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.

Postmastectomy syndrome (PMS) is a complex neurovascular set of symptoms that develops in most patients after breast cancer (BC) treatment and significantly reduces the quality of life. One of the potential mechanisms of its occurrence is considered to be an endothelial dysfunction. The possible method of reducing manifestation of endothelial dysfunction is systematic aerobic dynamic training.

Objective: To evaluate the influence of 12-week aerobic dynamic training program of moderate intensity on the endothelial dysfunction laboratory markers and life quality in patients with PMS.

Material and methods: Single-center prospective randomized trial included 40 patients with PMS divided into study (20 patients) and comparative (20 patients) groups, as well as 20 healthy female volunteers. The expression level of soluble intercellular adhesion molecule-1 (ICAM-1) and platelet endothelial cell adhesion molecule-1 (PECAM-1) were evaluated in all participants at baseline by enzyme-linked immunosorbent assay method, and additionally psychological and physical component of health by SF-36 questionnaire were assessed in patients with PMS.

Patients of study group received a course of 12-week partially controlled aerobic dynamic training of moderate intensity lasting 45 minutes with frequency equal 5 times per week. Patients with PMS were re-evaluated for ICAM-1 and PECAM-1, as well as for life quality.

Results: The group of patients with PMS after BC treatment had increased level of ICAM-1 in long-term period, that may indicate endothelial dysfunction. Statistically significant decrease of endothelial dysfunction laboratory markers was revealed in patients with PMS, who underwent the course of cardiorespiratory training. In the same time, the dynamics of changes in ICAM-1 was higher in the study group than in comparative group. Further, improvement of physical and psychological components of health by SF-36 questionnaire was found.

Conclusions: The program of cardiorespiratory trainings of moderate intensity in patients, who had BC treatment a year ago, decreases intercellular adhesion molecules level that may show an improvement of endothelial 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.

One of the methods of non-drug treatment of essential arterial hypertension, is manual, osteopathic effects on the spine, primarily the cervical spine. Despite the absence of these methods in clinical guidelines for essential arterial hypertension, they continue to develop and improve. One of the promising areas is manual-physical correction with an effect on the cervical spine and subsequent strengthening of the muscle corset with the help of physical exercises (method of A.Yu. Shishonin). One of the supposed mechanisms for reducing blood pressure (BP) in this case is the effect on the autonomic nervous system (ANS). In the course of the study, which was based on the study of heart rate variability (HRV), the presence of pronounced signs of a decrease in sympathetic influences and activation of the parasympathetic nervous system was shown. The parameters of statistical linear analysis (standard deviation of NN intervals; stress index, etc.) and the wave spectrum shifted towards sympathicotonia during therapy using the method of A.Yu. Shishonin. The HRV data were obtained against the background of a decrease in blood pressure and a decrease in heart rate (HR), which suggests the impact of manual physical correction on the ANS as one of the key mechanisms mediating its effect.