Medical and Social Expert Evaluation and Rehabilitation

BACKGROUND: In Russia, disability group assignment reflects the medical determination of disease severity and functional impairment, whereas self-rated health reflects personal perception of physical condition, functional capacity, and limitations.

AIM: This study aimed to assess the association between disability and such components of life perception as life satisfaction, self-rated health, and the presence of diseases, based on a representative population survey.

METHODS: Data from the Russian Longitudinal Monitoring Survey—Higher School of Economics (RLMS-HSE) for 2023 were analyzed. The study included 996 respondents who answered “yes” to the presence of disability, reported diseases from the specified list, and evaluated their health status and life satisfaction. Statistical analysis was performed using SPSS 26.0 (IBM Company).

RESULTS: Disability group I was reported in 8.3%, group II in 49.6%, and group III in 42.1%. The mean age of respondents was 65.4 ± 16.1 years; the proportion of persons aged ≥ 65 years was 62.7% in group I, 64.0% in group II, and 54.9% in group III (p = 0.02). The proportion of those rating their health as “poor” or “very poor” was 73.5% in group I, 50.8% in group II, and 42.7% in group III. The mean number of diseases was 4.4 ± 2.6 (without statistically significant differences between disability groups). The proportion of respondents who were “completely satisfied with life” or “rather satisfied” was almost 10-fold higher (39.6%) than those who rated their health as “very good” or “good” (3.4%; p = 0.007). When multivariable logistic regression was performed, being “completely satisfied with life” or “rather satisfied” was associated with age ≥ 65 years (p = 0.004; OR 1.55; 95% CI 1.15–2.07), self-rated health as “very good” or “good” (p = 0.02; OR 2.42; 95% CI 1.15–5.09), and financial well-being, i.e., absence of perceived poverty (p < 0.001; OR 1.97; 95% CI 1.49–2.59), whereas no associations were found with sex, number of diseases, or disability group severity (groups I and II compared with group III).

CONCLUSION: Not all persons with disability rate their health as “poor” or “very poor”, even in the presence of multimorbidity and disability group I. The proportion of respondents with disability who are satisfied with life exceeds the proportion of those not satisfied. Financial well-being is one of the key determinants of life satisfaction in persons with disability. These findings indicate the need to coordinate the capacities of state medical and social services and to improve living standards and material well-being.

BACKGROUND: Sensory impairments are included in screening instruments for frailty, are highly prevalent among older adults, but have been scarcely analyzed among patients with frailty syndrome.

AIM: This study aimed to assess the prevalence of frailty depending on the presence of sensory deficits in older age.

METHODS: The study included 354 patients. Frailty was assessed using the Fried Frailty Phenotype scale. Sociodemographic characteristics, health status, and behavioral data were collected. Analyses were performed using Statistica 10.0. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

RESULTS: Sensory difficulties were most frequently reported (58.1%), followed by cognitive, physical, and nutritional impairments (15.3%, 12.7%, and 1.9%, respectively). The prevalence of frailty syndrome was 19.5% (95% CI 15.2%–23.5%). Most participants in whom frailty syndrome was identified reported problems with vision or hearing. Frailty syndrome was associated with female sex, older age, very poor perceived health, depression, low body weight (body mass index ≤ 18.5 kg/m²), and a higher burden of comorbidity.

CONCLUSION: Incorporating sensory deficits into the definition of frailty significantly increases the number of identified individuals with this syndrome.

Dorsopathies and chronic pain are conditions that represent medical and social challenges due to their high prevalence, tendency toward chronicity, and the limited effectiveness of standard therapeutic approaches, ultimately leading to decreased work capacity and disability in the population. Conventional rehabilitation programs face multiple constraints, including geographic barriers, low availability of specialized care — particularly in rural regions — and insufficient patient adherence. The relevance of this review lies in the need to identify new, more effective and accessible strategies for rehabilitation that incorporate digital and telemedicine technologies (DTT). Based on the analysis of 70 eligible publications according to PRISMA criteria, a comprehensive review was conducted to evaluate the effectiveness of DTT in the rehabilitation of patients with dorsopathies and chronic pain. Based on the available data, various forms of DTT — synchronous (videoconsultations) and asynchronous (mobile applications, SMS reminders, VR/AR technologies, wearable devices based on biofeedback principles) — demonstrate effectiveness comparable to in-person rehabilitation in reducing pain intensity (according to visual analog scale data), improving physical performance (according to Oswestry and Roland–Morris indices), enhancing treatment adherence (up to 90%), and improving quality of life assessed using the SF-36 scale. Key mechanisms of positive DTT effects include reduction of kinesiophobia through graded virtual exposure, modulation of neuroplasticity, and optimization of movement patterns via real-time biofeedback. Despite existing organizational, regulatory, and technological gaps in the Russian Federation (lack of reimbursement frameworks within compulsory health insurance, software licensing challenges, risks of data privacy violations, low digital literacy), both international and Russian evidence supports the high potential for integrating DTT into rehabilitation programs.