Educational program 19/08/2018 - 01/09/2018 Intership Tech Reh-ESPRM-Kos Care

Educational program 19/08/2018 - 01/09/2018 of Intership under Erasmus+ Tech Reh project at Santo Stefano Rehabilitation Institute (Italy)




20.08.18.- 21.08.2018

Opening the program:

The opening speech is given to the professor of the Santo Stefano rehabilitation clinic - Alessandro Gîustini.

The professor welcomes all the participants of the seminar. In his speech, the speaker gives the details of the training to the participants emphasizing the organizational questions, a schedule of practical and theoretical studies.

Before the forthcoming presentation of the implementation of training technologies, it is necessary to thoroughly be familiarized with the history of the hospital's formation, its priorities, achievements in the field of modern rehabilitation and a multidisciplinary approach. An important focus for the success of the clinic is certainly the highly qualified team of the hospital, which works in unity, combining medical workers, junior medical staff, social workers, as well as representatives of the bodies of management organizers.

Santo Stefano - KOS is one of the leading private operators in the Italian market for the management of functional rehabilitation institutions. He works through Cos Care Company under the brand name of "Santo Stefano." The proposal range extends from intensive rehabilitation of the hospitals as part of a full range of services for the rehabilitation at home unit. Santo Stefano has extensive rehabilitation skills for people of all ages with problems caused by brain diseases that led to a period of coma; cerebral stroke; neurological diseases; pathologies of the muscular and skeletal system of traumatic or chronic degenerative origin even in conditions of severe and complex concomitant pathology and after the intervention of joint prostheses. The great experience of St. Stephan's rehabilitation in the treatment of severe craniocerebral trauma is their most important specialization. Some centers also have the rehabilitational skills, which are specified by the problems of the territories of presence: alcoholical, cardiological, for neurodegenerative pathologies (e.g., multiple sclerosis, ALS, Parkinson, etc.), rheumatological, respiratory. Under the Santo Stefano brand, the presence of the Kos group was also strengthened the field of psychiatry.





Professor also acquainted the audience with the first schools for young scientists in the field of robotics, which were held in June 2018. After the speech, the introduction word was given to the members of Uzbekistan delegation, its project coordinator, participants from TUIT and TASHPMI. Everyone was given the opportunity to present their position, roles and expected results from the completed project.

The following modules were presented by our participants:

- Basics on medical Rehabilitation;

-Basics of new modern technology in rehabilitation in musculoskeletal disorders;

-Laboratory Equipment work and its application in rehabilitation (Unit in Master Course);

-Basics to new technology in rehabilitation in neuroscience;

-State of the Art rehabilitation technology.

In the afternoon, Dr. Massimo Vallasciano, director of the Lampo laboratory Internship tech rah. has introduced the audience with the capabilities and technical equipment of the laboratory and presented a paper on the topic: "Presentation of the" Lampo "movement and posture laboratory - Role and perspectives of cooperation between engineers, doctors and health personnel in the evolution of rehabilitation activities and optimization of results for evaluation and treatment. The introductory part of the second half of the full program is devoted to acquaintance with the personnel of the Lampo laboratory, its priority goals and tasks. A wide range of technologies for rehabilitation was presented. Their thorough technical characteristics, application possibilities and productive integration were introduced. In particular, the surface electromyography: which includes the motor analysis in neurological orthopedic practice. At the presented presentation it was outlined the basic concepts and characteristics of each device. At further stages, it is planned to combine practical and theoretical knowledge with the example of a patient with motor disorders. In the course of the training, it was conducted the master class with the use of the modern EMG apparatus (the subject) on person. Antonio Ruggiero- Biomedical bioengineer.






Denitza Slavova, Speaker, Representative of Bulgaria The title of the report is "ICT and Rehabilitation technologies.

State of art or recovery technologies. Needs of education and implementation in rehabilitations ".

The speaker set the next tasks: to analyze the evolution of rehabilitation technologies in the last decades of development of bioengineering in medicine. A thorough analysis was conducted and the whole spectrum of the basic modern rehabilitation equipment’s and their qualitative and quantitative characteristics were presented. The presented report broadly highlighted all the positive and negative aspects of the applied technologies. The reporter and the team of their rehabilitation center set the new goals and a promising direction: further, long-term research in improving innovative technologies in the field of rehabilitation, the widespread and affordable use of virtual and telecommunication resources.


