OPTIMIZATION OF REHABILITATION TREATMENT OF VICTIMS WITH LOWER LIMB INJURIES AND DIABETES MELLITUS IN POLYTRAUMA THROUGH TELEREHABILITATION: CLINICAL AND FUNCTIONAL ASPECTS
DOI:
https://doi.org/10.11603/1811-2471.2026.v.i2.16409Keywords:
polytrauma, lower extremity, diabetes mellitus, telerehabilitation, LEFS, remote monitoring, rehabilitationAbstract
SUMMARY. Polytrauma with lower extremity injuries remains one of the leading causes of long-term disability and functional impairment. The clinical course becomes significantly more complicated in patients with diabetes mellitus due to impaired microcirculation, delayed tissue healing, peripheral neuropathy, and increased susceptibility to infectious complications. In this context, telerehabilitation is considered a promising approach for optimizing post-traumatic recovery and improving continuity of care between inpatient and outpatient treatment stages.
The aim – to investigate the effectiveness of a telemedicine model for the rehabilitation of patients with lower extremity injuries associated with polytrauma and diabetes mellitus.
Material and Methods. The study included 96 patients with lower extremity injuries and diabetes mellitus. The retrospective group consisted of 74 patients who underwent conventional rehabilitation, while the main group included 22 patients who additionally participated in a telerehabilitation program using a portable monitoring device. Functional recovery was assessed using the Lower Extremity Functional Scale. Additional parameters included the average daily duration of rehabilitation exercises, the number of visits to medical facilities during the 3-week rehabilitation period, and the total rehabilitation specialist time spent per patient.
Results. The retrospective group consisted of 54 men (72.97 %) and 20 women (27.03 %), while the main group included 16 men (72.73 %) and 6 women (27.27 %). Rehabilitation in the retrospective group was based on early functional mobilization, edema management, and physiotherapy for three weeks. In the main group, the standard rehabilitation protocol was supplemented with a telemedicine model incorporating a portable device for real-time monitoring of limb function and exercise performance. After 21 days of rehabilitation, the main group demonstrated a higher proportion of excellent functional outcomes according to the LEFS scale (13.64 % vs. 9.46 %). The average daily rehabilitation time was significantly higher in the telerehabilitation group ((41±3) min vs. (29±7) min; p<0.005). At the same time, the number of visits to medical institutions decreased from (12±3) to (4±2) (p<0.005), while the total rehabilitation specialist time per patient decreased from (253±18) min to (112±11) min (p<0.005). The telemedicine model enabled continuous remote supervision, individualized adjustment of rehabilitation exercises, and improved patient adherence.
Conclusions. The integration of telerehabilitation into the complex treatment of patients with polytrauma, lower extremity injuries, and type 2 diabetes mellitus contributes to improved clinical and functional outcomes, reduced need for in-person consultations, and optimization of healthcare resources. Telemedicine technologies may serve as an effective component of long-term rehabilitation and continuity of care for this category of patients.
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