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

Sarcopenia is a widespread condition in the elderly people, that occurs as a result of impaired muscle structure and function and is significantly associated with reduced quality and time of life. This review represents current approaches to the diagnosis of sarcopenia with reference to recent European and Asian consensus. They include rules for the evaluation of the main muscle strength and function tests (hand dynamometry, sit-to-stand test, 6-minute walk test, physical performance battery tests, etc.), physical and instrumental methods of muscle mass analysis (densitometry, bioimpedance analysis, magnetic resonance imaging). Furthermore, the pathogenetic relationship between the lack of physical activity and muscle dysfunction in elderly people is broached, including in particular the role of myostatin, interleukin-6, somatotropin and insulin resistance. The article represents possibilities of impact of aerobic, strength and neuromuscular physical exercises on prevention and correction of sarcopenic changes in different age groups based on the analysis of current clinical studies.

There is currently no systematic relationship between the quantification of funding for the treatment and rehabilitation of cardio-respiratory diseases and the length of a citizen's working life. The development of a universal evaluation methodology that can be used for qualitative and quantitative evaluation of the effectiveness of social and medical rehabilitation is a relevant area of research. The survey contains an analysis of the scientific approaches used in research on social and medical rehabilitation, as well as the development of medical and social rehabilitation and health resort and spa treatment, and to assess the impact of medical rehabilitation on restoration of ability to work. On the basis of the data obtained, a set of indicators for the assessment of the socio-medical rehabilitation of diseases of the cardio-respiratory system at the post-COVID period is proposed, which in the future will serve as a methodological tool in the field of medical and social rehabilitation, health resort and spa activities and at all stages of rehabilitation and preventive medicine.

Objective: To analyze the application efficacy of the carboxytherapy method with the aim of chronic pain syndrome reduction.

Material and methods: The available literature sources, published in the period from 2017 to 2022 yrs and indexed in international abstract databases Scopus, Web of Science and PubMed, have been analyzed. The search was done by following keywords: carboxytherapy, medical rehabilitation, chronic pain. The patient with chronic pain syndrome, who was treated by carboxytherapy during rehabilitation, was also observed, with a subsequent evaluation of the carboxytherapy application in comprehensive treatment.

Results: Analysis of available literature has shown that the different methodical variants of carboxytherapy are used to obtain analgesic, antispasmodic, anti-inflammatory and regenerative effects in patients with chronic pain. In the presented clinical case the use of carboxytherapy in the patient with chronic pain syndrome demonstrated the efficacy of technique, expressed in the positive dynamics in the evaluation of pain syndrome reduction on the visual analogue scale and the disability indicators in the Rollan Morris and Oswestry questionnaires.

Conclusion: Carboxytherapy reduces the intensity of chronic pain syndrome and can be applied as an additional method in medical rehabilitation. Further studies in this direction are needed.

Introduction: At present it remains relevant to develop new rehabilitation technologies for patients with circulatory system diseases who have undergone a cardiac surgery to restore the functions of the cardiorespiratory system more quickly, improve physical and mental health, and prevent the development of the atherosclerotic process.

Aim: To study the effectiveness and safety of the new rehabilitation technology for the inpatient stage of medical rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery (CABS) using high-tone therapy.

Material and methods: The study included 85 men (the average age was 56.8±2.46 years old) with post-sternotomy syndrome after CABS. They were divided into two groups by simple randomization: the first/main (42 patients) and the second/control (43 patients). The control group of the patients had a standard rehabilitation complex; the main group was additionally prescribed a high-tone therapy according to a local method. The immediate results of the treatment were assessed by the dynamics of the clinical picture, the six-minute walk test, respiratory function, echocardiography, the level of cytokines, C-reactive protein and natriuretic peptide (NT-proBNP); distant - by QOL endpoints (questionnaire MOS SF-36).

Results: The groups of the patients were comparable in all baseline parameters. After the course of the procedures in the main group of patients there were positive reliable (p<0.05-0.001) shifts in clinical (pain, shortness of breath, general weakness), functional (forced expiratory vital capacity, forced expiratory volume1, effusion separation) and laboratory parameters (leukocytes, interleukin-2 and 10, NT-proBNP). The intergroup analysis of long-term results registered significant (p<0.05) differences in the QOL of patients in the main group by subscales: the role of somatic problems, vitality and mental health. Compliance to the III stage of medical rehabilitation (outpatient/home) was noted with 95.2% of the patients in the first group and 93.0% in the second.

