Limitations In Life Activities Research Articles

Algorithm for expert rehabilitation assessment of autism syndrome in children

BACKGROUND: Despite the long-applied international classifications of diseases and disorders, in our country, no approved methodology has been approved for a comprehensive assessment of autism syndrome, considering categorical and dimensional approaches, age of the child, and polymorphism of symptomatology, which creates significant difficulties in diagnosis, determining the complex of rehabilitation measures, and assessing their effectiveness.
 AIMS: To develop an algorithm for the expert rehabilitation diagnosis of autism spectrum disorders (ASDs) in children with disabilities according to the domains of the International Classification of Functioning, Disability, and Health (ICF).
 MATERIALS AND METHODS: The study enrolled children recognized to have a disability for the first time due to autism in the St. Petersburg and Voronezh regions for 2016–2021. Data sources included state statistical reporting forms 7-D (sobes), acts and protocols of examinations, statistical maps, and data obtained from the Federal State Information System “Unified Automated Vertical Integrated Information and Analytical System”. The study is longitudinal and continuous. Analytical, documentary, data excavation, questionnaires, interviewing, statistical methods of research were employed. The methodology of the World Health Organization was used to study the functional profile according to the basic set for children with autism.
 RESULTS: Data on functioning and life activity limitations of children with autism-related disability were analyzed taking into account the clinical form of autism, age of the child (0–3, 4–7, 8–14, and 15–17 years), and presence of comorbid symptomatology according to the ICD-10 criteria (1992) and IFC domains (2001). The main predictors of the severity of autism manifestations were identified depending on the age of the child: 0–3 years, rates of psychomotor and speech development in epicrisis terms; 4–17 years, degree of deficit of social communication/social interaction; and assessment of limited stereotypical forms of behavior. In children aged 3 years, comorbid symptomatology was also assessed, taking into account the use of psychometric scales and research methods approved in the Russian Federation. Predictors of autism severity were translated into expertly significant domains of the basic set of the ICF for ASDs. Quantitative assessment was performed in a unified format using ICF qualifiers comparable to the system of quantitative assessment adopted in medical and social expertise.
 CONCLUSIONS: The results of the study allowed us to converge international and domestic standards of assessment of impaired functions and limitations of life activity in autism using the order of the Ministry of Labor of Russia № 585n as a ranking tool to translate the data on the functioning and life activity limitations of children with disability into the ICF determinants. The developed algorithm for expert rehabilitation diagnostics of autism syndrome is an important criterion for expert diagnostics, determining complex rehabilitation measures and evaluating the effectiveness of rehabilitation measures.

The trends of dynamics and characteristics of structure of population ovary cancer disability in the Chechen Republic

The article presents the results of analysis of issue of disability because of ovarian cancer in female population of the Chechen Republic. The object of study was total number of women, for the first time and repeatedly recognized as disabled ones. The analysis was applied to three age groups (the young, the middle aged and the elderly) in 2014-2020. It is established that dynamics of disability was characterized by negative trends of increasing of number of the disabled. The clear-cut age differentiation was revealed:the elderly disabled predominated. The study established that the disabled suffer of persistent malfunction of blood circulation system and of immune system that resulted in such life activity limitations as moving, self-service and work functions. The characteristics of structure of ovarian cancer disability according its severity were established. The disabled with second group of disability prevailed in all age groups. At that, percentage of women with first group of disability was higher in the middle-aged disabled. The results of the study testify actuality of optimization of onco-gynecological screening of female population for the purpose of early detection of risk factors and diagnosis of malignant process at initial stages of development. This is rational way to organ-preserving treatment and medical and social prevention of primary ovarian cancer disability. The results of the study can consider as scientific practical base for both targeted routing of preventive and therapeutic and rehabilitation measures.

Qualitative Analysis of a Twitter-Disseminated Survey Reveals New Patient Perspectives on the Impact of Urinary Tract Infection.

