METHOD FOR COMPLEX FUNCTIONAL REHABILITATION IN PATIENTS WITH NEOSPHINCTER SURGICALLY FORMED OF GRACILIS Russian patent published in 2013 - IPC A61N1/36 A61H1/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to physiotherapy. A method involves anal electric stimulation of the surgically formed neosphincter from 13-14 postoperative day for 46-47 days, 2 times a day. The electric stimulation is performed at bipolar pulse group frequency 100 Hz, pulse duration 2 ms. The relation of the stimulation and rest cycles is specified on the basis of the functionality of the patient's neosphincter muscles by formula T=t×E/A wherein t is a time of voluntary constriction of sphincter, E is bioelectric activity of voluntary constriction, A is bioelectric activity in test electric stimulation, T is a time of electric stimulation. The stimulation cycle interval is 1.5×T. Starting from the postoperative 14-16 day to one year, the patient performs active voluntary constrictions of sphincter with graduated amplitude of EMGs 50 to 150 mcV and time 5 to 20 seconds. The patient is trained to self-control the formed neosphincter when presenting EMGs of voluntary constrictions thereof and presenting the effectiveness of the process on a display. The duration is 15 - 30 minutes, 10-30 sessions per month. Starting from the third postoperative month, the electric stimulation is applied at stimulating current frequency 80 Hz. In the same period, the patient also carries out training exercises to strengthen the hip and buttock muscles when placing the patient on a stabilometrical platform. And the display shows recording all the movements and variations of the patient's body from the 'normal standing' position with controlling the effectiveness of training exercises by recording the EMGs of the patient's hip muscles. The duration is 10 - 30 minutes, once a day, 10 to 15 sessions per month. Starting from the fourth month, the electric stimulation is performed at stimulating current frequency 60 Hz. From the fifth month, the electric stimulation is performed at frequency 40 Hz. Starting from the sixth postoperative month and to one year, the electric stimulation is applied at frequency 20 Hz. A 1-week pause is made every 3 weeks of the electric stimulation course. From the sixth month to one year, a rectal balloon is additionally introduced into the patient's colon; once the balloon is filled, a receptor system of the rectum is stimulated, and the patient performs voluntary constrictions of the formed neosphincter. The duration is 10 - 20 minutes, once a day, 10 to 20 sessions per month.

EFFECT: invention provides functional transformation of neosphincter with formed tonic activity and neuro-reflex activity, improved functional state of a closing apparatus of the rectum, provided process of self-control of the formed neosphincter of the rectoanal reflex.

2 cl, 3 ex