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

The relevance of the study of neuromuscular dysfunction's causes and mechanisms is undeniable, considering the large number of nosologies accompanied by malfunction of muscles. Adequate diagnosis and correction of these disorders is impossible without understanding of their pathogenetic mechanisms. Currently, manual muscle testing (MMT) is a widespread technique. MMT is an agile diagnostic tool used by physiatrists, doctors in sports medicine, osteopaths and rehabilitation physicians to assess the functional status of muscles. Unconditionally, this method attracts with its low cost, which will optimize the financial costs of hospital and the healthcare system as a whole. In addition, there is no clear substantiation of the objectivity and validity of the MMT to date. The article considers the issues of neurophysiological principles, classification of methods and approaches, assessment criteria of repeatability and accuracy of MMT. Understanding of the pathophysiological mechanisms of MMT effectiveness will allow to timely correct the therapy and improve the results of treatment and rehabilitation of patients with neuromuscular dysfunction.

An analysis of the results of studying physical therapy methods obtained for 300 years of existence of the Russian Academy of Sciences is presented. The first hundred years brought together attempts of physical therapy methods' experiential studiyng, which led to the formation of physiotherapy in the late 19^th century. The synthesis of empirical knowledge allowed to form unifying theories of restorative and rehabilitation medicine in the 20^th century. The members of the academy have priority in identifying basic laws, effective technologies, and in creating domestic scientific schools and institutions. The article considers the main achievements of scientific schools, relevant directions of scientific studies' development. Restorative medicine of the 21^st century is built on basic achievements in the research of molecular, cellular and integral mechanisms of physical factors' therapeutic action, determination of the «targets» of their application in the body. The results of the assessment of physical factors' targeted action will allow to significantly increase the effectiveness of their therapeutic and preventive action on the body.

Cervical cancer (CC) has been increasing in prevalence, imposing a high economic burden, that is a serious problem for health care system, despite the success of HPV vaccination and the use of screening programs. Additionally, studies on rehabilitation programs impact on anxiety and depression in patients after CC surgery remain limited.

Objective: To evaluate the level of anxiety and depression in females undergoing various rehabilitation programs in the recovery period after surgery of early-stage CC.

Material and methods: The study included 103 female patients with CC divided into 2 groups: 1) undergoing multicomponent rehabilitation (CC-1, 51 patients) and 2) undergoing rehabilitation according to the principles of approved guidelines (CC-2, 52 patients). The level of anxiety and depression was evaluated before surgery and during 36 months after surgery according to the Hospital Anxiety and Depression Scale.

Results: The anxiety level before surgery was in average 10.7±3.0 scores on the HADS in the CC-1 group and 10.9±2.0 scores in the CC-2 group. It decreased up to 7.1±3.3 scores at the 3^rd month and remained within 5.6±3.4-5.4±3.5 scores in the CC-1 group, while in CC-2 group it varied between 8.0±2.1-9.6±2.3 scores throughout the study period. The depression level before surgery was 9.7±2.3 scores on the HADS in the CC-1 group and 9.9±2.8 scores in the CC-2 group. It reached 5.2±2.4 scores at the 3^rd month in the CC-1 group remaining further within the range of 5.3±2.5-5.7±2.7 scores until the 36^th month. The depression level remained in the range of 7.8±3.1-10.2±3.0 scores throughout the study period in the CC-2 group.

Conclusion: Multicomponent rehabilitation led to a faster and more pronounced reduction of anxiety and depression. This confirms the necessity of such programs application in the clinical practice in recovery period after surgery of early-stage CC.

Multiple sclerosis (MS) is a chronic demyelinating disease that is based on a complex of autoimmune inflammatory and neurodegenerative processes leading to multiple focal and diffuse damage of central nervous system. Treatment of MS causes great difficulties.

Objective: To analyze scientific data on the effectiveness and optimization of applying low-level laser therapy methods in patients with MS.

Material and methods: Databases and libraries, namely PubMed, Scopus, ResearchGate, Google Scholar, J-STAGE, eLibrary.ru, were used for search. Publications of interest towards analysis of the ways of optimization of low-level laser therapy techniques and its effectiveness improvement, prospects for the development of this treatment method were selected. The total number of publications equal 87, mostly in English and Russian, was found.