Few studies have harnessed social media to explore patients' experiences with urinary tract infection (UTI); therefore, we captured UTI experiences and future research suggestions through a Twitter-disseminated survey. The survey posed three qualitative questions inquiring about the impact of UTIs, greatest UTI management hurdle, and research suggestions. We also asked participants to rate how seriously others perceive UTIs and the importance of UTIs in their life (scale: 1-100 (highest)). The study period spanned from January to June 2021. Coding was performed in duplicate, followed by thematic analysis. Of 466 participants from 22 countries, 128 considered their UTIs recurrent (n = 43) or chronic (n = 85). Six major themes emerged: UTIs drastically impact (1) physical and (2) mental health and (3) cause severe limitations in life activities. Patients reported (4) negative clinician interactions and perceived inadequate care, (5) a lack of knowledge and awareness surrounding UTIs, and (6) research gaps in UTI diagnostics and treatment. The participants considered UTIs extremely important (median: 100, IQR: 90-100), but characterized others' perceptions of them as less serious (median: 20, IQR: 10-30). Our survey revealed a patient population struggling with UTIs, particularly chronic UTIs. Our findings highlight perceived shortcomings in current UTI treatment and diagnostics.

Physical exercise is associated with a reduction in plasma levels of fractalkine, TGF-β1, eotaxin-1 and IL-6 in younger adults with mobility disability.

Mobility disability (MD) refers to substantial limitations in life activities that arise because of movement impairments. Although MD is most prevalent in older individuals, it can also affect younger adults. Increasing evidence suggests that inflammation can drive the development of MD and may need to be targeted for MD prevention. Physical exercise has anti-inflammatory properties and has been associated with MD prevention. However, no studies to date have examined whether exercise interventions affect the peripheral inflammatory status in younger adults with MD. To this end, we used blood samples from young and middle-aged adults with MD (N = 38; median age = 34 years) who participated in a 12-week intervention that included aerobic and resistance exercise training. A pre-post assessment of inflammatory biomarkers was conducted in plasma from two timepoints, i.e., before the exercise trial and at follow-up (3–7 days after the last exercise session). We successfully measured 15 inflammatory biomarkers and found that exercise was associated with a significant reduction in levels of soluble fractalkine, transforming growth factor beta 1 (TGF-β1), eotaxin-1 and interleukin (IL) 6 (corrected α = 0.004). We also found significant male-specific effects of exercise on (i) increasing IL-16 and (ii) decreasing vascular endothelial growth factor-A (VEGF-A). In line with our results, previous studies have also found that exercise can reduce levels of TGF-β1, eotaxin-1 and IL-6. However, our finding that exercise reduces plasma levels of fractalkine in younger adults with MD, as well as the sex-dependent findings, have not been previously reported and warrant replication in larger cohorts. Given the suggested role of inflammation in promoting MD development, our study provides additional support for the use of physical exercise as a treatment modality for MD.

Practical application of the International classification of functioning during medical and social expertise of a child with cerebral palsy

The aim of the work is to assess the degree of dysfunction and limitation in daily life activities in a child with cerebral palsy, to provide an expert opinion for medical and social expertise by Medical Supervisory Committee (MSC) in accordance with the principles of the International Classification of Functioning, Disability and Health (ICF). Materials and methods. A clinical example of measuring the degree of disability of the cerebral palsy child in accordance with the ICF principles using standardized tools for functional status assessment and the ICF Categorical Profile. International standardized scales recommended by the international expert group to be applied for cerebral palsy children were used at the State Institution “Ukrainian Medical Center for Rehabilitation of Children with Organic Nervous System Disorders of Ministry of Health”. Results. During a comprehensive examination of the child with cerebral palsy, a multidisciplinary team of specialists determined the degree of body dysfunction and limitation in daily life activities as well as environmental effect influence on the level of functioning and social adjustment. Based on these findings, ICF Categorical Profile of the patient was formed capturing all spheres of his activity according to the functional state. Parents of the child received the medical conclusion based on the results of the examination for MSC expertise at the place of residence. Conclusions. The IСF covers the whole complex of life activity and functioning of CP children and reflects all the changes associated with their growth, development and state of health, as distinct from the classical clinical examination of patients. Standardized tools for the assessment of the degree of dysfunction and life activity limitations in CP children allow to avoid controversies between specialists from different medical institutions during medical and social assessment and when making a rehabilitation diagnosis. Members of multidisciplinary rehabilitation team can timely identify and correct dysfunctions, provide early career guidance based on child functional capacity by using the IСF principles to assess life activity in CP children.

