Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury最新文献

It is known that essential arterial hypertension (EAH) leads to structural-geometric and electrophysiological remodeling and these processes, following in parallel, do not always coincide. Thus, in patients with EAH, electrocardiographic (ECG) criteria of left ventricular hypertrophy (LVH) can occur without changing the mass of the left ventricular myocardium and its geometric characteristics. At the same time, they have independent diagnostic and prognostic value.

Purpose of the study: Evaluation of the effect of manual-physical effects according to the method of A.Yu. Shishonin on the amplitude manifestations of electrophysiological myocardial remodeling in patients with EAH.

Material and methods: We examined 148 patients with EAH with high normal blood pressure (BP), or arterial hypertension of the 1st degree, who were divided into the main and control groups. The main group included 114 patients (65 women and 49 men; mean age 61.8±5.2 years) with clinical manifestations of cervical osteochondrosis, who were treated with EAG using the method of A.Yu. Shishonin, including step-by-step manual-physical correction with the formation of a stable muscle corset in the cervical spine. The control group consisted of 34 patients (18 men and 16 women; mean age 61.6±4.0 years) who did not undergo treatment. To prove the effectiveness of the technique in reducing blood pressure and affecting the ECG pattern, instrumental diagnostic techniques for assessing blood pressure using the Korotkov auscultatory method and recording ECG criteria in 12 leads, respectively, were used.

Results: All amplitude ECG criteria had significantly lower values after EAG correction using the method of A.Yu. When assessing the dynamics of the number of patients with amplitude criteria for LVH, a reliable decrease in this indicator was shown during therapy using the method of A.Yu. Shishonin: from 25.69 to 9.03% according to the Cornell criterion and from 26.39 to 8.33% according to the Sokolov-Lyon index. Considering that all patients did not have morphological signs of target organ damage, including criteria for concentric myocardial hypertrophy, the obtained results can be explained by effects at the tissue and cellular level.

Conclusions: In the process of manual-physical correction using the method of A.Yu. Shishonin, a reliable decrease in the absolute values of the total amplitude indicators of the QRS complex teeth was revealed for all analyzed ECG criteria for LVH and a decrease in the number of patients with amplitude criteria for LVH.

Artificial intelligence (AI) technologies have been increasingly used in the field of healthcare over the past decade, which significantly increases the effectiveness of diagnostic, preventive and therapeutic measures. The development of comprehensive rehabilitation for the people with disabilities, is at the intersection of social and medical fields, and it is classically adopting innovative methods of healthcare, AI technologies in particular. However, the use of such technologies for various targeted rehabilitation groups (TRGs) people with disabilities, taking into account the specifics of possible rehabilitation measures and services, has not been sufficiently studied for today. The aim of the work is to identify the existing, most widespread and successfully applied AI technologies by analyzing foreign publications on the use of AI technologies in the comprehensive rehabilitation of the people with disabilities. The paper analyzed foreign studies described in systematic reviews and randomized controlled trials (RCTs) in the PubMed international medical database over the past 5 years (from January 2019 to May 2024). AI technologies were considered from the point of view of application in the areas of complex rehabilitation for different TRGs. The concept of TRGs is new and has no analogues abroad, however, its use in the analysis allows to systematize information about AI technologies in terms of applied tasks of rehabilitation of the disabled. The largest number of studies on the use of AI technologies in rehabilitation relate to the restoration of motor functions of people with disabilities. The analysis of the publication flow makes it possible to assess the prospects and identify areas of rehabilitation and TRGs where the use of AI technologies has been studied to a greater or lesser extent.

The rehabilitation of participants in a special military operation is conducted in accordance with the standards of Russian legislation regulating the activities of the subjects of the rehabilitation process. Due to specific functional impairments and challenges associated with transitioning from a military to civilian environment, the rehabilitation of combat veterans has distinctive features.

Objective: To identify the essential components of the rehabilitation process for individuals who have participated in a special military operation.

Material and methods: A literature review was conducted using the eLIBRARY.RU database, following the PRISMA flowchart for systematic reviews and meta-analyses.