Alessandro Giustini


He made the presentation on the need to create an educational course carefully prepared for different levels of the educational process. The professor noted the need to create an optimal module, both for health facility managers in the healthcare system, and for graduate students of institutes, narrow specialization doctors, and social workers. In order to achieve maximum results and to obtain a more productive module of teaching the integration of module is an important aspect.

Master class with patients in the rehabilitation department:



DIEGO for the rehabilitation of a one-sided or two-sided upper limb:

Robotic system for one-sided or bilateral rehabilitation of the upper limb, which allows to work, reducing the weight of the hand. This is a multi-dimensional robotic system for monolateral or bilateral rehabilitation of the upper limb. Diego allows you to work by reducing the weight of the weapon, leaving the therapist with a choice between doing rehab tasks using real objects or interacting with virtual reality games. Thanks to its management system, it is possible to conduct therapy in active, passive or active models, offering a very motivating rehabilitative strategy for patients with motor, sensory and cognitive deficits. It can be used in patients with wheelchairs or directly at the patient's bed.



Example: the patient is 55 years old, male. Diagnosis: left-sided hemiparesis, the consequence of ischemic stroke. The course of treatment was started after the 2 weeks of the underwent brain accident. There is a positive dynamic in the movements of the distal and proximal parts of the left limb started within 3 months. The patient holds a spoon by his own, performs the elements of fine motor skills. There is an improvement in the cognitive and emotional-behavioral spheres. There is no depression and apathy.


GLOREHA for the hands neuromotor rehabilitation:

Robotic glove for neuromotor rehabilitation of the hand. The system reads the movement of the fingers supporting movement, based on the residual motor skills of the patient.Gloreha can support the movement of the joints, on the one hand, and recognize the active movements produced spontaneously by the patient, in the other. The patient can follow the current exercise through simultaneous 3D animation, which helps to strengthen the stimulation of the cortex. The glove reads the movement of the fingers and if necessary helps in partly or totally to move based on the residual motor skills. The patient can also use the movement of a healthy hand to create through a robotic glove a similar movement at the deficit hand using the scientific principle called the "mirror neuron".


Example: the patient is 41 years old, male. Diagnosis: left-sided hemiplegia, the consequence of a hemorrhagic stroke. Total aphasia. The course of treatment is 5 months, there is a slight positive dynamics in the movements of the proximal parts of the left limb, in the form of raising the forearm and rotating the shoulder inside. There is a marked depression, apathy.



The lecture of the professor, from Lithuania, Alvydas Jocevicious - topic of the report is «ICT and Rehabilitation technologies.

State of art or of rehabilitation technologies. Needs of education and implementation in rehabilitations». The lecture is full of overview information about the possibilities of robotics technology, its application depending on the levels of damage (brain and spinal cord). The lecturer gave as an example the patients from his practice, the dynamics of positive results. The second half of the day was devoted to train in the rehabilitation department, on the following equipment:

PABLO controls the strength and movements of the arm and upper limb:

A wireless device that monitors the strength and movements of the arm and upper limb with targeted rehabilitation exercises. Pablo is a wireless device for the rehabilitation of the upper limbs and hands. Pablo estimates the strength of the arm and the multiple joints of the upper limb. The device has a convenient touch handle, connected to a PC to control the vertical and horizontal movements of the shoulders and the rotation of the hands. Through the choice of customized rehabilitation exercises, it is possible to program an interactive and cognitive treatments that stimulate the patient. Thanks to the use of special accessories and wireless sensors, Pablo also allows the expansion and focus the therapy on specific articular sites of the upper limb and trunk.





The patient: Is 20 years, the consequence of closed craniocerebral trauma, due to automobile trauma. Complaints to the weakness of the left arm, dysarthria. There is a decrease in concentration and perseverance. The course of rehabilitation was 2 months. It was noted the positive dynamics.