The Cerene Cryoablation Device for the Treatment of Heavy Menstrual Bleeding: 36-Month Outcomes from the Clarity Study

<h3>Study Objective</h3> To evaluate the safety and effectiveness of a novel cryoablation device (<i>Cerene Cryotherapy Device, Channel Medsystems, Berkeley, CA)</i> in premenopausal women with heavy menstrual bleeding (HMB) due to benign causes. <h3>Design</h3> A prospective, multi-center, single-arm, open-label study. <h3>Setting</h3> 8 sites in the USA, 1 in Mexico, 2 in Canada. <h3>Patients or Participants</h3> 242 Intent-to-Treat women, 25 to 50 years of age, with HMB, uterine sound ≤10 cm, and endometrial cavity between 2.5 to 6.5 cm. <h3>Interventions</h3> The Cerene single-use disposable device, delivered a 2.5-minute cryoablation of the endometrium. Analgesia and local anesthesia were administered per investigator discretion: 97% of subjects received a paracervical block with or without oral medications, 3% IV sedation, and none received general anesthesia. 180 USA treatments were performed in the physician office setting and none in the operating room. Subjects were evaluated through Month 12 and long term at Month 24 and 36. <h3>Measurements and Main Results</h3> 201 women were evaluated at Month 36. 88.6% (178/201) reported amenorrhea, a lighter than normal, or normal period. 91% (182/201) reported no or slight limitations in life activities in their Menorrhagia Impact Quality of Life (QoL) questionnaire. 85% (171/201) reported premenstrual symptoms (PMS) at a low frequency (none, rarely, or sometimes) in their PMS Impact QoL Survey. 84.5% (153/181) of subjects who reported level of satisfaction at the final study visit stated that they were satisfied or very satisfied with their treatment outcome. 7% (17/242) underwent a post ablation intervention for menstrual bleeding. <h3>Conclusion</h3> The Cerene endometrial cryoablation device maintains safety and effectiveness for the treatment of HMB through the long-term study visit at 36 months. It is a global endometrial ablation technique that can be performed consistently in the office setting requiring minimal anesthesia or analgesia.

Sensorimotor function does not predict quality of life in persons with multiple sclerosis

Quality of life (QOL) has been reported to be reduced in persons with multiple sclerosis. Further, associations between QOL and the clinical severity of the disease as well as sensorimotor function were shown. We reinvestigated impacting factors on QOL by the additional assessment of depression, fatigue, satisfaction with life, and a battery of end-effector based assessments of sensorimotor functioning. Models of multiple linear regression revealed everyday life activity limitations to be the driving factor within the used questionnaire and no association with sensorimotor tests, but depression, fatigue, and satisfaction with life. We conclude that either psycho-emotional coping and adaptability are the dominant determinant of QOL or that QOL is in need of a quantitative and objective reconceptualization.

Functional limitation on elderly people in the northeast and the feminization of eld in urban and rural areas of Brazil

Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderly residents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.

Features of the structure of adult disability due to hypertension

A retrospective statistical analysis of primary, repeated and General disability of the adult population in Moscow and in the Russian Federation was carried out. The observation period 20112017. Scope of the study: 31 373 disabled people (primary 11 069 and repeated 20 304), recognized as disabled due to hypertension during examination in the BMSE. The analysis of the dynamics of disability due to all classes of diseases in the Russian Federation is carried out. The total population was 324 832 people (90 808 primary and 234 024 repeated), who were recognized as disabled due to hypertension during examination in the BMSE. The observation period 20112017. The features of clinical and functional disorders and limitations of life activity in disabled people due to essential arterial hypertension (hypertension) were studied. A sample study was conducted in a cohort of disabled people (271 people due to hypertension).

Employee reliability analysis by criteria of life activities limitations

Problem statement. The urgency of the problem of analyzing the employee reliability with stable functional changes in their health is due to the tendency to increase the number of people with chronic diseases and injuries around the world. Paying attention to the issue of organizing labor employment in this category of the population underlines the desire of our country to resolve socio-economic issues important in the context of European integration. Possible increasing the level of occupational injuries, occupational morbidity, as well as the need for investment in the implementation of measures to adapt the workplace to the abilities of the employee, are the main obstacles to the effective employment of persons with disabilities at the workplace. The growing relevance of solving the issue of ensuring safety at workplaces is due to the fact that, when carrying out professional activities, a priori there is a mismatch between the characteristics of the contractor and the requirements of the occupaotial process and the workplace. Moreover, individual differences in the state of health of persons with disabilities lead to a decrease in the reliability of workers with disabilities. For planning effective decisions on occupational for persons with disabilities, an important step is the development of a methodology for assessing the level of reliability of an employee, taking into account its life activity limitations. Purpose. Numerous studies prove the importance of professional integration of people with disabilities, because it is proved that most people with special needs are able to effectively fulfill their professional duties. Improving occupational safety is an effective lever in resolving this issue. The purpose of the article is to analyze the issue of reliability in the context of ensuring the safety of persons with disabilities at the enterprise. Conclusions. Taking into account the limitations of life activity showed in the article, the principles of the theory of structural reliability are used, in which the of life activity limitations are divided into groups, determining the significance of their impact on the ability of an employee with a disability to perform safely and effectively professional activities in a production environment. Using this approach, it is possible to assess the reliability of workers with disabilities in the presence of persistent functional changes in the state of health of various degrees of severity by determining the values of reliability in the presence of individual disabilities.