Conclusion: The additional appointment of a high-tone therapy to the rehabilitation standard for the patients with post-sternotomy syndrome after CABS significantly improves the immediate and long-term results of the treatment (QOL) contributing to a more pronounced reverse development of inflammatory and edematous syndromes, an increase in physical activity and psychosomatic health. The absence of adverse reactions with all the patients indicates the safety of rehabilitation complexes.

Introduction: In order to optimize rehabilitation measures for post-traumatic stress disorder (PTSD) it is advisable to use natural therapeutic factors in the medical rehabilitation programmes of this category of patients, which is due to the pronounced psycho-corrective effects of climatic landscape therapy and nitrogen-thermal waters.

Aim: To study psycho-corrective effects of a new rehabilitation technique for the patients suffering from PTSD using natural therapeutic factors of Nalchik resort.

Material and methods: Thera has been carried out a randomized controlled trial that included 74 patients with PTSD. Two groups were formed by simple randomization: in the control group (CG/n=38) the patients had standardized pharmacotherapy, physical training and individual psychocorrection in accordance with federal clinical recommendations; in the main group (MG/n=36) terrencourt in the natural park of Nalchik resort and nitrogen-thermal baths were additionally prescribed. The effectiveness of rehabilitation measures was monitored using a questionnaire to assess the therapeutic dynamics of PTSD, the Beck Hopelessness scale, as well as the Neurotech Kolibri wireless BFB complex (Russia).

Results: A comparative analysis of monitoring of psycho-emotional status indicators proved the feasibility of the developed medical rehabilitation programme for PTSD patients. A significant improvement in psychoemotional status was observed according to the questionnaire for assessing the therapeutic dynamics of PTSD (on average by 2 times, p<0.01), according to the Beck hopelessness scale, according to which the clinically assessed suicidal risk and hopelessness level were reduced by 1.7 (p<0.01) times with the patients in the MG. According to the analysis of brain biopotentials during the primary training, the patients had insufficient control over the course of mental activity (63%), and at the end of the course the indicator improved to 97% (p<0.01). In the CG positive dynamics on both scales of psychological testing and analysis of brain biopotentials was significantly lower (by 12-15%, p<0.05-p<0.01).

Conclusion: After including in the standardized rehabilitation programme controlled walking in the mid-mountain Natural Park and nitrogen-thermal baths of Nalchik resort, there was a significant improvement in the psycho-emotional status of the patients suffering from PTSD, which indicates their psychocorrective effects and provides great opportunities to improve the effectiveness of medical rehabilitation.

The constantly high incidence of urinary system pathology in children, in which the pyelonephritis plays a leading role, requires to search the new approaches to the comprehensive medical rehabilitation of children, suffering from chronic pyelonephritis.

Objective: To evaluate the efficacy of comprehensive medical rehabilitation of children with chronic pyelonephritis, that includes lessons in «School of Health: social and psychological rehabilitation of children with renal disease» (thereafter - «School of Health»).

Material and methods: A prospective monocentric controlled randomized study has been conducted. The number of children equal 61 with chronic pyelonephritis was under observation. The study group included 32 children (mean age 9.44±0.6 years), who were performed the complex of medical rehabilitation (regimen - sparing; diet - table №1; therapeutic exercises; manual massage of lumbosacral region; sapropel's applications on lumbar region; interferential current therapy by the «AIT-01» apparatus; oxygen cocktail), that included the education in «School of Health». The comparison group consisted of 29 children (mean age was 9.45±0.7 years), who were prescribed similar complex, but without education in «School of Health». The control group included 20 somatically healthy children (mean age was 9.41±0.6 age). Methods of work used in «School of Health» contained: monitoring, questionnaires; problem-oriented education of parents; evaluation of medical and pedagogical activity of family within the framework of comprehensive medical rehabilitation; either group or individual theoretical and practical classes.