AMADEO for manual rehabilitation:

This is a system of motor rehabilitation of the hand, based on active and passive exercises of one or several fingers with a wide choice of scenarios and real situations. The possibility of multiple settings of exercises and adaptation for adults and children makes this tool a real support for the work of therapists for functional recovery and achieving an autonomy for patients with neurological deficits. Amadeo allows you to perform targeted rehabilitation on the wrist and fingers, restoring strength and motor dexterity, working both in passive and active mobilization. It acts through the use of modular software for each individual patient. Amadeo also allows the use of a "gaming" interface (for example, targeted games), which allows to get the high level of efficiency in enhancing oculo-manual coordination, dexterity and attention. All this is done with a game effect that stimulates the patient. In Santo Stefano, we use Amadeo in both acute and chronic hemiparetic or tetraplegic patients to increase functional mobility, oculo-manual coordination, and reduce spasticity.





Lecture of Alvydas Jocevicious: "E-health, ICT and telerehabilitation. Virtual Reality » The lecture highlights the new views on rehabilitation in medicine. It introduced the virtual reality for motor and cognitive rehabilitation due to the game effect.

Virtual reality means the computer mediation of a simulation, which makes it possible to see, hear, manipulate and interact with an artificial environment. In rehabilitation unit the Virtual Reality allows to visualize on the screen a simple movement made by the patient as a gesture aimed at receiving or moving an object (for example, inserting a ball into the basket) through the sensors applied to parts of the body. This is a "game" tool, which, thanks to immediate visual and auditory feedback, improves control of movement with accurate return of correctness or without exercise. In rehabilitation, it is used for motor exercises of patients who have suffered with brain damage, but also in the cognitive domain: for example, in assessing the reaction time, in restoring attention and memory disorders and also in solving problems. Robots and virtual reality can allow patients with serious disability problems to achieve a better quality of life. In recent years, the major Italian centers have begun to open the first robotic laboratories, hire bioengineers, more often to cooperate with universities. Here there is the first encouraging results of research that demonstrate the benefits of using virtual reality and robots along with traditional methods of treatment.


The second half of the day was devoted to training with patients using virtual reality. A new achievement for the rehabilitation center Santo Steafano was the opening and implementation of the innovative smart home called the SMART HOME. This high-tech project includes the equipping of comfortable, adapted for people with disabilities the mode of life equipment’s. This project takes into account everything that is necessary for the improvement of the quality of life of people with disabilities.




Lecturers: Alessandro Giustini Massimo


Lecture was dedicated to the national health system in Italy.

The speakers described in detail the structure, interdisciplinary approach, social assistance, the Italian health care financing system. All the advantages and disadvantages of the NHS system of Italy were discussed during the stormy discussions. The Italian National Health System (NHS or SSN in Italian abbreviation) is a universally available universal system that guarantees medical care to all citizens financed by general taxation (taxes), direct import (sanitary ticket) and paid services. According to the Entry # 32 of the Italian Constitution, which fixes the "right to health" of all persons, the NHS provides Primary Care: all those services to which the citizen applied directly at the territory (general practitioner, pediatrician PLS, medical insurance); Secondary and tertiary care: all those services which citizen applied through a general practitioner (examination by medical specialists, diagnostic tests, etc.).

This is not a single administration, but a set of national and regional organizations and institutions, and it is organized in accordance with different levels of responsibility and government: The central level: the government is responsible for ensuring all citizens to have the right for the health through a strong guarantee system based on basic levels of assistance (LEA); The regional level: the regions bear direct responsibility for the implementation of the government and the costs of achieving health goals in the country through general hospitals (Azienda Ospedaliera AO, JSC "Aziende Ospedaliere Universitier AOU or Polclinico") and local health authorities (ASL or AUSL) that organize and provide medical care at the regional level: the regions are directly responsible for the implementation of the government and the costs of achieving health goals in the country through general hospitals (Azienda Ospedaliera AO, JSC "Aziende Ospedaliere Universitier AOU or Polclinico") and local authorities (ASL or AUSL) that organize and provide health care in their territory through public or private accredited medical facilities. Founded in 1978 (Act No. 833 of December 23), operation from the July 1, 1980, the Italian NHS became the second best healthcare system in the world in 2000 in terms of cost-effectiveness and access to state aid to citizens after France (WHO study). In 2014, according to the rating compiled by Bloomberg, it was the third in the world in terms of cost effectiveness.




Visit to the MIOLAB laboratory: familiarization with the structure, master classes and discussion.

Composition of speakers and trainers:

Alessandr Rocchetti- director of the clinic; M.Franccesca Belardinelli, Marta Curzi, Matteo Mastri, Michelma Palmieri- leading specialists and trainers of the center.

