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

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.

Modern scientific research has shown that neurofeedback optimizes the functioning of the nervous system as a whole, increases the efficiency and productivity of various types of activities. In clinical practice, neurofeedback based on the β-rhythm of the brain has been effective in correcting conditions associated with decreased attention, promoting concentration and behavioral improvements. However, the influence of neurofeedback on the β-rhythm of the brain on the attention processes of athletes with different training orientations has not yet been sufficiently studied.

Objective: Studying the effect of neurofeedback on the β-rhythm of the brain on the characteristics of attention in athletes with different training orientations.

Material and methods: The study involved male athletes aged 18-22 years old, divided into 5 groups by sport and a comparison group. The course of neurofeedback on the β-rhythm of the brain consisted of 10 sessions, including graphic and game sessions, in which it was necessary to select a strategy for raising the β-rhythm of the brain during muscle relaxation, implemented under conditions of visual and auditory biofeedback. The characteristics of attention were studied using the Schulte method.

Results: The initial values of the studied characteristics of attention in the comparison group (CG) did not have reliably significant differences with similar indicators in the studied groups of athletes with different training orientations. Analysis of the dynamics of attention indicators in the GS showed a tendency, without significant changes, to improve the efficiency of attention (EA) and the total time of work in the test. A course of neurofeedback based on the β-rhythm of the brain contributed to the improvement of attention characteristics in athletes, depending on the direction of the training process. EA increased to a high level in young men of cyclic, game, complex-coordination sports and among martial artists, and in athletes of speed-strength sports - to a level above average. Athletes of all studied groups who completed the course of β-training increased the speed of development with consistently high values in representatives of cyclic sports, in almost all groups the stability of attention increased to a high level (p≤0.05), with the best values in the coordination sports, among team sports athletes the indicator reached an average level.

Conclusion: Optimization of attention characteristics when using neurofeedback according to the β-rhythm of the brain in athletes is specific depending on the direction of the training process, and in total leads to a significant improvement in the studied indicators.

Urinary tract infections, in particular acute gestational pyelonephritis (AGP) determine a high risk of developing various complications of pregnancy and childbirth. The development of new medical technologies for the treatment of AGP remains relevant. It has not only high direct effectiveness, but also shows a distinct impact of secondary prevention of pyelonephritis exacerbations and a fetoprotective effect. An objective evidence for these effects is the study of long-term treatment outcomes.

Objective: To evaluate the general condition of pregnant women in a randomized controlled study of the long-term observation period who underwent acute gestational pyelonephritis, birth results, quality of life of the patients and vitality of the newborns.

Material and methods: The study included 93 women at the age of 16 to 40 years old who underwent AGP. They were divided into two groups by simple randomization: the main/MG (46 people) and the control/CG (47 people). The control group of the patients was prescribed the drug standard; the main one had intravenous ozone therapy (OT) in addition to it.

Results: In the MG the patients had significant differences (p<0.05-0.001) with women of the CG in such indicators as: repeated relapses of gestational pyelonephritis (4.5 times), late gestational toxicosis (2.6 times), the number of newborns with normal growth and weight parameters (1.9 times), bacteriuria (3.0 times), leukocytouria (4.0 times), medical care for the main disease (5.0 times), outpatient treatment (8.0 times) and quality of life indicators - physical and social activity as well as general health.

Conclusion: An additional prescription in the standard of care for patients with AGP based on intravenous administration of an ozone-oxygen mixture significantly improves the long-term results of the therapy and the quality of life of patients who have undergone AGP, and also has a distinct fetoprotective effect. The absence of adverse reactions with all the patients including in the long-term follow-up period indicates the safety of a new complex of restorative treatment for AGP.

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.