Results: The categories and characteristics identified in the analytical review allow us to identify the main components of the rehabilitation of participants in a special military operation. These include the goal of rehabilitation for military personnel, the specific functions of specialists, psychological orientation of the process, interdisciplinary approach, versatility, and multidimensional, barrier-free practices. From the initial stages of medical rehabilitation, it is important to focus on an integrated approach that involves various specialists.

Conclusion: The analysis allows us to understand the specific aspects of the rehabilitation of combatants and identify its main components that contribute to the understanding of this phenomenon. The interconnection of medical, psychological, and social issues guides theorists and practitioners towards using an interdisciplinary approach and organizing barrier-free rehabilitation programs.

Current guidances for the prevention and treatment of non-specific neck pain recommend therapeutic exercise as one of the main methods of its therapy. Existing clinical guidelines provide vague advices on the nature of physical training use for this purpose.

Objective: To evaluate the effectiveness of different types of physical exercises for the treatment and prevention of non-specific neck pain.

Material and methods: An analysis of publications over the last 10 years, presented in RSCI, PubMed, Google Scholar, Cochrane, Embase, PsycINFO, Scopus, SPORTDiscus, MEDLINE electronic databases on treatment of non-specific neck pain with therapeutic exercise was performed. The following publications were selected: 22 systematic reviews, 16 meta-analyses and 27 randomized controlled trials involving adults with cervicalgia. The classification of clinical guidelines for usefulness and effectiveness, as well as a scale of evidence levels were used to evaluate the analyzed materials based on the principles of evidence-based medicine.

Results: To evaluate the effectiveness of different types of physical trainings for non-specific neck pain treatment, 9 complexes were selected: exercises for motor activity (motor control) development, strength training, stretching, aerobic training, isometric exercises, pilates, yoga, Chinese health-improving gymnastics and physical rehabilitation using virtual reality. The greatest benefit and effectiveness of therapeutic action have been established in the training of motor control, use of strength and isometric exercises. The results of the evaluation of systematic reviews, meta-analyses and randomized clinical trials served as the basis for it. Other types of physical exercises used for exercise therapy for non-specific neck pain were also effective, but had a less convincing positive effect.

Conclusion: Physical exercises are one of the most useful methods of cervicalgia treatment, thus trainings on motor activity development are the most effective.

The need for sanatorium-resort treatment In Russia is increasing. At the same time, there is not enough development of health and recreation areas suitable for the establishment of sanatoriums. The article presents a rationale for the prospects of health and recreation area development and possibility of using geothermal waters and muds from the Essovsky hydrothermal deposit for treatment and rehabilitation. The performed literature review and survey of health and recreation area of Esso village of the Kamchatka Region show the prospect of development of the territory for resort and recreation development using the thermal water deposit resources. Thermal waters and muds of the Essovsky deposit contain highly active balneological components, in addition, new data on the presence of radon in the accompanying gases of wells of the deposit extend the possibilities of using these nitrogen-siliceous waters in balneology. Esso village is located in an ecologically clean place in the center of Kamchatka Peninsula, on the territory of the Bystrinsky Nature Park, which has a unique ecosystem. The relatively developed infrastructure of Esso village, predominance of steep slopes and presence of an active ski resort on the territory of the Bystrinsky district allows to develop winter sports with a comprehensive use of health and recreation area for rehabilitation. Despite the huge potential, the Essovsky hydrothermal deposit is used mainly by local population for amateur treatment, but not enough for the purposes of balneology. It was concluded using the method of comparative analysis of natural factors of the Bystrinsky district with active health and recreation areas of the Russian Federation (Belokurikha, Bylyra, Kuldur, etc.), which have similar characteristics, that it is necessary and expedient to comprehensively develop health and recreation areas and build an «Esso» balneological resort of federal importance.

Many patients who have suffered from SARS-CoV-2 infection (new coronavirus infection, NCI) face long-term consequences affecting the respiratory, cardiovascular and nervous systems, as well as the appearance of new symptoms that are not characteristic of their previous health condition. Studies indicate that patients who have undergone NCI are at risk of developing thrombotic disorders and problems with the cardiovascular system due to the presence of a low-grade inflammatory process (LGI). In this regard, there is a need to develop new methods and tools, including non-pharmacological approaches, to combat LGI.