The rehabilitation specialists of the Miolaba Center cares for people with needs related to neurological, orthopedic and traumatological problems, including sports, cardio-respiratory, lymphatic, postural, phonetic, swallowing or aging.

In Miolab Center there is a multidisciplinary team of rehabilitation specialists with skills that cover all the disabling diseases. Rehabilitation pathways and recovery goals are determined by the health care staff and the responsible director who shares with the patient and his family and adjusts according to the patient's clinical picture and characteristics. The responsible director periodically monitors the rehabilitation activities. The center offers a series of rehabilitation activities, manual therapy, instrumental therapy, which strongly supports patient recovery, group activities, and a rehabilitation pool where the patient is followed by a staff of physiotherapists specializing in therapeutic waterways. Thus, the patient can be evaluated by several professional staffs, each of which specializes in other aspect, to review its conditions and for a multidisciplinary and global approach.

Recovery is divided into:

1. Rehabilitation in the water, individually or by group. The water, in rehabilitation pool becomes a context, as well as a tool to restore skills, maintain functionality, tone and relaxation.

2. Rehabilitation therapy. Postural rehabilitation: Sukhard, Mackenzie, Sawyer, respiratory physiotherapy, speech therapy, functional rehabilitation, Feldenkrais method (functional integration), neuromotor physiotherapy.

3. Manual therapy. Individual and / or group exercises, passive mobilization, connective tissue massage, pump massage, lymphatic massage, lymphatic bandage, regional massage therapy, bandages, kinesiopapiring, manual therapy with osteopathic approach, exercises of pilates.

4. Activities of the group. Back School, Bone school, Pilates, gentle exercises, before and after - water birth, neonatal Acquaticità, Feldenkrais method (know each other through movement), Pre-Natal Pilates Fisios, Postnatal Pilates Fisios, AcquaSoft, Water Pilates movement during pregnancy. 5. Instrumental therapy. Tecarterapia, YAG laser, shock waves, ultrasound, magnetic, analgesic electrotherapy (TENS, Diadinanmiche, galvanic), iontophoresis, electrostimulation, Walker View walkthrough analysis, Baropodometry, static and dynamic stability tests.

6. Logopedic therapy.


When you need to undergo a diagnostic examination, what you are looking for is the Center, which gives you the opportunity to pass the exam quickly, to be equipped with quality and accurate tools and where the competent specialists are able to adequately interpret what are marked by exams and give cautious therapeutic indications.


Myolab is able to meet these needs with the ultimate goal of offering patients with the best experience of diagnosis and prevention. The Center provides the following diagnostic imaging services in cardiology, vascular and neurological areas:

1. Soft tissue ultrasound

2. Morphological echography

3. Osteoarticular ultrasound

4. Obstetrics and gynecological examination of the II level

5. Electrocardiogram for rest and stress

6. Echocardiography

7. Vascular echocolodoppler

8. Electromyography



Specialist in outpatient activities

Myolab Outpatient Clinic offers patients with medical professionals with recognized reliability and competence, short and reliable tools of the level of productivity and time. The following services are included in the number of specialized outpatient activities:

1. Andrology

2. Cardiology

3. General Surgery

4. Dermatology

5. Vascular Diagnostics

6. Dietetics

7. Physiatry

8. Gastroenterology

9. Gynecology

10. Neurology

11. Orthopedics

12. Otolaryngology

13. Pediatrics and pneumoallergenology

14. Treatment of feet diseases

15. Psychology and psychotherapy

16. Science of food

The landmark on the competitiveness of athletic fitness and the certification of non-competitive athletic fitness

The center of sports medicine Myolab is the starting point in the certification of athletes, agonists and non-athletes.

In fact, annually there is more than 4,000 medical visits that conducts the Miolab among many athletes in the territory who decide to rely on our Sports Medicine Center to obtain certification for their activities. Moreover, the agreement with the National Health Service annually allows almost thousand minors athletes to visit this clinic free of charge, presenting their doctor's demands for competitive certification and the request of the company to which they belong. The level of professionalism and the latest equipment of the The Sports Medicine Center, active in Myolab, is studying the special courses for athletes (both professionals and amateurs) who not only returned from an injury, to put them back in a restored position on time but also in the fullness of their business so that they can improve and realize their work by the help of an extremely professional assessments conducted using the best equipment.