The causes of disability as a result of the elbow joint injuries

The aim of the work is to find out the causes of disability as a result of the elbow joint injuries.Materials and methods. 56 people disabled due to elbow joint injuries were examined. Identification of the disability causes was performed according to the criteria of life activity limitation in the disability groups (I, II, III) establishment. In this research, the medical reasons that led to persistent functional and morphological disorders were considered.Results. The conditions of the elbow joint that led to disability consisted of functional disorders in the form of contracture or ankylosis which were observed in 100% of the affected patients, and morphological disorders in the form of slow healing - 33.9%, deformities of the elbow joint bones - 32.1%, neuropathies of the radial, median, ulnar nerves - 16.1%, false joints - 8.9%, obsolete dislocations - 5.4%, defects of the radial head - 1.8% and osteomyelitis - 1.8%.Functional abnormalities in the form of contracture were more frequently observed in conservative treatment (24.5%), extramedullary osteosynthesis (45.3%), and osteosynthesis with K-wires and screws (15.1%), and ankylosis - in conservative treatment (2 of 3 cases).Morphological disorders in the form of: pseudoarthrosis were more often found in conservative treatment and extramedullary osteosynthesis (40% each); slow healing - in extramedullary osteosynthesis (42.1%), transosseous osteosynthesis (21.1%) and conservative treatment (21.1%); neuropathy – in extramedullary osteosynthesis (44.5%) and transosseous osteosynthesis (33.3%); obsolete dislocations - in conservative treatment (66.7%); bone deformities - in extramedullary osteosynthesis (50.0%) and conservative treatment (38.9%).Conclusions. The reasons for the formation of disability as a result of the elbow joint injuries are: a) morphological conditions in the form of slow fractures healing (33.9%), deformities of the elbow joint bones (32.1%), neuropathies (16.1%), pseudoarthrosis (8.9%), obsolete dislocations (5.4%), defects of the radial head (1.8%) and osteomyelitis (1.8%); b) functional conditions in the form of contractures with functionally impaired range of motion – 25.0% and ankylosis in functionally impaired position – 5.4%. Disorders of the morphological and functional state of the elbow joint leading to disability may depend on both the severity of the injuries and the types and quality of the treatment.

TAKING INTO ACCOUNT FUNCTIONAL LIMITATIONS IN ASSESSING THE RISK OF INJURY OF EMPLOYEE WITH DISABILITY

The organization of employment of vulnerable groups, including people with disabilities, is an important so-cio-economic issue, because providing opportunities for professional development creates the conditions for im-proving the level of economic protectability of disabled person, as well as has a positive influence on his psycho-logical state. However, the employment of people with special needs at the workplaces is connected with an in-creased risk of injury. This is due to the presence of persistent functional changes in the health state of workers with disabilities, as well as dangerous and harmful factors present at the workplace. Therefore, employers seek to avoid employing people with disabilities, despite the requirements of human rights law, anti-discrimination laws, and programs and services aimed to provide support and employment opportunities for people with disabilities. The purpose of the article is to develop a scientifically grounded approach to taking into account the func-tional state of persons with disabilities in determining the risk of injury at performing production tasks at the workplaces of enterprises of basic sectors of the economy. The novelty of the approach to risk assessment is based on the using individual risk of injury specific to the enterprise of a particular industry, taking into account the functional state of a person with a disability working at a particular workplace, carried out by using the appro-priate coefficient. The value of the coefficient depends on the number of criteria for life activity limitations, which are determined by the medical and social expert commission, as well as the maximum value of the severity of the criteria. Thus, the proposed approach allows taking into account not only the general level of injuries inherent in a particular industry, but also the individual characteristics of a particular employee. This approach allows providing the employer with information in decision-making about improving the management system of occupa-tional safety at the enterprise. Keywords: person with disability, occupational safety, individual risk, trauma

