to the previous professional activity, but with reduced physical activity; complete retraining with work at the previous enterprise; complete retraining in a rehabilitation center with employment in a new specialty. Retraining creates conditions for home work or work in special workshops (departments of enterprises) with a shortened working day, individual production standards and constant medical supervision. The issue of retraining persons who have become disabled is decided by the Medical and Labor Expert Commission; referral for retraining is issued by social security, R. of persons who have lost or sight, carried out on the basis of educational and production enterprises of societies of the deaf or blind; For mentally ill patients, therapeutic and industrial therapy is used for this purpose.

Social R. means, first of all, the guaranteed rights of sick and injured people to free medical care, preferential receipt of medicines and vouchers to hospitals, material support in the event of partial or complete loss of ability to work, and the mandatory implementation by the administration of institutions and enterprises of all proposed labor recommendations (related to the length of the working day, with the exception of working night shifts, providing additional leave, etc.). Along with this, social R. includes the entire range of measures to restore or compensate for impaired function with the help of modern engineering and technical solutions (technical R.), including the improvement of various types of prostheses (see Prosthetics) for defects of the musculoskeletal system, carrying out hearing aids (Hearing Prosthetics), providing disabled people with special vehicles, creating special designs of household appliances and fixtures, etc. ( rice. 1-3 ). Social R. for children and adolescents with acquired or congenital physical defects is carried out in specialized medical and educational institutions (kindergartens, schools, technical schools) (pedagogical R.). The resocialization of disabled people, in particular the blind and deaf, is promoted by the relevant societies.

The implementation of a phased rehabilitation system is based on strict adherence to certain principles: the earliest possible start and comprehensive implementation of all types of restorative therapy with the involvement of specialists in various fields (including lawyers, sociologists, etc.); continuity of rehabilitation measures; continuity between individual stages of R.; individualized nature of all rehabilitation measures; implementation of R. in a group of patients. The organizational and methodological basis of the recovery process is a special rehabilitation program, consisting of three successive stages: clinical, sanatorium and adaptation.

The clinical stage of R. begins already in the intensive care unit or intensive care, continue in one of the departments of the hospital (Hospital) and are completed in a specialized rehabilitation department organized at large hospitals, where it is possible to carry out individualized physical training programs. Implementation in clinical practice modern methods monitoring the patient’s condition allows you to optimize physical activity and at the same time ensure its safety. Special meaning at this stage mental R. acquires: carrying out adequate and strictly individualized treatment for the patient’s condition psychotropic drugs and the use of psychotherapy methods in order to increase the patient’s desire for recovery, strengthen his self-confidence, readiness to overcome risk factors for this disease, and create the need to return to work. By the end of the clinical stage, it is desirable to restore the patient’s ability to self-care, normalize sleep and digestive function, which are often impaired due to more or less prolonged immobilization.

The next stage of R. is carried out in specialized departments local country sanatoriums (see Sanatorium), usually located at a relative distance from the industrial center and with sufficient facilities for physical exercise (gymnastics halls, sports grounds, walking routes, physiotherapy rooms, etc.) and the necessary equipment (in particular, bicycle ergometers). For R. persons who have suffered, intensive care wards with appropriate equipment are equipped and additional staff of therapeutic physical education instructors and doctors (psychologists, psychotherapists, specialists in functional diagnostics). The tasks of mental R. at the sanatorium stage (stage of convalescence) include normalization of the patient’s affective status, prevention of hypochondriacal personality development, elimination of manifestations of somatogenic asthenia and feelings of dependence on others (primarily medical personnel), formation in the patient’s need for a steady, albeit gradual resocialization. Patients are transferred from hospital to suburban rehabilitation centers by free trip. For the entire period of sanatorium rehabilitation (usually 24 days), a Certificate of Incapacity for Work is issued.

The final, adaptation stage of R. is implemented on an outpatient basis by a doctor at a clinic or dispensary, where all information about somatic and mental state patient from a country sanatorium. At this stage, R. includes preventing the progression of the underlying disease, preventing possible complications the latter, maintaining the working capacity of the person being rehabilitated (taking into account not only the severity of the pathological process suffered, but also the functional reserves of the body) and conducting an examination of working capacity. In this case, the following options are possible: full R. (reinstatement at the previous job); incomplete R. rational employment with easier working conditions); disability requiring constant medical supervision (see. Clinical examination).