Restoration and rehabilitation, routes for athletes recovering from injuries, are specifically designed to optimize the time to return for the sports. This is the main goal of the Myolab Sports Medicine Center, which pursues an athlete (professional, agonist or amateur) at all stages of the recovery process: from determining a diagnosis to a prognostic evaluation from setting up an individual rehabilitation path until he returns to full sports activity. Personalized tests, assessments and training plans to improve athletic performance. Myolab's specialization, skills and professionalism in personalized tracks to improve athletic performance. The goal is pursued by the help of appropriate tests, evaluations of the newest generation and modern tools.

1. Evaluation scores and assessment exams: Step analysis using Walker View Baropodometry, static and dynamic stability testing of Monopodal and Bipodalic, a proprioceptive test, a Post Post Global Dynamic Postural Assessment Test, an isokinetic test for physical and physical tests.

2. Rehabilitation

In addition, the Center offers avant-garde instrumental therapy for the treatment of pain and management:

• Cryotherapy (the game is ready)

• Manutech

• Alogotech

• Tecarterapia

• Laser therapy

• Hydrotherapy

• Shock Waves

• etc.

Participants of the training participated at the Pilates rehabilitation and water procedures for children with autism spectrum disorders.




With MioLab Team


The lecturer Alvydas Jocevicious: "Basics on medical rehabilitation in Italy and in Europe. Basic technologies and evidence-based approach to the rehabilitation of neurological disorders - TBI, stroke, acquired brain injuries in children and adolescents, SCI - Examples of holistic approach to recovery in neurological disorders.

At the end of the lecture, the participants of the training conducted an introductory meeting with Enrico Brizioli- the chairman of the KOSE GROUP. During the meeting, the prospects of further cooperation in the field of rehabilitation between Italy and Uzbekistan were discussed. The project coordinator Igor Virkhov delivered a grateful speech to the management and organizers of the international training. All the participants made a positive feedback about the seminar. They expressed positive wishes for dynamic cooperation.

To the TehReh team the Professor Elena Ilieva was joined – she is a representative of the Medical University of Plovdiv, Bulgaria. She presented scientific research and innovations in the rehabilitation of cancer patients. The lecture comprehensively covered a long and time-consuming way to improve the rehabilitation system in oncology unit. Lecturer, noted the need to implement rehabilitation services in oncology practice. According to the data obtained by Bulgarian scientists, during the scientific research, the introduction of active sports (aerobics, fitness, water sports, etc.) into the rehabilitation complex positively influenced the overall physical health and psychological mood of patients with oncopathology. According to the plan, the second half of the day was devoted to the practical training in the rehabilitation unit working with the patients with orthopedic pathology: - the postural treatment. Orthopedic rehabilitation is aimed to restore the reduced or lost functional motor skills due to illness or injury, and also to maintain and restore functions, which are weakened in chronic diseases, in particular, orthopedic, traumatological or rheumatological. An orthopedic rehabilitation is considered in different contexts depending on the needs of the patient and the progression of the disease. Rehabilitation can be provided by the hospitalization regime for an immediate urgent stage to outpatient treatment to continue the activity. The proposed operational protocol informs of the beginning of physiotherapy and rehabilitation treatment before and after the evaluation, followed by a periodic review of the therapeutic program aimed at functional recovery and maximum patient autonomy, according to an individual rehabilitation project. Rehabilitation is also integrated with an educational program for joint rescue and using the measures that can compensate any temporary or residual functional limitations in daily life that cannot be further improved at the end of rehabilitation.


The beginning of the productive day began with the lecture of Professor Elena Ilieva, representative of the Medical University of Plovdiv, Bulgaria.The title of the lecture was: "Basic technologies and evidence based approach to the rehabilitation of musculosckeletal disorder and osteoarthritis / The role of physical and rehabilitation medicine physicians". The lecture consecrated modern methods of correction in the rehabilitation of musculo-articular pathology.

The methods include:

- Acupuncture; -physiotherapy methods (laser therapy, electrostimulation);

-shock wave therapy;

- balneotherapy, spa therapy;

-injection methods (botulinum toxin, plasmapheresis);

-biomechanical methods, etc.

The lecturer demonstrated the results of scientific research in the field of skeletal and musculo-articular pathology treatment (rheumatism, arthritis, prosthetics, etc.) with has an evidence based approach and having a high level of scientific novelty and practical significance.

