Assessing the effectiveness of complex programs for adaptation and preparation for the functioning of the biomechanical «human-prosthesis» system, taking into account the level of lower limb amputation

Abstract. The relevance of the problem of adaptation and preparation for the effective functioning of the biomechanical «human-prosthesis» system is dictated by the high need caused by the growing number of patients with lower limb amputations, both due to chronic diseases or domestic injuries, and due to trauma as a result of combat operations. Objective to evaluate. The effectiveness of complex adaptation and preparation programs for the functioning of the biomechanical «human-prosthesis» system, taking into account the level of lower limb amputation. Material and methods. 60 patients who underwent primary prosthetics at JSC CITO took part in the study, of which 26 patients had amputations at the hip level and 34 patients with amputations at the tibia level. All patients received comprehensive adaptation programs, including: stabilometric training on the COBS platform (Physiomed, Germany); practicing linear walking in a body weight unloading system on a treadmill and in a ceiling rail system; walking training on the «CMill» track (Physiomed, Germany and in the robotic complex «G-EO System» (Physiomed, Germany). The course of physiotherapy included: electrical myostimulation; shock wave therapy of the postoperative scar area; vacuum lymphatic drainage of the limb stump; local magnetic therapy of the limb stump. Results. Under the influence of the complex adaptation course, high clinical effectiveness was noted, which was manifested in achieving better functioning of the biomechanical «human-prosthesis» system and was confirmed by the high effectiveness of restoration of biomechanical, speed and coordination parameters of walking during podometric assessment of the walking stereotype. Also, as a result of the study, predictors of a favorable outcome were identified, both with any type of prosthetics, and specifically taking into account the level of amputation, and the optimal duration of the adaptation course was determined, taking into account the level of amputation. Conclusion: the use of developed programs for adaptation and preparation for the effective functioning of the biomechanical «human-prosthesis» system is a highly effective method of restoring patients after primary prosthetics of the lower limb and requires not only an integrated, but also a personalized approach to implementation, taking into account the level of amputation.