Determination of the medical and social levels of disability as a basis for successful comprehensive rehabilitation.

Disability is an interdisciplinary-medical, social and professional phenomenon. The goal of medical professionals is to treat a person and restore his or her fitness. The group of disabled people in Poland is characterized by a lower level of education than among non-disabled people and high unemployment. The purpose of vocational rehabilitation is to make it easier for a disabled person to obtain and maintain appropriate employment and career advancement. Social rehabilitation is defined as an activity aimed at enabling a disabled person to fully participate in social life. The tasks of the local government addressed to disabled people include conducting occupational therapy workshops (WTZ), occupational activity establishments (ZAZ), community self-help homes (ŚDS) and social welfare homes (DPS). The aim of the study was to analyze the implementation of self-government tasks in the field of social and vocational rehabilitation of disabled people, with particular emphasis on ZAZ in the Lubelskie Voivodeship in 2008-2017. The work uses data collected in 2008-2017 by the Regional Center for Social Policy (ROPS) in Lublin. In addition, in December 2017, they were sent by e-mail to ROPS and Marshal’s Offices in voivodship cities in Poland, inquiries about tasks and ways of implementing these tasks in the field of social and vocational rehabilitation of disabled people in 2008-2017. The available data on expenditure from the State Fund for Rehabilitation of the Disabled (PFRON) was collected. The research material was statistically developed using the IBM SPSS Statistics (v. 25) and Statistica (v. 13) statistical packages. In the years 2008-2017 in the Lubelskie Voivodeship, PLN 75,529,959 was allocated for vocational and social rehabilitation of people with disabilities, the most (PLN 9,158,243) in 2016. In the same year, the largest number of people used the ZAZ. In 2008-2017, the average annual amount of expenditure on social and vocational rehabilitation of disabled people in all Polish provinces was PLN 7 576 718.9. In the discussed period, the highest amounts from PFRON were allocated to the rehabilitation of disabled people in the Śląskie Voivodeship, and the lowest in Lubuskie, while Lubelskie received average amounts. In Poland, in the field of social and vocational rehabilitation and employment of disabled people, solutions similar to those already developed are applied in the countries of Western Europe. The costs of financing vocational rehabilitation, understood as financing the functioning of the ZAZ by voivodship self-governments, are constantly growing. The growing expenses incurred on the activities of the ZAZ do not significantly improve the situation related to vocational rehabilitation and employment of disabled people. Improving the operation of the system of vocational and social rehabilitation of people with disabilities should not only consist in increasing the funds spent under the current inefficient system, but should be preceded by a thorough analysis of the current state and the development of extensive organizational changes.

Implantable cardioverter-defibrillator (ICD) therapy is current the main approach to prevent sudden cardiac death. It was demonstrated that patients with ICD are characterised by worse quality of life (QOL) and exercise capacity and are prone to depressive symptoms. Thus, comprehensive rehabilitation is indicated in ICD recipients. To evaluate safety and benefits of comprehensive cardiac rehabilitation early after ICD implantation. The study group consisted of 45 patients (28 males, mean age 62.2 years) in whom a program of comprehensive cardiac rehabilitation was initiated at 6 weeks after ICD implantation. Rehabilitation consisted of two phases: 2-week inpatient Phase I and 12-week outpatient Phase II. Before and after the rehabilitation program, all patients were evaluated with transthoracic echocardiography, treadmill spiroergometric exercise test according to the modified Naughton protocol, a Polish version of the SF-36 questionnaire to assess QOL, and the Beck Depression Inventory (BDI) for depressive symptoms. No deaths during the study and no complications or adverse events during rehabilitation or exercise testing were noted. Following comprehensive cardiac rehabilitation, we found an increase in left ventricular ejection fraction (30.09 ± 12.75 vs. 35.43 ± 13.4%; p = 0.002), peak oxygen uptake (VO₂) (21.3 ± 9.2 vs. 24.2 ± 10.3 mL/kg/min; p = 0.007) and duration of exercise (9.14 ± 3.7 vs. 9.53 ± 3.8 min; p < 0.05). An improvement was also noted in terms of depressive symptoms, as BDI score decreased (14.81 ± 9.27 vs. 12.83 ± 10.75; p = 0.020). QOL improved (p < 0.05), particularly the physical index (p = 0.02), as was the New York Heart Association class (p < 0.001). Improvement in peak VO₂ was associated with better QOL (SF-total, r = -0.34; and physical index, r = -0.36). We also found a correlation between alleviation of depressive symptoms (BDI score) and improvement of QOL (SF-total, r = 0.52). An improvement in left ventricular systolic function, exercise capacity and QOL and a reduction of depressive symptoms were observed in patients who took part in a program of early comprehensive cardiac rehabilitation after ICD implantation. No complications or side effects during rehabilitation sessions or exercise tests were observed in the study group.