The next step in the study of innovations in rehabilitation was the visit to the LAMPO laboratory with a team of Lampo Laboratory Team-Cristina Fiorucci, Mary Sargsyan. There was a goal set by the team: to acquaint with the evolution of virtual reality-Nirvana, G Walk, Free EEMG. A detailed analysis and functional characteristics of each equipment were presented. NIRVANA is an innovative therapeutic solution for the rehabilitation of patients with neuromuscular pathologies. The system contains special exercises aimed at overcoming the cognitive and motor deficits. This is a set of pre-set tasks, as well as tools for creating customized tasks in accordance with the special needs of patients. The effectiveness of the NIRVANA system is based on the motivating approach: the goal orientation and the form of the game, as well as the possibility of feedback at the touch level - all this stimulates the patient's activity.
An innovative system with a motivating therapeutic approach

NIRVANA® is the world's first non-marking system providing complete sensory immersion (acoustic and visual) to virtual reality without invasive devices that can limit the patient's movement or affect the nature of interaction with the system. NIRVANA® reproduces scenarios that can be projected onto horizontal and vertical surfaces using an optoelectronic infrared system: the patient can interact with the virtual environment in a natural way, moving against the background of the projected images. In addition to the several modes and increasing levels of complexity, each task is defined by multiple reverse sensory connections: in comparison with the traditional therapeutic approach, the patient receives powerful cognitive and motor stimuli, which increases his motivation to perform more difficult and complex exercises. Exercises can be of various types: perceptive, aimed at perceiving the environment, aimed at achieving the goal (to follow the animal or go along the line, etc.), motor (event occurs when the patient crosses an object) or game (football, balloons, etc.).



Effective therapeutic support for the rehabilitation centers

NIRVANA® is applicable to any rehabilitation institution that provides the therapeutic treatment for the patients with cognitive and motor skills deficits in both lower and upper extremities. NIRVANA ® is a truly effective tool for rehabilitation after central nervous system lesions (for example, as a result of stroke or TBI) or in chronic and progressive neurological diseases (eg Parkinson's disease or multiple sclerosis). The system includes the set of pre-set set exercises for the upper and lower limbs and the body to assist physician-therapists. Some exercises are aimed to restore the control of motor functions and rehabilitation, it can be used in a combination of several disorders, such as Parkinson's disease, multiple sclerosis and unilateral paralysis. Other exercises with specific visual and acoustic feedback are used exclusively for a certain pathology. For example, the visual feedback can be used for Parkinson's disease, for cyclical synchronization in a one-sided paralysis, spatial orientation in a “ignoring syndrome”.

Parameters, reports and integration with additional devices

For any exercise, there are the measurable parameters so that the doctor can measure the effectiveness of the patient's work and change the level of difficulty of the exercise in a timely manner. An assessment with visualization for the patient is the most important motivational factor. The quantitative parameters calculated on the basis of data after each exercise can be supplemented with a video report. The information is recorded in the database with the help of the RFID identification card, forming an excellent tool for assessing the patient's progress during rehabilitation and serving as a source of information on the entire rehabilitation process. After each test, a report with a list of exercises and results for each task is automatically generated. The NIRVANA® system can be integrated with the EMEM FREEEMG system for comprehensive assessment of the patient and a detailed study of the various strategies for completing the assignment.






The main advantages:

• Easy installation and calibration

• Automatic adaptation to lighting changes

• User-friendly visual interface management

• Creation of various interactive training plots

• Masked projection, blending effects, blurred boundaries

• Calendar and a plot sequence programming

• Remote control and on / off scheduler

• 30 accessible for operation training tracks and effects

• Unlimited effects library, replenished via the Internet

At the end of the theoretical part, the practical skill was carried out with patients on an innovative Nirvana equipment.