Objective: To evaluate the effect of grape polyphenols and magnetic therapy on the state of the LGI in patients with asthma who have undergone COVID-19.

Material and methods: The study included patients with a verified diagnosis of asthma, as well as a history of NCI and with manifestations of postcovid syndrome living in the Republic of Crimea. Patients (n=50) according to indications, namely the presence of manifestations of postcovid syndrome, were referred for sanatorium treatment to the Department of Pulmonology of the Sechenov Institute in Yalta. The intervention group (n=20), in addition to standard sanatorium treatment, received a concentrate of polyphenols of Fenokor grapes produced by Resfood LLC, as well as a course of low-intensity magnetic therapy (MT) using a low-frequency magnetic therapy unit with frequency control of UMTvp-MADIN Lux (Magnetoturbotron), Russia. The second group was a control group, and consisted of 30 patients who were comparable in gender and age to the experimental group. ELISA kits manufactured by Cloud Clone Corp. were used to determine the level of C-reactive protein (CRP), zonulin, lipopolysaccharide (LPS), sCD14, LPS-binding protein, and bactericidal protein that increases bacterial permeability (BPI). (Wuhan, Hubei, China).

Results: In patients of group 1, after a course of sanatorium treatment with the use of polyphenol concentrate and MT, a significant decrease in the level of CRP was revealed (p<0.011). In both groups, a statistically significant increase in the concentration of BPI, sCD14 and zonulin was registered (p<0.05). There were no significant changes in the level of CRP in group 2 (p>0.05).

Conclusions: The use of grape polyphenol concentrates in combination with MT helps to reduce the level of C-reactive protein and increase the activity of components of LPS-binding systems in humans during the recovery period after COVID-19. However, sanatorium treatment can contribute to stress and changes in intestinal permeability, which requires additional research to understand its effect on the enterohematic barrier and protection against excessive translocation of bacterial components from the intestine into the blood.

The prevalence of degenerative diseases of the spine, including neck and low back pain, which reduce the ability to work and lead to disability, is increasing. We have studied the materials of clinical studies, meta-analyses and systematic reviews devoted to the evaluation of the results of manual therapy in patients with degenerative spine diseases, including those who underwent surgical treatment. The analysis (38 sources were analyzed, including 15 meta-analyses and 21 systematic reviews) revealed the ability of manual therapy to influence the level of acute and chronic pain (local and projection), duration of pain-free period, functional status of patients with degenerative spine diseases, including those with radiculopathy and after surgical treatment. There is medium-quality evidence (9 studies, 1176 patients) of a positive effect of manipulation and mobilization on vertebral pain levels and spinal motor activity in patients with chronic low back pain - manipulative therapy and mobilization compared with exercise or physical therapy statistically significantly reduced pain (SMD=-0.28, 95% CI -0.47 to -0.09, p=0.004; I 2 =57%). It was also observed that the effect was stronger at 3 months after intervention (370 patients SMD=-0.68, 95% CI -1.14 to -0.23; I2= 73.7%) and 6 months of follow-up (3 studies, 223 patients) (SMD=-0.72, 95% CI -0.99 to -0.45; I2= 0%). Medium-quality evidence suggests that myofascial release is more effective in controlling pain than control treatments (LFC, simulated osteopathic manipulative treatment, physiotherapy) (ES: -0.69; 95% CI: -1.05, -0.33; P=0.0002), even at follow-up after 12 weeks (ES: -0.73; 95% CI: -1.09, -0.37; P<0.0001). There is also medium-quality evidence (47 RCTs, 2678 individuals) of the efficacy of manual therapy for cervical and lumbar radiculopathy. In particular, mobilization of the nervous system resulted in a significant reduction in pain intensity (Hedges' g=-1.097, 95% CI=-1.482 to -0.712, p<0.001, I2=85.338%). Thus, the review presented evidence based on meta-analyses and systematic reviews of medium and low quality that manual therapy for degenerative spine diseases relieves acute and chronic pain in the cervical and lumbar spine, reduces musculoskeletal and radicular pain, and is effective in the rehabilitation of patients undergoing surgical treatment for herniated discs.