Results: It was demonstrated, that low-level laser therapy can be considered a promising method of MS treatment. Mechanisms of therapeutic action of low-intensity laser radiation were shown, as well as the results of several clinical studies were presented.

Conclusion: It was concluded that optimal values of all technique's indicators, namely wavelength, operation mode, power, frequency, exposure, etc., should be used. Laser blood irradiation (intravenous or external) and laser acupuncture, systemic techniques of low-level laser therapy are obligatory carried out with local irradiation of lesions.

Objective: To substantiate the use of photochromotherapy (narrow-band optical radiation with an average wavelength of 650 nm) in the complex treatment of children with developmental speech delay on the type of general speech underdevelopment (GSU) of I and II degree.

Material and methods: A number of children equal 70 aged from 4 to 6 years with developmental speech delay were examined. All patients were randomized into 2 clinically comparable groups: the 1st (study) group included 35 patients who received medical treatment in accordance with clinical recommendations in combination with the use of narrow-band optical radiation with an average wavelength of 650nm for 10 days; the 2nd (comparison) group consisted of 35 subjects who received standard drug therapy according to the established clinical recommendations. All patients underwent a comprehensive clinical examination and a special neurological investigation, including electroencephalography and electromyography, as well as an assessment of the development of speech functions and dynamic coordination of gesture, the level of social and communication skills development and neuropsychological processes.

Results: The following data were obtained during the complex treatment with the inclusion of narrow-band optical radiation with an average wavelength of 650 nm (red radiation): statistically significant improvement of speech development (p<0.05); improvement of values of social adaptation skills of medium (71%) (Z=2.769; p=006) and low level (29%) (Z=2.691; p=0.007); significant positive dynamics of speech status (Z=3.911; p=0.000); spontaneous activity relief at rest, indicating normalization of muscle tone.

Conclusion: The inclusion of photochromotherapy in standard therapeutic regimens for children with developmental speech delay on the GSU type of I, II degrees contributes to a significantly confirmed pronounced clinical improvement and can be recommended for practical health care.

The number of middle-aged and elderly population is increasing every year. At the same time, the course of most chronic diseases worsens with age, which can be explained by significant changes in body composition, including redistribution and increase of fat mass and decrease in muscle and skeletal mass. Thus, a decrease in muscle mass becomes intrinsic for the body from the age of 40 and develops on average by 0.5-1.0% per year. The prevalence of patients with sarcopenia is estimated to be between 11 and 50% in different age groups of population: middle, elderly and senile. In addition, the decline in physical activity associated with the urbanization and automation of labor exacerbates the disease at a younger age, which predicts an increase in the number of such patients in the future.

Objective: To determine the role of physical rehabilitation in sarcopenia.

Material and methods: A systematic review including studies found in PubMed, MedLine, Scopus and Web of Science Core Collections databases for 2019-2022 was conducted. The used enrollment criteria were the following: systematic reviews, including cross-over or cohort studies targeting at persons aged from 40 to 90 years of both sexes, with available data on sarcopenia, its severe form or other combinations of physical performance markers called sarcopenia. The mandatory parameter for inclusion in the study was the presence of the effectiveness assessment of physical rehabilitation without limiting its parameters. The systematic review was performed in accordance with the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020.

Results: The best kind of training are 30-60-minute comprehensive methods with predominance of resistance exercises with minimum duration of the course of 3 months and frequency of 3 inconsistent in-person trainings per week under the supervision of a specialist for patients with sarcopenia in order to increase muscle strength and mass, as well as performance. The intensity should consist of the following parameters: start with fewer sets but more repetitions (12-15) with less intensity (55% of maximum) and move to more sets with less repetition (4-6) and greater intensity (>80% of maximum).

Conclusion: This article describes the parameters of exercises that are most effective in terms of muscle strength and mass increase and safe for patients. The compilation and further study of this complex in practice are needed.

