Rehabilitation of patients with vertebrogenic muscular-tonic and radicular syndromes

Dear Editor, Electrodiagnostic tests are electrical technologies for evaluating the body’s neurophysiology and used as a complementary method for diagnosing the neuromuscular disorders. These tests are commonly used to diagnosis these disorders: Anterior horn cell disease, Polyneuropathy, Mononeuropathy, Plexopathy , Radiculopathy, Polyradiculoneuropathy, Neromuscular junction and Muscular disorders (1, 2). Because the prevalence and demographic features of disorders referred to electrodiagnosis departments are undetermined, this study was performed. People enrolled the study were patients whom were referred to electrodiagnosis units in Yazd from June 2009 to June 2011.Studied variables were: age, sex and test results included: normal, carpal tunnel syndrome (CTS), cervical and lumbar radiculopathy (Cer. Rad, Lum. Rad.), trauma, peripheral neuropathy (P.N.), nerve entrapment (N.E.), myopathy, motor neuron disease (M.N.D.), myotonia, neuro-muscular junction (N.M.J) disorders (myasthenia). In two years consecutive study, EMG-NCV findings of 2933 patients were analyzed. 1651 patients were females and 1282 patients were males which female gender was more significantly (P < 0.001). Patients’ mean age was 43.2 ± 16.4 which 1805 patients were more than 40 and 1128 were under 40 years old (P < 0.001). CTS, lumbar and cervical radiculopathy and peripheral neuropathy were more in patients over 40 years old and trauma, motor neuron disease, myotonia and myasthenia were more in patients under 40 years old significantly(P < 0.001). Numerous studies emphasized the more prevalence of CTS in patients over 40 years because of osteoarthritis and diabetes mellitus (3-5). More normal reports in patients over than 40 yeras old are may be due to rheumatologic disorders, neuromuscular pain with articular, tendonal or muscular origin in which may lead to false diagnosis and refer normal patients for EMG-NCV (6-8). Normal variable and CTS were more in females and cervical radiculopathy, trauma, nerve entrapment and myotonia were more in males significantly (P < 0.001). Several studies indicate more prevalence of CTS 3 to 7 times in females (3-5). In our study this ratio was 6.5/1. In this study cervical radiculopathy was more prevalent in men like other studies (P = 0.024) 9. 32.3% of reports were normal which may be due to high prevalence of soft tissue disorders, muscular pain around shoulder and pelvic griddles such as bursitis, tendonitis and myofacial pain which may be misdiagnosed as radicular pain or other peripheral diseases (6-8). So obtaining precise history and performing complete general and neurologic examination could lead to decrement the referring rate of patients with diseases other than motor unit involvement lead to lowering cost of EMG-NCV for health and treatment system (Table 1). Table 1 Prevalence Distribution of Findings Based on Age and Sex

This literature review aimed to study the use of isokinetic testing in patients with neuromuscular diseases (NMDs) and to identify directions for future research of isokinetic testing. The MEDLINE (January 1, 1965, to July 1, 2010), Cumulative Index to Nursing and Allied Health (1980 to May 2010), and Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2009) electronic databases were searched. The literature search was conducted using the keywords muscle assessment, muscle strength, evaluation, isokinetic, neuromuscular diseases, muscle fatigue, functional test, rehabilitation, and literature search. Relevant references cited in the selected articles were also considered, regardless of the year of publication. The search strategy yielded 13 articles involving a variety of patients with known NMDs. All studies demonstrated that isokinetic dynamometry is appropriate and safe for ambulatory patients with NMDs. Isokinetic testing has proven to be reliable (intratest/intertest correlation coefficient ranged from 0.65 to 0.98), with the proximal muscles having the highest reliability, and sensitive to disease progression and to the effects of various therapeutic interventions. However, isokinetic testing has never gained wide acceptance, partly because of concerns about stabilizing the dynamometer and the subject during the test and of the lack of standardized protocols for isokinetic strength measurement. Isokinetic testing is an important part of the comprehensive evaluation and rehabilitation of patients with NMD. Research has demonstrated its efficacy in providing clinically relevant information. When integrated with a complete history, physical examination, and functional evaluation, isokinetic testing and exercise can be a valuable tool for the clinician in the assessment, rehabilitation, and performance enhancement of patients with NMD. Such equipment, however, has several disadvantages, rendering it usually impractical in the clinical setting.

