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The system of rehabilitation in Ukraine is ineffective presently, because it does not follow any international experience and most physicians and instructors involved in physical therapy do not possess updated knowledge about functional anatomy and the principles of restoration of functions. All measures referred to “rehabilitation” are in fact only a sum of actions, “ritual” in their character: the use of medicine that has no effect on the restoration of functions; physical exercises without specified, time-limited rehabilitation goals; the patient’s “physical activity” in the stages of rehabilitation, which, in fact, repeats the actions of the previous stage; cyclic iteration of the above-mentioned step-by-step actions without real prospects for further recovery. Further, there is lack of specialists in rehabilitation in Ukraine, which has only now started to actively create a modern system of rehabilitation. Since August 2016, the National Classification of Occupations has given new names to professions, including: a doctor of physical and rehabilitation medicine, an ergotherapist and a physical therapist. The current regulatory framework is being reorganized so as to create jobs in health care facilities for specialists in medical and physical rehabilitation. Finally, the Ministry of Healthcare of Ukraine initiated the implementation of the International Classification of Functioning, Disability and Health in the Ukrainian rehabilitation.
Biomechanical factors such as reduced muscle strength and narrowing of the knee joint play an important role in the initiation and progression of primary osteoarthritis. Pharmacological treatment is not always effective and, in some cases, is accompanied by side effects. However, some factors associated with osteoarthritis, such as muscle dysfunction and decreased physical activity, may be improved through physical rehabilitation. In this article, we describe the pathogenesis, clinical manifestations and approaches to physical rehabilitation for biomechanical disorders associated with primary osteoarthritis of the knee (gonarthrosis).
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