Stroke is a blood vessel disease that is mostly caused by high blood pressure, resulting in rupture of blood vessels and bleeding in certain areas. This disease can be interpreted as a pathological condition that affects the entire body, for example paralysis, impaired cognitive function, difficulty speaking, emotional difficulties, pain and problems in daily life which cause various activity limitations for the sufferer. This of course requires appropriate medical rehabilitation that is appropriate to the condition of stroke sufferers. Medical rehabilitation is provided with the aim of optimizing and even returning the patient's body functions to normal. This rehabilitation has three main focuses, namely: medical, social and vocational rehabilitation. Stroke sufferers who are still recovering and do not receive a good rehabilitation program are certainly less able to carry out activities independently, such as from sitting to standing with balance and without the help of other people, as is found at the elderly posyandu in Keprabon Village. In the rehabilitation process, of course, family support is very necessary in helping to get optimal results. So this activity aims to provide education about sit to stand exercise to stroke sufferers and the families of sufferers at the elderly posyandu in Keprabon Village. With this physiotherapy training program activity, it is hoped that it will provide good benefits for sufferers and their families because it aims to increase the independence of stroke sufferers who are in the posyandu in Keprabon Village by increasing functional activities, especially balance in carrying out movements from sitting to standing by routinely doing sit to stand exercises. proper exercise.

Recovery of all brain functions affected after stroke is essential for the patient's quality of life, with comprehensive rehabilitation key. Identify social and environmental factors affecting access to comprehensive post-ictus rehabilitation, and assess long-term effects of comprehensive rehabilitation on patient functionality. 171 consecutive patients (84 women and 87 men) hospitalized in 2015 in Neurology Service with first ischemic stroke, without prior functional dependence, candidates for comprehensive rehabilitation are studied. Various socio-environmental and clinical variables potentially associated with access to it are analyzed. The long-term prognostic impact (average period of 54 months) on the functional situation is studied using the Barthel index. The average age of patients is 69 years. Only 53% were able to access the recommended comprehensive rehabilitation. Predictor variables of access were resulted: residence in urban environment (OR: 2,957; 95% CI: 1,067-8,199; p = 0.037), complement with private rehabilitation (OR: 2,89; 95% CI: 1,130-7,392; p = 0.027), best Rankin to high (OR: 22,437; 95% CI: 3,247-155,058; p = 0.014). After average follow-up for 54 months, of the 137 survivors, access to comprehensive post-ictus rehabilitation was independently associated with better long-term functional situation (OR: 12,441; 95% CI: 4.7-32.5; p < 0.001). Comprehensive post-ictus rehabilitation is associated with better long-term prognosis, but access to it is conditioned by environmental and social factors such as the place of residence and the possibility of contracting private services.

one-level hypothetical model was formulated to explore factors that influenced the self-reported readiness of workplace managers to engage in workplace (vocational) rehabilitation of past-injured workers attending their workplaces. Seven supervisor latent variables were considered, using 270 supervisors self-rated self-efficacy measures, estimating their ability to pursue four related roles associated with vocational rehabilitation in the workplace. Models identifying supervisor self-efficacy pathways leading to their readiness to engage in vocational rehabilitation in their workplaces were tested using Partial Least Square Analysis (PLSPATH). The study's outcomes suggest that supervisor readiness to engage in workplace vocational rehabilitation with rehabilitating employees can be directly associated with four variables. Together, these variables accounted for 41 per cent of the variance of the supervisors' self-efficacy scores, defining their readiness to engage in workplace vocational rehabilitation. Significant predictors which had a direct influence on supervisor readiness to engage in vocational rehabilitation were: their perceived financial and liaison roles associated with vocational rehabilitation and their concern with meeting legal aspects of this process. The capacity of the supervisor to interact with others within the workplace organisation when engaging in vocational rehabilitation was also seen as a significant determinant of their readiness to engage in rehabilitation activities. The gender of the supervisor or the number of employees for whom the supervisor was responsible for, were found to have no significant influence on their self-efficacy levels. Statistically significant supervisory readiness to engage in vocational workplace rehabilitation is subject to their self-rated abilities to undertake multiple roles involved with the rehabilitation process and a more reflective approach is warranted to prepare supervisors for this role.