One of health care priorities in recent years is the process of rehabilitation. In this connection different pro- grams are developed, which support this process for patients with wide range of diseases. The Program for prophylaxis and rehabilitation of NSSI (National Social Security Institute) was introduced in Bulgaria in the year 2001. Material and method: The present study analyzes the health effect of the rehabilitation, conducted within the NSSI Program for prophylaxis and rehabilitation for patients with lumbar intervertebral disc damage with radiculopathy (ICD 51.1). Health economic evaluation was performed by economic cost benefit analysis. The study includes 100 patients, which attended in three following years (2007, 2008 and 2009) Spe- cialized hospital for rehabilitation - National complex PLC branch Banite. Their health condition was evalu- ated using the functional index of Steinbrocker before and after undergoing the rehabilitation. Results and discussion: A tendency for significant improvement of the patients` health condition was reported for the studied three years. The average number of patients with improvement was increased from 42% in 2007 to 51 % in 2008 and reached 60% in 2009. The performed economic analysis shows objectively the connection be- tween rehabilitation benefit for the patient and costs.

Cervical radiculopathy is common in clinical practice. It is the main reason to neck pain. Depending on the severity, neck pain can interfere with daily activities. In this regard, in order to identify the symptoms and to undertake optimal treatment of the problem, a full clinical and functional examination must be performed. The most commonly used and imposed test in practice to assess the condition of the muscles is manual muscle testing (MMT). Recent studies of muscle dysfunction in various neuromuscular disorders have focused on the use of apparatus methods to assess and monitor functional recovery. For this reason, based on the successful results of the use of a manual electronic dynamometer, we applied in a clinical setting testing with Hand-Held Dynamometer (HHD) to monitor functional recovery in patients with cervical radiculopathy. Aim: The aim of the study was: to monitor and compare changes in muscle strength during functional recovery in patients with cervical radiculopathy using standard Manual Muscle Testing and Hand-Held Dynamometer. Materials and methods: The study was conducted in the period from December 2019 to April 2020. They were selected 16 patients of different origins of pain in the neck portion (osteochondrosis, spondylosis, disk herniation). Functional, hardware and statistical methods were used to monitor and evaluate the results. HDD-muscle testing was also included in the experimental group. Results: The practical experience of using a Hand-Held electronic dynamometer proved to be facilitation not only for the researcher but also for the patients. The inclusion of an HHD in the conducted research allowed fast and accurate assessment of the physical function and the weakened muscle groups. This allowed individual dosing and targeted exercise of weakened muscle groups in each individual patient. Conclusion: The use of HHD to assess muscle strength leads to objectification and a more rational presentation of the results of muscle strength testing.

Background Dizziness and balance problems are common symptoms in patients with cervical radiculopathy. Objective To evaluate the effect of neck surgery postoperatively combined with either structured rehabilitation or standard approach in patients with cervical radiculopathy and dizziness and/or balance problems, and investigate factors influencing dizziness and balance at 6-month follow-up. Methods Individuals (n = 149) with cervical radiculopathy and dizziness and/or balance problems were randomized preoperatively to structured postoperative rehabilitation or standard postoperative approach. Outcomes were intensity of dizziness and subjective balance, and clinical measures of balance. Results Self-reported measures improved at three months (p ˂ 0.001 to p = .007) and the standing balance at six months (p = .008). No between-group differences. Baseline values, neck pain, and physical activity level explained 23–39% of the variance in 6-month outcomes for self-reported measures. Baseline values and physical activity level explained 71% of the variance in walking balance, and lower baseline scores were significantly associated with standing balance impairments (OR 0.876). Conclusion Patients improved significantly in dizziness and subjective balance intensity shortly after surgery, and in standing balance at 6 months, independent of postoperative rehabilitation. Neck pain, physical activity, and neck muscle function influenced dizziness and balance, although preoperative values and neck pain were of most importance for 6-month outcomes.