USE OF NEURAL NETWORKS IN SAFETY MANAGEMENT AT THE WORKPLACE OF EMPLOYEES WITH DISABILITY

The problem of safety management at the workplaces of workers with disabilities is one of the key issues when solving the problem of employment of a person with stable functional changes in his health status at the workplace in an enterprise conditions. An employer who, according to legislation, is responsible for ensuring safe work conditions at the workplace, in most cases connects the employment of a person with a disability with a possible increase of the injury level. The rational selection of the workplace, taking into account the limitations of life activity caused by human health, makes it possible to formalize this process, giving the employer the opportunity to make well-grounded decisions subject to safety requirements. The article discusses the basic principles of developing and using an artificial neural network in solving the issue of selecting a workplace for a person with a disability that may have different life-limiting, in order to reduce the degree of discrepancy between the employee's health status and specifics of work activity. Network input signals are conditioned by the life limitations of a person with disability. The output signals of the neural network are the coefficients that characterize the level of discrepancy in the employee's employment at the workplace, which is characterized mainly by physical activity, mental activity, or psycho-emotional and sensory activity. The use of artificial neural networks is a perspective direction in managerial decision-making, particularly in the field of workplace safety for workers with disabilities. The principle of creation an artificial network allows to take into account the life limitation of a person with stable functional changes in health status, as well as to provide sufficient efficiency and flexibility of the management decision-making process, taking into account the context of production activity. Keywords: human with disability, occupational safety, neural network, management

The characteristics of limitations of life activity of the disabled persons older than able-bodied age due to Parkinson's disease

The article presents characteristics of limitations of life activities of the disabled older than able-bodied age due to Parkinson's disease and considering clinical data, stages of illness, severity of disability and disorders of functions of organism. The highest percentage in the structure of life restrictions was taken by restrictions of first, second and third degree related to self-service, movement, labor activity (12.1%, 9.5% and 10.5% respectively). The lowest percentage of restrictions of first, second and third degree related to education, control and communication.

The prevention of disability as a leading priority of caring of mother and child health

The prevention of disability in children and support of families fostering disabled children and children with limited capacities in health are included into number of main priorities of the state social policy of the Russian Federation. Thereupon, the project "Childhood Decade" is an important stage that includes social care of disabled children and children with limited capacities in health and their integration in modern society according the Decree of the President on implementation of state policy in the field of family and children care. The underestimation of children disability is supposed to be present produced by such causes as social motivation of family, complicacy of legal official registration, harsh requirements of medical social expertise services, inadequate awareness of medical staff about criteria of disability. According the WHO European Regional Bureau, in Russia there are 250 000 children with limitations of life activity mainly caused by somatic pathology, who have no status of disabled person and no state social support. The prevention of children disability is considered as a system of measures of caring mother and child health all along childhood. The priority directions of prevention considering causes of development of disability and its structure according particular disease are marked. The data is presented related to modern technologies of decreasing genetic load on population from position of prevention of hereditary, inborn and orphan diseases. In particular studies non-infectious pathology acquiring greater significance in development of disability in children of various age groups since neonatal period is considered. The new directions of research are proposed to affect the processes of incapacitation of child on more profound pathogenic level and to develop organization of preventive activities in this area.

Postural Changes After Abdominoplasty in Morbid Obese Patients.

In the multidisciplinary treatment of obesity, the role of a plastic surgeon is to remove the excess of skin after weight loss to obtain cosmetic, functional, and psychological benefits. Obesity modifies body geometry, increases the mass of different segments, and imposes functional limitations in life activities that may predispose the obese to injury. The authors evaluated the postural conditions of obese patients, before and 12 months after surgery. The study included 15 obese patients of both genders affected by class II obesity. Postural function was evaluated preoperatively and 12 months postoperatively. Patients underwent conventional abdominoplasty surgical procedure. In all patients, plantar pressure distribution and balance (stabilometric test) were evaluated before and 3 months after surgery. The static pedobarographic revealed a significant reduction in forefoot peak pressure; total plantar force; rearfoot plantar force percentage; midfoot plantar force percentage; and forefoot, midfoot, and rearfoot plantar contact areas percentage 3 months after surgery; the dynamic's one showed a reduction in the first metatarsal peak pressure and plantar contact. The stabilometric values showed a reduction in the range of center of foot pressure (CP) displacement along y axis, the average displacement of the CP speed from the mean (RMS y velocity), and CP mean peak in the condition of vision. Our study demonstrates the beneficial effect of dermolipectomies and the consequential weight loss on postural stability of obese men. Such findings may support the hypothesis that dermolipectomy may improve postural stability with and without vision. The data demonstrate that the benefits are related to the magnitude of the resected tissue.