The risk of recurrent stroke in the first year after is 15.8%, the probability of which reaches more than 30.0% after 5 years and more than 45.0% after 10 years. Pronounced limitations of vital activity are formed in every second patient, the probability of death within the first month ranges from 23.2% to 40.7%. It has been established that such controlled risk factors as smoking, diet and low activity are responsible for the risk of recurrent stroke and are present in 90% of stroke patients. A positive change in modifiable factors can improve the health and quality of life of patients and reduce the likelihood of mortality from cardiovascular diseases by 9%-10%. An urgent task of modern rehabilitation is to find strategies for the prevention of cerebrovascular events and aspects that allow optimizing the medical and social rehabilitation of patients with IS. The purpose of the study: development of recommendations aimed at optimizing the medical and social rehabilitation of IS-stroke patients and improving their health in outpatient clinics. Materials and methods. The study of the state of health was carried out based on medical documentation, lifestyle characteristics of patients after stroke – based on the results of a survey of 1,438 patients with IS. Results. A high prevalence of negative factors such as overweight, smoking, lack of stress relief skills, insufficient night sleep and sedentary lifestyle has been established in patients with IS, which are more pronounced in patients with recurrent IS and in the older age group. The average number of adverse factors per patient with primary IS is 3.8±0.17, with repeated – 3.95± 0.19. It was revealed that low physical activity (r = + 0.714, m =± 0.18), insufficient night sleep (r = + 0.672, m =± 0.16), irrational eating habits (r = +0.624, m =± 0.14), smoking have a significant (p &lt;0.001) effect on health (r = + 0.648, m =± 0.16), lack of stress relief skills (r = + 0.622, m =± 0.14), overweight (r = +0.456, m =±0.14). Comprehensive medical and social rehabilitation, adapted to the social and hygienic characteristics and preferences of patients, contributed to an increase in motivation for a healthy lifestyle, more effective restoration of impaired functions and the prevention of new cardiovascular events. Conclusion. In order to restore functioning after IS, it is necessary to carry out medical and social rehabilitation, including drug therapy, classes with a medical psychologist and training in a healthy lifestyle. To enhance the success of rehabilitation, a personalized plan is devised that considers the patient’s health condition and socio-hygienic background. The effectiveness of rehabilitation depends on the degree of the patient involved in the activities. Scope of the results. Use of medical and social rehabilitation, including drug therapy, sessions with a medical psychologist and training in a healthy lifestyle to formulate preventive measures.

BACKGROUND: Radiation therapy is a critical component of breast cancer treatment but often leads to side effects such as radiation dermatitis and fibrosis. These adverse effects negatively impact upper limb function and reduce patients’ quality of life. Preventing radiation-induced reactions and fibrosis requires a multidisciplinary approach. While the effectiveness of comprehensive medical rehabilitation—including physiotherapeutic prevention, psychological correction, therapeutic exercises, and nutritional support — is well-documented, research on the application of low-temperature argon plasma remains limited. AIM: To evaluate the effects of low-temperature argon plasma on neuromuscular excitability in breast cancer patients undergoing external radiation therapy. MATERIALS AND METHODS: The study included 60 women undergoing radiation therapy for breast cancer. All participants received a medical rehabilitation program that included general magnetotherapy, therapeutic exercises, training on biofeedback-based weight-bearing platforms, nutritional support, and psychological correction. Patients in the main group (n=30) additionally underwent low-temperature argon plasma treatments. Outcomes were assessed using the Visual Analog Scale (VAS), the Radiation Therapy Oncology Group (RTOG) scale, and neuromuscular excitability testing conducted with the Eleskulap-Med TeKo device (Med TeKo,Russia; registration certificate No. FSR 2011/09988, dated February 4, 2011). RESULTS: At the completion of radiation therapy and comprehensive rehabilitation, statistically significant differences were observed in radiation reaction severity between the main group and the comparison group (p=0.016), as assessed by the RTOG scale. Significant improvements were also noted in neuromuscular excitability parameters of the pectoralis major muscle (pars sternocostalis) and pars clavicularis in the main group. CONCLUSION: Low-temperature argon plasma therapy reduces neuromuscular system impairments in breast cancer patients undergoing radiation therapy, supporting its role as an effective component of multidisciplinary medical rehabilitation.