The lecture of Elena Ilieva "Modern technologies in rehabilitation of children with neurological disorders". The lecturer conducted a large-scale review of modern equipment for the rehabilitation of children with neurological diseases (cerebral palsy, hemiparesis, etc.). There were presented the results of scientific research of recent years in the field of robotics and the application of virtual reality in the complex treatment of children with neurological diseases. These scientific articles clearly demonstrate the positive dynamics of clinical data and the need to continue research in the field of innovative technologies in rehabilitation. Also, an overview of the modern rehabilitation equipment for the treatment of diseases of musculoskeletal diseases was conducted. The lecturer presented the high importance of social, physical and psychological help to such a patient, who make up about 70% of all pathologies. An important aspect is the support and implementation of these technologies at the governmental level. The next presentation was presented by the representative of the BTC Bioengineering company - Evaluation and treatment with integrated and immersive virtual reality systems - Nirvana system, G walk, Free EEMG. The lecturer gave a briefing on the operation of the Free EEMG system. Described all qualitative and quantitative characteristics of an equipment with its directions in medicine, opportunities and advantages. A master class was held with visual application over the subject. This master class caused a stormy discussion and a lot of questions. The engineers of our team have studied all the technical parameters of the equipment, its possible shortcomings and the possibilities of using it in practice.





The lecture: Advanced technological equipment for the recovery of the functions of the lower limb and of the walk New technologies in the treatment of spasticity /Shock wave therapy.

The lecture was devoted to the introduction into the practice of rehabilitation of robotics - an exoskeleton. The lecturer is a representative of the hospital from the Ancona city, presented his scientific project on the innovative use of exoskeleton in the rehabilitation of multiple sclerosis. The lecturer embraced the most socially significant link in society - the disabled people. People with disabilities are people who have certain limited opportunities. And if a person whose disability has come due to this or that internal disease, one quite probably can go out and serve himself, but the patients with spinal injuries very often remain confined to bed for the rest of their lives. Several years ago it seemed that there is no hope for a normal way of life for such a patient. But nowadays everything has changed. And this happened thanks to the appearance of medical exoskeletons- the real helpers, without which people with fractures of spine and various injuries of the extremities would simply lose their hope of being able to become a full members of society again.



The word "exoskeleton" can be translated as an "external skeleton". And in fact, if you look at this equipment, it turns out that it is attached to the outside of the human body and performs those functions that the disabled person is simply unable to perform for one or another reason. Especially often this device is used for the spine fractures. At the same time, the vertical position of the body and even walking are conducted in an automatic regime. The peculiarity of the exoskeleton is that it most accurately repeats all the person's movements that are performed while walking, and it seems that a person with very serious diseases walks independently. Yes, in some cases, in fact, only an exoskeleton is sufficient to start the movement, but in others, the most severe cases, other adaptations such as crutches can be used, which give the person an additional support. First of all, an exoskeleton is useful for the people who have suffered from a spinal cord injury, and their rehabilitation is very difficult. In most cases such persons cannot independently sit, stand or walk, not mentioning the self-service. When using an exoskeleton, everything is changed in our eyes. A person can not only move independently, but also sit down and get up without additional help, climb or go down the stairs. And also people who spent most of their life in a wheelchair have now the opportunity to get up and walk, which for most of the spinal pathology patients before that time was simply unreal. The exoskeleton will be useful for children who are disabled in childhood, especially with such a widespread and serious illness as a cerebral palsy. In severe cases, children can not only sit on their own, but also walk and even stand. When using an exoskeleton, everything changes. It is the vertical position of the human body that is very important for the normal functioning of all its organs and systems. And, finally, the exoskeleton will become indispensable for the elderly, who because of this or that disease of the musculoskeletal system can no longer move independently. But it is very important that the elderly person can walk on his own feet as long as possible. In this case, the exoskeleton will be a real salvation for elderly women and men who have problems with their joints.

Another sphere of exoskeleton application is physiotherapy and rehabilitation. And here again, in most cases, it helps people with an injuries of the spine, who want to return to their former life after the surgery and treatment course.


The applied technology allows to carry out the rehabilitation procedures for both chronic and acute musculoskeletal system disabilities in people of almost all ages. The main purpose of such activities is to restore the full motor activity. It can be restored by the processing of a minimum amount of nerve impulses and with the initiation of limb movement. Here, in such a case a person is simply learns to walk again, which is especially characteristic for spinal cord injuries, and also after unsuccessful surgeries in the spinal area.

Moreover, such rehabilitation not only helps to restore the lost skills, but also restores the work of almost all the organs and systems, including the pelvic organs, heart and vessels, lungs, muscles and bones.




The last day of the Educational program 19/08/2018 - 01/09/2018 Intership Tech Reh-ESPRM-Kos Care was dedicated to award the certificates for the participants of the training, as well as summing up the results of the training.