Subjects and methods. Thirty patients, including 9 (30.0%) men and 21 (70.0%) women, with signs of radiculopathy (RP) in late-stages Lyme borreliosis (LB) were examined. A control group comprised 30 patients with vertebrogenic RP in the presence of dystrophic changes in the vertebral column. Results. 56.7% of the patients with LB were observed to have its primary chronic course in the absence of the acute period of LB. The latter with the signs of RP showed a topic association between the pain location and the tick bite site in 43.3% of the patients. A gradual disease development was more frequently (63.3%) observed in LB while the periods of remission and exacerbation were more typical (56.7%) in vertebrogenic RP. In the patients with LB, pain syndrome depended on posture and physical exercise less frequently (30.0%) than in those with vertebrogenic RP (96.7%). Bilateral pain irradiation was more characteristic of RP in LB than in dystrophic lesions of the vertebral column. The symptoms of tonic muscle tension and limited movement volume in the afflicted part of the vertebral column were significantly less common in the patients with LB than in those with vertebrogenic RP. LB was marked by a concomitance of radicular and polyneuritic disorders (83.3%) and vertebrogenic RP was characterized by a preponderance of the radicular-type of sensitivity disorder (100%). Systemic inflammatory syndrome and polysystemacy of manifestations were more characteristic of LB. The benefits of nonsteriodal antiinflammatory drugs in LB patients with RP were significantly worse than in those with vertebrogenic RP; regression of symptoms in LB was seen only after a course of specific antibiotic therapy.

Amputation of a lower limb is a serious intervention that has a profound impact on a person's life and ability to work. The loss of a limb often causes significant physical and psychological changes that require comprehensive rehabilitation. The patient faces new physical limitations, such as loss of mobility, changes in balance and the need to adapt to prostheses. According to a report by the Wall Street Journal, since the beginning of the Russian-Ukrainian war, the number of people in need of amputation in Ukraine has risen to levels not seen since the First World War. The publication estimates that between 20,000 and 50,000 Ukrainians have lost one or two limbs. Therefore, the study of current trends in the rehabilitation of patients with lower limb amputation in the context of war in Ukraine is extremely relevant. Purpose. To analyse and systematise current trends in the rehabilitation of patients with lower limb amputation. Materials and methods. To achieve the objectives of the study, the researchers analysed scientific literature and systematised information using electronic databases such as PubMed, Google Scholar and others. Research results. Today, physical therapy for patients with lower limb amputation is characterised by a combination of traditional rehabilitation methods and innovative approaches. Kireev and others developed an algorithm that includes rehabilitation activities at 4 main stages. Preoperative rehabilitation, stage I, is aimed at improving postoperative outcomes. It has been suggested that the preoperative programme used in the treatment of young patients with lower limb amputation should consist of chest physiotherapy, muscle and joint mobility training, focusing on maintaining strength and function. During the second stage, before prosthetics, the rehabilitation process includes the aforementioned therapeutic gymnastics and physiotherapy, as well as massage and kinesiotaping. Important issues in preparing an amputated stump for prosthetics include preparing the postoperative wound and scar, controlling edema, preventing muscle atrophy, and preventing the formation of contractures in the joints of the amputated lower limb. In addition to the above-mentioned traditional methods, innovative approaches are actively used at the stage of training with a prosthesis: robotic prostheses, biofeedback technologies, and VR technologies. Giacomo Valle's research has shown that the use of a robotic prosthesis in combination with biofeedback technology not only increases the patient's movement speed, but also increases his or her confidence. Research by Rami L. Abbas demonstrated the feasibility of using VR technologies, which showed a significant improvement in the balance markers, TUG, DGI and BBS tests (P &lt; 0.05). Lifelong rehabilitation, stage IV, involves monitoring the patient for psychosocial adaptation, stump skin pathologies, pain, musculoskeletal disorders, cardiovascular diseases, other chronic diseases, health, and ensuring the use of appropriate footwear for the contralateral limb. Conclusions. Thus, the current trends in combining traditional methods with innovative approaches in the rehabilitation of patients with lower limb amputation are appropriate and justified. It is through the use of therapeutic gymnastics, massage and kinesiotaping in combination with the use of biofeedback technologies, robotic systems and virtual reality that the best results are achieved.