People with communication disability after stroke experience low rates of return to vocational roles. Vocational rehabilitation is recommended; however, there are no clear guidelines informing vocational rehabilitation for people with communication disability. Understanding the needs and experiences of this population is critical to improving vocational stroke rehabilitation outcomes. This study aimed to: (1) investigate the experience of vocational rehabilitation for people with communication disability after stroke, (2) identify gaps and, (3) provide preliminary recommendations for tailored service delivery. Seven participants with an identified communication impairment following stroke were recruited from a larger clinical trial of early vocational rehabilitation (20% of total sample, n = 34). To address the study aims, a qualitative design was employed. Semi-structured, in-depth interviews were conducted and analysed using thematic analysis. Data were integrated with demographic and intervention audit data to contextualise participant experiences, identify vocational rehabilitation gaps and inform preliminary recommendations. Participants were five men and two women aged 24-69 years whose communication profiles included difficulties with auditory comprehension and information processing, reading comprehension, thinking, executive function and self-regulation, as well as difficulties with verbal and written expression. Vocational rehabilitation was perceived as beneficial but participants identified gaps including limited access to psychological and peer-based support during early rehabilitation, limitations to accessing specialist vocational rehabilitation programs, barriers to accessing ongoing rehabilitation after resumption of vocational activity, and limited preparedness for the degree of impact that their communication changes had on execution of vocational roles and responsibilities. Vocational environments are communicatively demanding and people living with acquired communication difficulties face a range of vocation-related participation barriers even when communication difficulties are mild. Greater emphasis on evaluating the vocational communication environment and targeted communication training and preparation for colleagues within the workplace is recommended to reduce barriers faced. Interdisciplinary rehabilitation, inclusive of psychological care, may support working-age stroke survivors to recognise and acknowledge changes in their communication function, lead to improved engagement in the rehabilitation process, and ensure early identification of factors likely to influence successful return-to-vocational activity. What is already known on the subject Stroke is common amongst people of working age yet fewer than half of stroke survivors will return to pre-stroke vocational roles. Communication difficulties affect anywhere between 24% and 45% of people after stroke and include changes to language abilities, motor speech, vision, hearing and cognition. This group experiences much lower rates of return to vocational roles when compared to people with stroke who do not have a concomitant communication difficulty. Vocational rehabilitation is recommended. However, currently there is limited evidence to inform vocational rehabilitation guidelines for people with stroke and communication difficulties. Achieving a successful return to vocational activity is associated with improved life satisfaction for people with communication difficulties after stroke and is a key research priority for this population. What this study adds This study investigated the experiences of people with communication difficulty after stroke who reported a goal of returning to pre-stroke vocational activity. Data associated with types of interventions received, the experiences and perceptions of vocational rehabilitation, and experiences of returning to vocational activity were analysed to identify core rehabilitation needs and develop preliminary recommendations to inform future vocational rehabilitation guidelines for this population. What are the clinical implications of this work? The present study provides preliminary evidence that people experiencing communication difficulties after stroke require a more integrated rehabilitation pathway. During early stages of vocational rehabilitation psychological and peer-based support is indicated to support adjustment to changed communication function and to enable productive goal setting and engagement in rehabilitation. Clinicians need to complete a detailed analysis of the vocational communication environment and consider the communication activities involved in the individual's future vocational duties in order to plan meaningful rehabilitation. A multidisciplinary approach is required and additional training for clinicians is indicated to support clinicians to work collaboratively within the vocational setting.