Results: It was found, that absolute majority of children had psychological changes (more than 70% of children), unbalance of all capability components (cognitive, emotional, behavioral), low motivational component in addition to clinical and laboratory presentations of chronic pyelonephritis at the initial stage of rehabilitation. There was a positive clinical and laboratory dynamics (reduction of dysuric syndrome, toxidrome), favorable influence of education in «School of Health» to the childrens' psychological condition, affected by comprehensive medical rehabilitation.

Conclusion: Comprehensive approach to the medical rehabilitation of children, suffered from chronic pyelonephritis associated with «School of Health» organization leads to stabilization of chronic renal inflammation, psycho-emotional condition of patients, helps to prevent the progression of chronic pyelonephritis.

Health care in general and medicine in particular play an important role in the geopolitical landscape and the political positioning of the state in the modern world. The health of the citizens of the country is the most important resource of national security. This article, based on a SWOT-analysis, highlights the strengths and weaknesses of the foreign and national resort industry as a part of medical diplomacy, with decomposition to its individual participants. The undoubted advantage of our country in terms of humanitarian policy, on the world stage is shown, specifically in the context of national key success factors, including the technological capabilities of domestic medical science and practice, regarding the availability of trained staff, specialized variable climatic sanatorium and resort institutions network with unique technologies and natural healing resources, coupled with international experience in humanitarian cooperation, developed healthcare system and sanitary and epidemiological supervision of the country. Medical diplomacy and national resort medicine as an active participant of the branch, are strategically important areas in public diplomacy, having the ability to play an important role in achieving national goals in geopolitics.

Recovery of athletes after strenuous muscular activity is one of the most up-to-date trends in current sports medicine. Therefore, neurobiofeedback technology, a complex of ideas for methods, based on biological feedback, is sufficiently promising. Available studies of neurobiofeedback by beta rhythm use in clinical medicine indicate a powerful therapeutic and rehabilitative potential of the method with pronounced correction of higher mental functions activity, volitional control and voluntary regulation of activity.

Objective: To examine the impact of one procedure of neurobiofeedback by beta rhythm of the brain on the cardiovascular system functional state in the athletes with different character of motor activity.

Material and methods: The study included 1020 male athletes aged 18-21 years. Depending on the motor activity, patients were divided into 5 groups: 1st group - cyclic sports athletes (38%); 2nd group - speed-power sports athletes (25%); 3rd group - combat sport athletes (3%); 4th group - team sports athletes (17%) and 5th group - athletes of complex coordination sports (17%). The procedure of neurobiofeedback by beta rhythm of the brain was done in the conditions of active waking at open eyes. Registration of bioelectric activity of the brain and training on beta rhythm were done in the Fz-Cz lead by the international system «10-20» with the arrangement of indifferent electrode on the earlobe of the subjects (PAC «BOSLAB», Institute of Molecular Biology and Biophysics, Novosibirsk, Russia).

Results: Heterochronic pattern of changes in the indicators of systemic pressure, cardiac and vascular activity of the athletes' body during a single procedure of neurobiofeedback by beta rhythm of the brain in the preparation period of the training process, depending on the character of athletic activities, was found. In response to the impact, the following indicators have changed significantly: heart rate and index of functional changes in combat sport athletes (3rd group); stroke and cardiac output in all groups. Cardiovascular regulation index and specific peripheral vascular resistance significantly increased in the groups 2-5. Cardiac index significantly decreased in the groups 1, 2, 4 and 5. Qualitative changes in types of blood circulation occurred in all groups: in groups 1, 3 and 5 - from hyperkinetic to eukinetic, in group 2 - from hyperkinetic to hypokinetic, in group 4 - from eukinetic to hypokinetic, contributing to the economization of cardiovascular activity function.

Conclusion: The use of neurobiofeedback by the beta rhythm of the brain in the practice of sports medicine requires additional detailed research of the features and development of individual methods depending on the type of athletic activity, features of cardiac activity regulation, etc.

In recent decades, a promising area of physiotherapy has been intensively developed In Russia and abroad - magnetic therapy, based on the use of various types of magnetic fields for preventive, curative and rehabilitative purposes. The use of high-intensity pulsed magnetotherapy is promising. The effectiveness of the method in a number of diseases of childhood, which has an active stimulating effect on the state of the neuromuscular apparatus, has been proven.