Objective To investigate the effects of deer play of Wu Qin Xi on cervical mobility, TCM symptoms and anxiety in elderly patients with cervical spondylotic radiculopathy. Methods Sixty patients with orthopaedic inpatients from June 2017 to June 2018 were enrolled. In the 6 to December 2017, 30 inpatients who met the criteria were selected as the control group, and 30 patients who met the criteria from January to June 20 were the intervention group. Two groups of patients were treated with conventional nursing, and the intervention group was treated with deer play on the basis of the control group. Cervical dysfunction index (NDI) was compared before intervention, 2 weeks and 4 weeks after intervention; clinical symptoms and signs and neck activity were compared before intervention and 2 weeks after intervention; anxiety scores were compared before intervention and after 4 weeks of intervention (GAD-7). Results The NDI scores of the intervention group were 19.23±2.19 and 9.23±1.85 at 2 and 4 weeks respectively. The scores of the control group were 21.37±1.40 and 11.63±2.95, respectively. The difference was statistically significant (t=3.77-4.49, P<0.05). After 2 weeks of intervention, the clinical symptoms and signs and neck activity of the intervention group were 5.47±1.78, 19.17±1.26, 4.87±0.78, 11.50±1.46, the control group were 7.40±2.53, 16.23±1.87, 6.17±1.26, 13.17±1.56, and the difference between the two groups was statistically significant (t=-7.12-4.81, P<0.05). After 4 weeks of intervention, the GAD-7 score of the intervention group was 1.07±0.20, and the control group was 1.56±0.29. The difference between the two groups was statistically significant (t=6.55, P<0.05). Conclusion Luxi can improve the symptoms of neck pain in elderly patients with cervical spondylotic radiculopathy, improve cervical function and relieve anxiety. Key words: Nursing care; Wu Qin Xi; Nerve root type cervical spondylosis; Old age

Dystrophinopathies — a group of hereditary X-linked neuromuscular diseases characterized by worsening fibrofatty degeneration of skeletal muscles, muscular weakness, low exercise tolerance, as well as orthopedic, cardiovascular and respiratory complications. Study of the effectiveness of physical medical rehabilitation in patients with neuromuscular diseases, evaluation of the influence of external and internal factors on functional capabilities and effectiveness of the conducted rehabilitation are highly relevant. Objective. To evaluate the effectiveness of physical medical rehabilitation of patients with dystrophinopathies at the outpatient stages of the disease’s course and the influence of anthropometric characteristics and functional status of patients’ motor capabilities. Material and methods. The study included 47 patients with genetically confirmed Duchenne muscular dystrophy (DMD) (the 1st group — 32 patients at an early outpatient stage, mean age 7.0±0.2 years; the 2nd group — 15 patients at a late outpatient stage, mean age 9.0±0.2 years) and 17 patients with Becker muscular dystrophy (BMD) (the 3rd group, mean age 12.0±1.2 years). All patients performed aerobic exercises 3 times a week, the duration of rehabilitation course was 4 months. The distance of 6-minute walk test (6MWT) with fatigue assessment on the visual analogue scale, the speed of rising from the floor with assessment of the functional class on a 6-point scale, the functional capacities on the Motor Function Measure (MFM) scale, dimension D1 (standing and transfers) were evaluated at baseline and after 2 and 4 months. Results. Positive dynamics has been revealed in the form of elongating 6MWT distance, increasing speed of tests for time performance with increase of test’s functional class, improvement of motor functions on the MFM scale at the end of case follow-up in the 1st and 3rd groups (p&lt;0.01). A high correlation of the patients’ motor capabilities with reduction of strength and speed indicators, moderate relationship with age and anthropometric indicators have been found (p&lt;0.01). Conclusions. Performance of aerobic exercises without weight combined with exercises on an ergocycle allows to improve motor capabilities in patients with DMD at the early stages and in patients with BMD. Exercising at the late stages of DMD can slow down the disease’s progression. The dynamics of motor capabilities’ indicators in regular performance of dynamic aerobic exercises are more influenced by the initial functional status, less — by age and concomitant overweight and high body mass index.

