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

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.

Autoimmune diseases of the nervous system are characterized by the formation of pronounced neurological deficiency and often lead to disability. Complementary medicine as an adjuvant or preventive therapy of various diseases, including autoimmune ones, is increasingly attracting the attention of doctors and researchers. Traditional Chinese medicine (TCM) has a complex of treatment methods, including acupuncture, phytotherapy, nutrition, physical exercises and other methods that are often used in common with the recognized approaches of the official medical science. The article describes the TCM methods application in autoimmune diseases of nervous system, presents the practical experience of using acupuncture, phytotherapy, diet, physical exercises. It was concluded that TCM is important and frequently underestimated health care resource, especially in prevention and treatment of autoimmune diseases of nervous system.

Surgery is one of the leading treatment methods of patients with primary or recurrent malignant neoplasms in the thoracic or abdominal cavity. Extensive abdominal interventions are accompanied by such adverse outcomes as blood loss, hypoxia, inflammation, blood clotting abnormality, emotional and cognitive disorders, that increases the incidence of serious complications and worsens the treatment outcome and life quality in weakened oncological patients. Multimodal pre-rehabilitation before surgery can significantly decrease the incidence and severity of postoperative complications. The rehabilitation complex includes exercise therapy, nutritional and psychological support, smoking cessation and pharmacotherapy. Currently, there are a number of questions facing rehabilitation specialists and oncologists, that are related to the determination of pre-rehabilitation optimal timing and process duration, the choice of specific physical exercises, determining the load intensity. This review presents a current view on understanding of surgical stress in extensive abdominal interventions, its effect on the oncological process course, summarizes the experience of last years in choosing pre-rehabilitation program taking into account pathogenetic mechanisms of surgical stress and individual patient's characteristics. Special attention is paid to the comparison of physical exercises' various types, their action mechanisms at different stages of pathological process, the issues of load dosing during pre-rehabilitation activities.

Several chronic non-communicable diseases are associated with arterial hypertension and are closely related to increased blood pressure. The theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC) was formulated in connection with the above-mentioned processes. This theory, including the hypothesis of the «egoistic brain», is a broader concept. The key point of TCAAEBC is hypoxic anaerobic metabolism, which affects reflex vascular zones, including the neurons of the respiratory and cardiovascular centers of the rhomboid fossa of the medulla oblongata. Hypoxia correction using manual techniques, physical exercises, and other non-pharmaceutical methods under certain conditions can stabilize the level of blood pressure and has a curative effect in the case of arterial hypertension syndrome.

In the early 20^th century, the term «selfish brain» appeared in scientific literature, around which theory was formed, finding its proof in the work of doctors and scientists. The basic principle of the theory is that the superior hierarchy of the brain, whose needs are prioritized, results in the primary satisfaction of one's own needs, often to the detriment of the functioning of other organs and systems. The origins of the theory of «selfish brain», according to researchers, lie in the work of neurosurgery pioneer Harvey Cushing, who discovered a reflex named after him and consisting in increasing arterial pressure at high intracranial pressure. Later, the field of action of this phenomenon was expanded by specialists who showed that an increase in arterial pressure can occur not only in critical situations and arise not only at high intracranial pressure, but also as a result of hypoxia of the brain. It was also found that the remodeling of intracranial vessels in hypertensive disease may be not only a consequence, but also a cause. Currently, similar patterns have been established in relation to other processes - exchange, immune and others. It was found that the priority of brain energy needs in different situations can affect insulin resistance and glucose tolerance. These effects can be realized through various mechanisms, but the advantage is through vegetative (autonomous) nervous system, mainly through sympathetic link, and also through simulation of the functioning of parasympathetic link. It is known that there is currently a rapidly increasing number of pathologies associated with degenerative-dystrophic processes of the spine, and other factors that disrupt the blood flow in the vertex-basilar zone of the Willis circle, Correction of these processes with the help of a set of manual techniques and physical methods (A. Yu. Shishonin's method with correction of aerobic-anaerobic energy balance in the reflex zones of the brain stem) Can have a good effect on the treatment of hypertensive disease and other chronic non-communicable diseases.

New information on the results of scientific research may change the understanding of the etiology and pathogenesis of diseases, which makes adjustments in treatment approaches. Cyclic local traction therapywas created in USA by the group of scientists for NASA (Axiom Worldwide, Tampa, FL) and approved by FDA in 2003. The year 2023 is the 20^th anniversary of its successful application in practical medicine. Evaluating the effectiveness of the method, it has been shown that after undergoing treatment in patients with chronic back pain, the height of the intervertebral discs increases, pain syndrome and frequency of taking pain medications decreases, daily activity and duration of walking without pain increases. It is assumed that the treatment effect was achieved due to the «vacuum» effect, which could contribute to the regeneration of the intervertebral disc. It is also known about the possibility of intervertebral disc herniation reduction after a course of traction therapy and it was believed that this was ensured by «retraction» of the hernia back into the intervertebral space under the influence of the longitudinal ligament. However, fundamental studies of the past century and the present indicate the presence of other mechanisms affecting the structures of the vertebral motor segment, especially the processes occurring inside the intervertebral disc and contributing to the regression of the intervertebral disc herniation.

Traumatic brain injury, which is often considered as a silent epidemic, is a public health problem. The duration of acute recovery period remains a commonly used criterion for injury severity and clinical management. In this connection, the first stage of medical rehabilitation is carried out in the conditions of resuscitation and neurosurgery department in the hospital providing specialized care. Rehabilitation techniques such as postural training, phase verticalization, individual kinesiotherapy, transcranial micropolarization and etc. are used.

Objective: To assess the effectiveness of using transcranial micropolarization in acute period of severe traumatic brain injury in children.

Material and methods: The study on the effectiveness of using transcranial micropolarization in acute period of severe traumatic brain injury in 85 children, divided into 2 groups, was carried out. The study group (42 patients) received the transcranial micropolarization on the 2nd day after severe traumatic brain injury. The control group (43 patients) received only rehabilitation in neurosurgery department. The neurological status in the patients of both groups was assessed on the 2nd day after severe traumatic brain injury in resuscitation department, and after 1, 3 and 6 months.

Results and conclusion: The inclusion of transcranial micropolarization in the early medical rehabilitation of children with severe traumatic brain injury increases consciousness level in a shorter period of time, that predicts early patient's socialization.