BACKGROUND: The Short Form-36 (SF-36) is one of the most widely used tools to assess quality of life in breast cancer patients. According to MEDLINE, the SF-36 is used in 95.0% of research studies to assess the quality of life in various diseases. Advantages of SF-36 include wide availability, ease of use, and high validity. AIM: The aim of the study was to evaluate the effect of general magnetic field therapy in comprehensive medical rehabilitation on the quality of life parameters using a SF-36 questionnaire in breast cancer patients at 2–4 days and 1.0–1.5 months after surgery. MATERIALS AND METHODS: A randomized, placebo-controlled study was conducted in patients (n=107) after surgery for breast cancer. All patients were divided into three groups balanced by age and clinical and functional parameters, and received a course of medical rehabilitation which included individual postoperative sessions of exercise therapy (posture treatment; movement therapy with breathing, general stimulating, special, and relaxation exercises; sensorimotor training using a biofeedback simulator; individual sessions with a medical psychologist; one session of instrumental physiotherapy). Comprehensive medical rehabilitation included fluctuating current therapy in group 1 (n=35), local magnetic field therapy in group 2 (n=35), and general magnetic field therapy in group 3 (n=37). RESULTS: Analysis of quality of life parameters in the early postoperative period demonstrated effectiveness of the comprehensive physical rehabilitation program using exercise therapy, balance boards, and sessions with a psychologist in combination with one of the physical treatment options. Positive results increase patients’ confidence in the success of their rehabilitation. After providing the general magnetic field therapy in comprehensive medical rehabilitation, most of the SF-36 quality of life parameters improved, which indicates the beneficial effects of the general magnetic field on situational and personal anxiety, asthenic and vegetative manifestations, and sleep, as well as prolongation of these effects. Patients who received fluctuating current therapy as part of medical rehabilitation improved their pain index and physical function, probably due to analgesic and anti-inflammatory effects of this treatment option. CONCLUSION: Comprehensive physical rehabilitation combined with physical therapy increases the patient’s independence in daily living, self-care, and mobility.

To evaluate the outcomes of comprehensive rehabilitation in patients with AI after hemorrhoidectomy to improve quality of life after surgery. A retrospective study was carried out on 46 patients (mean age 53.8±15.4 years) after hemorrhoidectomy with fecal incontinence, 13 (28.3%) males and 33 (71.7%) females. The main group included 25 patients who received comprehensive rehabilitation, including biofeedback training and tibial neuromodulation (TNM) for 15 days. The control group consisted of 21 patients who received TNM at home also for 15 days. The severity of fecal incontinence was determined using the Wexner score. The functional state of the sphincter before and after surgery was assessed using the anorectal manometry (sphincterometry) (WPM Solar, the Netherlands). Comprehensive rehabilitation resulted in a statistically significant clinical improvement: a decrease in the Wexner score in both males and females. No significant differences in manometry results were observed: the anal sphincter tone increased by 16.0% in females and 10.6% in males, and contractility increased by 17.7% and 15.1%, respectively. Monotherapy with TNM in control group patients improved tone indices by 8.7% in females and 6.8% in males, and contractility by 6.2 and 5.4%, respectively, which was lower than in the main group. Contraindications to physiotherapeutic procedures based on electrical stimulation, extracorporeal magnetic stimulation, and magnetic translumbosacral neuromodulation determine the only possible choice of medical rehabilitation, which is the combination of biofeedback training and TNM (as superior to TNM monotherapy). If out-patient medical rehabilitation is not feasible, patients are recommended to complement the home course with a specially designed set of exercises for anal incontinence treatment.

Introduction.Transient ischemic attacks can be a predictor of a more severe cardiovascular event, the risk of which depends on many factors that requires a personalized approach. Neuropsychological disorders (cognitive, emotional) have a significant impact on quality of life and social activity and are often underestimated in patients with TIA. Comprehensive medical rehabilitation with the inclusion of antithrombotic therapy and psychocorrection measures may reduce the risk of recurrent cardiovascular events in patients with TIA.Purpose of the study: to substantiate the efficiency of complex medical and non-pharmacological rehabilitation in patients who underwent TIA by analyzing the characteristics of the main and leading concomitant diseases.Materials and methods. The morbidity of 351 TIA patients was studied and analyzed. The average age of the examined patients was 58.6 ± 2.2 years, there were 64.9% of women and 35.1% of men. All patients received an individualized medical rehabilitation program for 12 months with correction of identified neuropsychological disorders. Depending on background and concomitant diseases the antiplatelet or anticoagulants therapy was differently administrated.Results and dicussion. Psychological, cognitive, and physical disorders (based on subjective complaints) are common in patients with TIA. The prevalence of mental disorders in patients with TIA was 138.2 cases per 100 patients. The correction of cognitive impairment, depressive symptoms is associated with improved quality of life (p &lt; 0.05). Repeated acute cerebrovascular events (TIA, ischemic stroke) were recorded during the first 6 months after TIA in 29 patients (10.4%) with severe stenosis of the brachiocephalic arteries, severe arterial hypertension and paroxysmal atrial fibrillation.Conclusion.The importance of comprehensive medical and social rehabilitation of patients with TIA is determined. The participation of a psychotherapist as a member of a multidisciplinary team is necessary. A significant role of the secondary prevention of acute cerebrovascular events is assigned to rational antithrombotic therapy.