BACKGROUND: The use of dental implants, being the gold standard in the dental rehabilitation of edentulous patients, is often accompanied by the development of inflammatory complications leading to loss of the implant. Common methods in dental practice for the prevention and treatment of peri-implantitis based on local antiseptic and antibacterial drugs and periodic measures of professional oral hygiene are limited and do not contribute to solving the existing problem. AIM: Assessment of the clinical effectiveness and dynamics of the quality of life of patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination. MATERIALS AND METHODS: the study was carried out with the participation of 116 patients with peri-implantitis of classes I and II according to S.A. Jovanovic. All patients were divided into 4 groups using simple fixed randomization. The first group (control; n=28) received standard dental therapy, including professional oral hygiene and local use of antiseptics. In the second group (comparison group 1; n=29), in addition to standard therapy, a course of ozone therapy was performed, for which the peri-implant area was irrigated with ozonated saline solution with an ozone concentration of 2.5–5.5 μg/ml for 15 minutes. In the third group (comparison group 2; n=30), standard treatment was supplemented with a course of MDM therapy. Patients of the fourth group (main group; n=29), along with standard treatment, received complex treatment, including a course of ozone therapy and MDM therapy. The results were assessed after the end of therapy based on the dynamics of dental indices, the osseointegration parameter of the implant and the level of quality of life of the patients. RESULTS: A course of use of various treatment regimens was accompanied by a significant improvement in the clinical and dental status of patients, but the severity of the effect was different in the groups. To a lesser extent, positive changes were identified in the control group. Additional course use of therapeutic physical factors (ozone and MDM therapy) was accompanied by a significant increase in regression of complaints and improvement in objective indicators of dental status. Achieving the maximum positive result was clearly evident in the main group with the complex use of the studied physiotherapeutic factors. The use of the correlation adaptometry method to assess the clinical effectiveness of various treatment regimens for peri-implantitis made it possible to establish that under the influence of the integrated use of ozone and MDM therapy, the most pronounced decrease in mutual correlations between the studied parameters is observed. This indicates an increase in functional reserves and adaptive capabilities of patients in the main group. CONCLUSION: the results obtained convincingly prove the high effectiveness of the complex use of therapeutic physical factors in the implementation of a therapeutic strategy aimed at eliminating inflammatory manifestations in the area of dental implants and improving the quality of life of patients.

High-resolution ultrasound allowed for more detailed morphological assessment peripheral nerves and muscles. It is important to elucidate ultrasound features of peripheral nerves or muscles in various neuromuscular diseases because ultrasound is a widely used, non-invasive and easily accessible diagnostic tool. We attempted to demonstrate characteristic findings of nerve ultrasound in patients with Charcot-Marie-Tooth disease (CMT), Amyotrophic lateral sclerosis (ALS), and Cervical radiculopathy. In patients with CMT1A, cross sectional areas (CSAs) of all the nerves we examined were significantly larger than those in normal controls. Additionally, median nerve CSA had positive correlation with CMT neuropathy score, and negative correlation with nerve conduction velocity. In patients with ALS, increased CSA forearm/upper arm ratio of the median nerve was a characteristic finding to support the diagnosis. In patients with cervical radiculopathy, we could observe that decreased CSA and diameter of the nerve root corresponding to the findings of MRI and electromyography. These results demonstrate that the combination of electrophysiological study, diagnostic imaging, and nerve ultrasound could lead to accurate diagnosis of various neuromuscular diseases.

Annotation. The relevance of the study is due to the high prevalence of diseases with bronchoobstructive syndrome and the significant social and economic losses they cause. Of particular importance is the need to understand the impact of both treatment regimens and social, biological and organizational factors on the risk of exacerbations, which will increase the effectiveness of medical care at all levels. Taking into account such factors is important both for clinical forecasting and for the development of health care policies. The purpose of the work is to assess the impact of biological, social, organizational factors and treatment regimens on the risk of exacerbation of diseases with bronchoobstructive syndrome, using data from medical institutions of different levels. The study analyzed 731 archival charts of inpatients of three medical institutions in Vinnytsia region for 2019-2024. The effectiveness of ten main and six accompanying treatment regimens was assessed. To model the risks of exacerbations and time intervals to them, a Weibull model with Bayesian MCMC analysis was used based on the R software environment using the libraries «nimble», «coda», «survival», etc. According to the results of the analysis, no significant differences in effectiveness were found between the main treatment regimens. Among the accompanying therapies, regimen No 2 was the least effective with marginal statistical significance. Social and organizational factors were important: employment significantly reduced the risk of exacerbation by 12% (RR=0.885), compliance – by 34% (RR=0.663), and treatment in cluster and supracluster level institutions was associated with a significantly lower risk of exacerbation compared to the interdistrict level (RR≈0.48). The diagnosis of asthma was also associated with a 38% risk reduction compared to COPD. Instead, each year of study was associated with an annual increase in risk of 16%. The individual risk of exacerbation of diseases with bronchoobstructive syndrome depends mainly not on the applied treatment regimen, but on social, organizational factors and patient compliance with the treatment regimen. Optimizing the patient's route and ensuring compliance are key areas for reducing the risk of exacerbations.