There is a long-observed relationship between the pathology of the spine and arterial hypertension. There are a number of explanations for this, including one based on reflex effects and obstruction of blood flow to the cerebral vasodilatory centre localized in the rhomboid fossa projection. Obstruction can be absolute and relative, preventing the increase of blood flow during stress, when the brain turns on additional energy demand (phenomenon of «selfish brain»). In conditions of insufficient blood supply anaerobic metabolism is included, requiring in the future, the addition of anaerobic glycolysis products. This leads to the persistence of an elevated level of AD and is part of the theory of centralized compensation of aerobic-anaerobic balance (theoretical aerobic-anaerobic energy concept, TAAEBC). The existing methods of manual manipulation and physical action on the spine, mainly the atlantoacral section of the cervical spine, have, according to existing publications, varying degrees of effectiveness. The modern approach to treatment of arterial hypertension and correction of metabolic disorders by A. Shishonin is promising. It is based on the TAAEBC concept and assumes a system approach and long-term effect through a consistent three-step manual and physical interventions aimed at restoring, retaining and long-term support of the vertebral blood flow.

Archive documents and sources in scientific electronic databases were analyzed in order to study the historical origins of the health resort business in terms of children's health resort medicine in the Samara government. It has been established that the period of origin and intensive development of balneology for children in the Samara region occurred at the beginning of the 20th century and the first children's sanatoriums began to function thanks to the initiative of the Society of Governmental Physicians for charitable funds of the Samara nobility and merchantry in territories with natural and climatic therapeutic factors, namely Sernovodsky resort, Barboshina glade and Postnikov ravine. A comparative analysis of the dynamics of morbidity structure of children admitted for sanatorium treatment, as well as general education institutions, from which information on the health of school pupils is received, has been conducted over a period of 120 years. Despite the change of years and generations, there is a general concept of sanatorium health improvement of school pupils as a future social and economic pillar of society, with the formation of a healthy generation for both the region and the country in general.

Peripheral magnetic stimulation (pMS) has shown its effectiveness in the treatment of lower urinary tract symptoms, such as symptoms of an overactive bladder (OAB). The perineal region (pelvic floor) and the sacral roots area (projection S3 of the root) are used as the locus of stimulation. The published literature presents protocols with different parameters of stimulation, while each of them reliably demonstrates clinical efficacy, however, no comparative studies have been found to select priority stimulation modes when analyzing available sources.

Objective: To compare the efficacy and safety of different frequency - 1 and 5 Hz - modes of sacral MS in patients with symptoms of OAB.

Material and methods: A single blind prospective randomized comparative clinical study included 59 patients with OAB symptoms. The patients were divided by simple randomization into the group 1 (n=30), which received MS 3 times a week for 5 weeks with a frequency of 1 Hz per sacral root area (S2-S4), and the group 2 (n=29), in which stimulation was performed at a frequency of 5 Hz, while the remaining parameters and duration of therapy were identical to group 1.

Results: Sacral pMS with different frequency modes (1 and 5 Hz) is reliably equally effective against the clinical symptoms of OAB, which is confirmed by the absence of significant intergroup differences. In patients receiving MS with a frequency of 5 Hz, there was a more pronounced increase in maximum cystometric capacity, normalization of the maximum and average urine flow velocity and regression of the residual urine volume (p<0.001, p=0.007, p=0.011 and p=0.012 compared with group 1). The greatest difference in indicators was observed in the increase in the maximum cystometric capacity - +31±25 ml at MS with a frequency of 1 Hz and +109±96 ml at MS with a frequency of 5 Hz (p<0.001). MS is a safe procedure and is well tolerated by patients.

Conclusion: pMS when exposed to the area of S2-S4 roots for 20 minutes 3 times a week with a course for 5 weeks is reliably effective against the clinical symptoms of OAB at different frequency modes (1 and 5 Hz). At the same time, MS with a frequency of 5 Hz may have an advantage over stimulation of 1 Hz in terms of its effect on urodynamic parameters (maximum cystometric capacity, peak and average urine flow velocity and residual urine volume), which may be associated with a large inhibitory effect on detrusor.