A DIFFERENTIATED ALGORITHM FOR PRESCRIBING A REHABILITATION PROGRAM WITH FIVE BASIC PROTOCOLS DEPENDING ON THE TYPE OF ANKLE SURGERY
Keywords:
ankle joint, differentiated rehabilitation, five protocols, ORIF, arthroscopy, ligament reconstruction, arthrodesis, endoprostheticsAbstract
Introduction. Existing rehabilitation protocols after ankle surgery are often one-size-fits-all and do not take into account the specifics of a particular surgical procedure. A differentiated approach using several basic protocols appropriate to the type of surgery appears to be more scientifically sound and effective.
The aim of this study was to substantiate and test a differentiated algorithm for prescribing a rehabilitation program with five basic protocols (A, B, C, D, E) depending on the type of surgery.
Materials and Methods. A prospective, controlled study of 132 patients after ankle surgery performed between 2020 and 2025 at the Scientific and Practical Center for Rehabilitation and Rehabilitation at Samara State Medical University was conducted. The comparison group (n=59, 2020–2022) received traditional rehabilitation; the study group (n=73, 2023–2025) received a differentiated program with one of five protocols depending on the type of surgery. Efficacy was assessed using the AOFAS scale at days 14, 28, and 42.
Results. The distribution of patients by protocol corresponded to the clinical structure of the surgeries: ORIF (Protocol A) – 78 patients (59.1%), arthroscopy (B) – 28 (21.2%), ligament reconstruction (C) – 17 (12.9%), arthrodesis (D) – 6 (4.5%), and endoprosthetics (E) – 3 (2.3%). The use of a differentiated approach resulted in an increase in AOFAS scores of 16.7–30.9% compared to standard management. The greatest relative increase was achieved in Protocol E (+30.9%) and Protocol C (+26.1%). All protocols showed statistically significant differences from the comparison group (p < 0.001).
Conclusion. A differentiated approach with five basic protocols ensures higher rehabilitation effectiveness compared to a universal program and allows for consideration of the specific needs of each type of surgical intervention.
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