Background/Objectives: The extent to which compression or inflammation contribute to the development of cervical radiculopathy and its associated symptoms remains unclear. This study aimed to evaluate whether herniated disc size correlates with baseline symptom severity and/or clinical outcome in patients with cervical radiculopathy, treated surgically or conservatively. Methods: This multi-centre retrospective cohort study included 206 patients with cervical radiculopathy due to a herniated disc. MRI scans from 108 patients in the NECK trial (surgical treatment, evaluating disc replacement) and 98 from the CASINO trial (surgical versus conservative treatment), were used to classify herniation size. Clinical outcome was assessed using the Visual Analogue Scale for arm and neck pain, the Neck Disability Index and the EuroQol VAS at baseline and one year after treatment. Binary logistic regression models were used to evaluate associations between herniation size and clinical outcome, adjusting for treatment type, gender, Body Mass Index and age. Results: A total of 107 patients presented with a small herniation, and 99 had a large herniation. Baseline mean NDI scores were 39.1 ± 15 (surgical group, n = 165) and 32.9 ± 16 (conservative group, n = 41). No association was observed between herniation size and clinical condition (OR 1.010, p = 0.323). After one year, mean NDI scores were 16.2 ± 15 (surgical group) versus 19.6 ± 22 (conservative group), with no significant associations between herniation size and outcome in either group. Similar findings were found for VAS arm and neck pain and EQ-VAS. Conclusions: Disc herniation size on baseline MRI showed no correlation with symptom severity or one-year clinical outcomes, suggesting that inflammatory mechanisms, rather than mechanical compression alone, play a key role in cervical radiculopathy.

SMART isn't

Actuality. Pathological changes of the maxillofacial apparatus associated with pathological abrasion of hard tissues of teeth, aggravated by partial loss of teeth, have a special place among dental diseases due to the complexity of the clinical picture, the presence of risk factors for orthopedic treatment with the use of dental implantation and functional rehabilitation of patients. The aim. Improvement of the clinical algorithm of orthopedic rehabilitation of patients with pathological abrasion of teeth, burdened by defects of dental rows with the use of dental implantation and methods of functional rehabilitation assessment. Methods. Under our observation were 34 persons aged from 30 to 59 years, of which 15 men and 19 women with pathological abrasion of the hard tissues of the teeth of the I-II degree, aggravated by defects of the lateral areas of the tooth rows. Dental implantation and orthopedic treatment were performed after traditional sanitation of the oral cavity and professional oral hygiene. The control group included 12 people of the same age group with intact dentitions and physiological forms of bite, who had intact dentitions without clinically diagnosed diseases of periodontal tissues, pathological wear and teeth affected by the carious process. The ISQ Osstell device was used to determine the degree of primary stability of the implant, as well as the degree of osseointegration. Veneers, semi-crowns and jacket crowns were used to restore the anatomical shape of teeth that had undergone pathological wear. The degree of functional rehabilitation of patients after complex orthopedic rehabilitation was evaluated electromyographically. The results. During the first month after the installation of the implant, a decrease in stability was observed in the bone-implant connection, then from the second month, a gradual increase in the stability of the implant begins, which already exceeds the initial one by the sixth month, with maximum values after 12 months, which confirms the presence of the phenomenon of remodeling of bone tissue around implant. According to the results of an electromyographic study, it was established that before the start of treatment, significant statistically significant changes were noted in the determined indicators of the bioelectric activity of the masticatory muscles in patients with pathological abrasion of the hard tissues of the teeth of the I-II degree, burdened by small included defects of the dentition, compared to the control group, then as six months after the end of the treatment, the data indicate a tendency for the electromyographic indicators of patients with pathological abrasion of the hard tissues of the teeth of the I-II degree to approach the indicators of the control group. The value of the «K» coefficient in the examined group of people after the completion of treatment also testifies to the positive dynamics of adaptation to the established orthopedic structures. Conclusions. Pathological abrasion of the hard tissues of the teeth of the I-II degree, burdened by defects of the dentition, is accompanied by significant changes in the bioelectric activity of the masticatory muscles, which proves the functional changes of the masticatory apparatus in conditions of complex clinical pathology. Based on electromyographic indicators, dental implantation, in combination with the restoration of the anatomical shape of affected teeth with orthopedic structures, allows full functional rehabilitation of dental patients with pathological wear of hard tissues of the teeth, burdened by defects of the dentition.