In outpatient clinics, these problems are solved on the basis of the rehabilitation treatment department of a large city clinic (the area of ​​operation of such a department is determined by the relevant health authority) or the rehabilitation treatment room, which is organized in a city clinic serving 30 thousand or more adults. The grounds for referral for rehabilitation treatment are: myocardium after an acute period of the disease; on the heart due to coronary disease or valve disease; motor and speech disorders due to vascular diseases or brain contusions and after neurosurgical operations; spine (without dysfunction spinal cord) pelvic bones, upper or lower extremities, consequences of operations on peripheral nerves due to injury, tumor, etc. The main objectives of such a department (office) are: timely start of rehabilitation treatment; use of the complex necessary methods R. with a differentiated approach to their use in different groups sick; drawing up individual rehabilitation treatment programs; ensuring continuity, continuity, consistency, phasing in the organization and implementation of the entire treatment program.

Rehabilitation treatment of patients is carried out by the following specialists: therapist, traumatologist-orthopedist and. The general set of measures at the adaptation stage of R., according to individual indications, includes various types drug therapy, physiotherapy, physical therapy and massage, reflexology and occupational therapy under the supervision of functional, radiological, laboratory and other research methods. If necessary, a clinically trained psychologist, a representative of the social security system (Social Security) and other specialists are involved. In some cases, physical R. is carried out jointly with a specialist from the rehabilitation treatment department of a clinic or a regional medical and physical education clinic. IN special control in this case, persons with a current pathological process and all those undergoing medical examination (even with full restoration of their previous working capacity) need it in the first year after the illness that became the basis for rehabilitation.

Rehabilitation of mentally ill patients. In mental illness, primarily species-specific human activity and social functioning are disrupted. This determines the well-known specificity of R.’s methods and tasks aimed at the resocialization of mentally ill patients. Thanks to the successes of psychopharmacotherapy and the humanization of medicine, the prerequisites have been created for carrying out activities aimed at returning many mentally ill people to a more active social life. Refusal of excessive measures of isolation and restraint of mentally ill people contributes to the implementation of various forms social activation, professional and communicative training, expansion and deepening of individual and group psychotherapy.

The concept of R. for mentally ill patients is based on a systems approach, in which a person is viewed as complex, having different levels of functioning, the highest of which is social, and the rest are included in it as necessary basis. The R. process is a complex biosocial system in which its resocialization acts as a system-forming factor. There are four principles of R. The first is the principle of partnership, i.e., involving the patient in active cooperation with staff in the process of R. The second is the principle of versatility of efforts, i.e. their focus on different spheres of functioning (psychological, professional, family, social, leisure sphere). The third is the principle of unity of psychosocial and biological methods of influence. The fourth is the principle of stepwise (transitional) efforts, emphasizing the need to maintain a certain sequence in the application of various elements of the rehabilitation complex, and a gradual increase in loads.

The holistic process of R. includes three stages, each of which has its own specific tasks and characteristic proportions of applied influences and, accordingly, is carried out at various levels psychiatric care(Psychiatric care). The goal of the first stage - restorative therapy - is to prevent the defect and restore impaired functions. At this stage, active treatment is carried out and hospital forms of psychocorrectional and psychotherapeutic work are used (carried out in hospitals or semi-hospitals). The task of the second stage - readaptation - includes the adaptation of patients to life and work in out-of-hospital conditions (in occupational therapy workshops, dispensaries, special workshops). Occupational therapy, vocational training or retraining of patients are of particular importance. At the third stage, the individual and social status of the patient is restored. This work is carried out by dispensaries, sick clubs, and public organizations.

Bibliography: Kabanov M.M. Rehabilitation of the mentally ill, L., 1985; Kanalov M.G. and Afanasenko R.F. Modern aspects of rehabilitation, Ufa, 1983; Kogan O.G. and Naidin V.L. Medical rehabilitation in neurology and neurosurgery. M., 1988; Modern advances in the rehabilitation of patients with myocardial infarction, ed. I.K. Shkhvatsabaya and G Anders, M., 1983; Tarasov O.F. and Fonarev M.I. Rehabilitation for childhood diseases, L., 1980, bibliogr.; Teleshevskaya M.E., Burtyansky D.L. and Filatov A.T. Rehabilitation of patients with neuroses, Kyiv, 1980; Yumashev G.S. and Epifanov V.A. Surgical and rehabilitation of patients with damage to the musculoskeletal system, M., 1983.

Installation for vacuum forming of anatomical models, intended for the production of individually adjusted parts of prosthetic limbs, orthopedic devices, dentures">

Rice. 2. Installation for vacuum molding of anatomical models, intended for the production of individually adjusted parts of prosthetic limbs, orthopedic devices, dentures.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what “Rehabilitation” is in other dictionaries:

- (lat.). Return to previous position; reconciliation, restoration. Dictionary of foreign words included in the Russian language. Chudinov A.N., 1910. REHABILITATION restoration to the previous state, return, reconciliation, affirmation in the former... ... Dictionary of foreign words of the Russian language