CHAPTER 81 - Vocational rehabilitation and personhood: A physiatrist’s vital calling

There is currently no systematic relationship between the quantification of funding for the treatment and rehabilitation of cardio-respiratory diseases and the length of a citizen's working life. The development of a universal evaluation methodology that can be used for qualitative and quantitative evaluation of the effectiveness of social and medical rehabilitation is a relevant area of research. The survey contains an analysis of the scientific approaches used in research on social and medical rehabilitation, as well as the development of medical and social rehabilitation and health resort and spa treatment, and to assess the impact of medical rehabilitation on restoration of ability to work. On the basis of the data obtained, a set of indicators for the assessment of the socio-medical rehabilitation of diseases of the cardio-respiratory system at the post-COVID period is proposed, which in the future will serve as a methodological tool in the field of medical and social rehabilitation, health resort and spa activities and at all stages of rehabilitation and preventive medicine.

To investigate possible changes in the rate of conducted neuropsychological assessments and rehabilitation process for patients with multiple sclerosis (pwMS) during the last two decades. The change in the rate of vocational rehabilitation process was also evaluated. Cognitive deficits are frequent among pwMS and negatively affect patients' working ability and quality of life. Preliminary evidence suggests that neuropsychological rehabilitation positively affects cognitive symptoms. Vocational approaches are widely recommended for pwMS. A retrospective survey of all multiple sclerosis (MS) patients diagnosed and treated at the Department of Neurology in Kanta-Häme Central Hospital over the period 1988-2013 was conducted using hospital records. The rate of neuropsychological assessment and rehabilitation processes as well as vocational rehabilitation processes were evaluated. A total of 417 pwMS were identified. A neuropsychological assessment was performed for 104 (24.9%) of these patients, of whom 21 (20.2%) were evaluated between 1988 and 1999 and 83 (79.8%) between 2000 and 2013. Of the 417 patients, eight (1.9%) received neuropsychological rehabilitation, each of these after the year 2000. Only 25 (6.0%) of the 417 pwMS received vocational rehabilitation. Fourteen (56.0%) of the 25 patients received vocational rehabilitation between 1988 and 1999 and 11 (44.0%) between 2000 and 2013. Neuropsychological assessment has been a rarity in MS in Finland, but a marked increase in frequency has occurred since the year 2000. Although understanding of MS-related cognitive impairment and its impact on working ability has increased, the rate of neuropsychological and vocational rehabilitation has remained low.

The relevance of a comprehensive approach to the treatment of patients with congenital defects and deformities of the maxillofacial area is explained by several important factors. Congenital defects, such as cleft lip and palate, as well as various jaw deformities, significantly impact the physical, psycho-emotional, and social well-being of the patient, requiring multidisciplinary intervention. These anomalies not only disrupt facial aesthetics but can also lead to functional disorders, such as feeding difficulties, speech and breathing impairments, and an increased risk of developing dental diseases.This work discusses the comprehensive treatment of congenital cleft lip, palate, and jaw deformities. The study involved 1,415 children with congenital pathology of the maxillofacial area who received inpatient treatment in the maxillofacial surgery department of the Osh Interregional Unified Clinical Hospital from 2020 to 2025. The aim of the study is to comprehensively examine aspects of the treatment and rehabilitation of children with congenital cleft lip, palate, and jaw deformities. The research results confirm that comprehensive treatment and rehabilitation of children with congenital pathologies require multi-stage interdisciplinary cooperation among specialists, including surgeons, orthodontists, orthopedic specialists, speech therapists, otorhinolaryngologists, pediatricians, and others. The collaborative efforts of these specialists ensure the complete restoration of defects and deformities in the maxillofacial area, allowing children to reach a level that is indistinguishable from healthy children, significantly improving the patients' quality of life. Conclusion: To achieve effective medical and social rehabilitation of children with cleft lip and palate, it is essential to organize systematic methodological work at dispensary centers and develop a unified, interconnected strategy for the interaction of all specialists involved in the rehabilitation process.