A review of this month's lawsuits and rulings

Termination: Generous New York statute language gives former employee's suit a boost Dismissal: Unreasonable accommodation request vindicates university Accommodation: Granting of generous medical leave exonerates college district Retaliation: Failure to allege major life activity limitations dooms former student's suit Adult learner: University properly accommodated disabled student

О ранней помощи детям и их семьям

In the past 40 years, assistance to children — aged from newborn to 3 years old with developmental disabilities, limitations of life activity or having a risk of developing disorders — is actively developing. Such technology of assisting small children and their families is called «early intervention». For more than 25 years, support for families and small children under programs of early intervention has been introduced in Russia. In our country, the term «early help» is used to describe this type of assistance. Basic definitions used to describe the technology, the methodological foundations and principles of early assistance, the organizational basis for the implementation of early assistance are considered in this article.

Computer-Assisted TKR Vs Conventional TKR: Post-Operative Ankle Radiographic Finding and Ankle Clinical Assessment

Background: Few previous studies showed that the conventional total knee replacement (TKR) has affection to the same side of talar tilt (TT). We expected to prevent this problem by the computer-assisted (CAS) TKR. Objective: The purpose of this study was to compare between pre and post-operative talar tilt and ankle clinical assessment on the CAS TKR and the Conventional TKR in 28 patients (56 knees) whom underwent bilateral TKR. Material and Method: 28 patients, 56 knees, whom underwent both CAS total knee replacement (TKR) and conventional total knee replacement (TKR), in both knees, with the combination of Gap Balance and Measurement Resection techniques performed by one surgeon (P. Sriphirom) at Rajavithi Hospital, Bangkok. The post-operative has a 12 months follow-up for ankle radiographic finding by tibiotalar angle (TTA), tibial articular surface angle (TAS), and talar tilt (TT) = (TAS-TTA) and for ankle clinical assessment by foot functional index (FFI) from pre-operation and post-operation from both groups. The study also compares the CAS TKR with the Conventional TKR for pre-operation and post-operation. Results: 56 knees, 28 patients, mean age = 67.79 years whom underwent bilateral TKR by the Conventional group and the CAS group had pre-operative TT (TT = TAS - TTA). The Conventional group = 1.5 (-5, 8), the CAS group = .5 (-5, 8), P value = .65. On post-operative TT the Conventional group = .0 (-5, 3), the CAS group = 1.0 (-3, 8), the P value = .4. The comparison of pre-operative TT and post-operative TT in the Conventional group, the P value = .01. On pre-operative TT and post-operative TT in the CAS group, the P value = .65. TT was significantly different in the Conventional group but was not significantly different in the CAS group. The ankle clinical assessment by foot functional index (FFI), which is (1) Pain, (2) Difficulty living, and (3) Daily life activity limitation. The pre-operative FFI in the Conventional group = 1.85 (.81, 6.88) and pre-operative FFI in the CAS group = 1.91 (.24, 66.5), the P value = .57. The post-operative FFI in the Conventional group = 1.68 (0.24, 7.0) and post-operative FFI in the CAS group = 1.65 (.24, 6.76), the P value = .04, which showed a significantly different between the post-operative FFI from both groups. In the Conventional group the post-operative FFI was not significantly different from pre-operative FFI, the P value = .2 but for the CAS group the post-operative FFI was not significantly different from pre-operative FFI, the P value = .04. Conclusion: This study has shown that the conventional TKR effected to post-operative talar tilt but the CAS TKR has less effect and was not significantly different to ankle joint. Finally, the study needs to be conducted on more patients and to be observed on a longer term follow-up.

Methods of assessing the health and social status of elderly disabled persons

Execution of documentation is an essential component of the vocational work of experts engaged in the provision of medical and social assistance to the disabled, from the clinical diagnostic to rehabilitation. In the article there is presented the questionnaire of the assessment of health and social status of the elderly disabled person, which allows to reflect the existence of violations of the functions and limitations of life activity, the degree of their severity, needs in certain types of rehabilitation, including with the use of technical means of compensation of disturbedfunctions. This type of documentation allows to reduce (speed up) the time on the execution and to increase the level of the vocational competence of the professionals engaged in medical and social activities as well in health institutions as social protection institutions. With properfilling ofpreprinted forms (layout, template) it will be received medical and social portrait ofa disabled elderly person. Questionnaire can also be used in execution ofscientific research.