Arterial hypertension is a major risk factor for cardiovascular disease, affecting a large proportion of the population worldwide. The study of the listed literature made it possible to assess the effectiveness and necessity of physical exercise in the treatment of hypertension syndrome, including various types of exercise, intensity, duration, and frequency, since drug treatment is not enough for successful therapy. To prevent and treat hypertension, a comprehensive approach is required, including aerobic exercise, which will lower blood pressure by dilating blood vessels.

Dystrophinopathies - a group of hereditary X-linked neuromuscular diseases characterized by worsening fibrofatty degeneration of skeletal muscles, muscular weakness, low exercise tolerance, as well as orthopedic, cardiovascular and respiratory complications. Study of the effectiveness of physical medical rehabilitation in patients with neuromuscular diseases, evaluation of the influence of external and internal factors on functional capabilities and effectiveness of the conducted rehabilitation are highly relevant.

Objective: To evaluate the effectiveness of physical medical rehabilitation of patients with dystrophinopathies at the outpatient stages of the disease's course and the influence of anthropometric characteristics and functional status of patients' motor capabilities.

Material and methods: The study included 47 patients with genetically confirmed Duchenne muscular dystrophy (DMD) (the 1st group - 32 patients at an early outpatient stage, mean age 7.0±0.2 years; the 2nd group - 15 patients at a late outpatient stage, mean age 9.0±0.2 years) and 17 patients with Becker muscular dystrophy (BMD) (the 3rd group, mean age 12.0±1.2 years). All patients performed aerobic exercises 3 times a week, the duration of rehabilitation course was 4 months. The distance of 6-minute walk test (6MWT) with fatigue assessment on the visual analogue scale, the speed of rising from the floor with assessment of the functional class on a 6-point scale, the functional capacities on the Motor Function Measure (MFM) scale, dimension D1 (standing and transfers) were evaluated at baseline and after 2 and 4 months.

Results: Positive dynamics has been revealed in the form of elongating 6MWT distance, increasing speed of tests for time performance with increase of test's functional class, improvement of motor functions on the MFM scale at the end of case follow-up in the 1st and 3rd groups (p<0.01). A high correlation of the patients' motor capabilities with reduction of strength and speed indicators, moderate relationship with age and anthropometric indicators have been found (p<0.01).

Conclusions: Performance of aerobic exercises without weight combined with exercises on an ergocycle allows to improve motor capabilities in patients with DMD at the early stages and in patients with BMD. Exercising at the late stages of DMD can slow down the disease's progression. The dynamics of motor capabilities' indicators in regular performance of dynamic aerobic exercises are more influenced by the initial functional status, less - by age and concomitant overweight and high body mass index.

Stanislav Iosofatovich Zalesky - the first head of the Department of General Medical Chemistry of the Imperial Tomsk University (currently the Department of Chemistry of the Siberian State Medical University), a versatile scientist and public figure, acknowledged expert in medical, chemical, hydrogeological and balneological sciences. Professor S.I. Zalesky participated in the creation of health resorts of international importance In Russia and performed a great research and practice aimed at making the richest natural therapeutic factors of Siberia available for treatment. Investigation of the waters and muds of the Siberian region for a purpose of creating resorts for the health improvement of people is one of the most important aspects of his scientific activity. S.I. Zalesky developed a scientific approach to sampling and determination of the chemical composition of natural objects, the therapeutic effect of which he associated with the iron compounds contained in them. Professor S.I. Zalesky successfully combined the hard work in expeditions with teaching activities primarily in the Imperial Tomsk University, then in the Saint-Petersburg Women's Medical Institute as a professor in the Department of General, Analytical and Physiological Chemistry. Stanislav Iosofatovich was deeply involved in educational activities. He founded the «Samoobrazovanie» popular science magazine in 1901 and edited the «Recept» pharmaceutical journal since 1902. Russian translations of textbooks were published under his editorship. He compiled a number of popular books and brochures in the sphere of balneotherapy and hygiene in addition to «Samoobrazovanie», «Narodnoe zdorov'e», «Sputnik zdorov'ya» and separately. Tireless research, educational and public activities of the scientist, his scientific foresight have initiated the development of balneological health resorts in Siberia, Altai, Caucasus and Ukraine. The search and study of archival materials on the multi-faceted activity of professor S.I. Zalesky allowed to establish an invaluable contribution of the scientist in the development of health resorts of Russia.