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

Search and development of new physiotherapeutic technologies of regenerative medicine for the treatment of patients with different diseases is an urgent task of modern medicine.

Objective: To analyze scientific data on the effectiveness of the peripheral magnetic stimulation (PMS) application in patients with different diseases.

Material and methods: An analysis of publications in databases of electronic resources (PEDro, PubMed, Embase, eLibrary, Cochrane Library) over the past 20 years was carried out, the results of PMS application in patients with different nosologies were presented.

Results: The majority of the presented articles confirm the clinical effectiveness of PMS application mainly in patients with diseases of the nervous system, spine and genitourinary system.

Conclusion: Further research to confirm the effectiveness of the therapeutic impact of magnetic stimulation in patients with other nosologies is needed.

Climate change and formation of regional weather features increase both direct (immediate effects of extremal temperature and other weather and climatic anomalies) and indirect (environmental deterioration, etc.) consequences of global climate change. The development of investigations of medical weather assessment, medical and meteorological forecasting system, the use of treatment and preventive measures give the opportunity to prepare for weather biotropic conditions and reduce weather-conditioned exacerbations.

Objective: To assess the clinical effectiveness of non-drug comprehensive methods, including balneotherapy and physiotherapy, in patients with somatic diseases, complicated by increased meteosensitivity, depending on the features of weather conditions in the Moscow region.

Material and methods: The study included 120 patients diagnosed with «osteoarthrosis/osteoarthritis» with predominant hip and knee joint damage. The majority of patients had comorbidities, namely hypertensive disease (67.2%), ischemic heart disease (32.8%), chronic obstructive pulmonary disease and bronchial asthma (10.8%), grade II-III obesity (10%) and compensated diabetes mellitus (9.2%). The severity and main symptoms of the meteopathic reactions' manifestation were assessed by questionnaires consisting of three blocks, HAM, SF-36 tests and psychological stress scale. Medical and meteorological assessment of weather conditions in Moscow included analysis of the main weather-forming factors for 4 main synoptic observations in 10-minute mode for current and predictive 2 days, as well as daily characteristics of solar activity. Treatment methods included alternating magnetic field (AMF) procedures, general sodium chloride baths, massage and rehabilitation exercises (RE) (1st group); AMF, «dry» carbon dioxide baths, applications with brine on the affected joints and RE (2nd group); AMF, «dry» radon baths, applications with brine and RE (3rd group).

Results: The conducted studies have revealed the trigger role of most biotropic combinations of weather-forming factors that provoke exacerbation in patients with joint diseases. Sodium chloride, «dry» carbon dioxide and radon baths combined with AMF, applications with brine on the affected joints and RE are pathogenetically justified and contribute to increase of adaptive potential, functional reserves of the body and provide significantly high (p<0.05) meteocorrective action.

Conclusion: The obtained results can be used for rehabilitation of patients with joint diseases complicated by increased meteosensitivity.

Chronic ischemic heart disease (CIHD) is the leading cause of morbidity and mortality, increasing in proportion to the growth of the older population. Rehabilitative measures in patients who have undergone the myocardial revascularization, with back pain currently have insufficient evidence base. The differentiated program of medical rehabilitation (MR) at the stage of sanatorium-resort treatment is not regulated. A description of the comorbid patients' functional status will create a differentiated system of individual rehabilitation program set up.

Objective: To develop an algorithm for assessing the functional status of patients after myocardial revascularization with chronic low back pain.

Material and methods: The single-center cross-sectional cohort study (September 2021 - May 2022 yrs) included 50 patients after a myocardial revascularization with chronic low back pain (36 women, 14 men; median age 63.5 [55.5; 67.5] years), who were the study group and 10 patients with CIHD (5 women, 5 men; median age 65.0 [62.0; 68.0] years) who joined the control group. All patients underwent clinical (neurological and therapeutic examination), functional (clinical tests, echocardiography) and laboratory (general and biochemical blood analysis, blood cytokine levels) investigations, the functional class of impairment was defined.

Results: There are 4 groups with combined pain syndrome (cardiogenic and vertebrogenic) in different ratios due to different functional and laboratory status among patients after the myocardial revascularization with chronic back pain. The presence of cardiogenic pain syndrome was associated with an increase in leukocyte and peripheral blood glucose levels, interleukin-6, myocardial mass enlargement, while vertebrogenic pain syndrome correlated with personal anxiety.

Conclusion: The evaluation of the functional status of patients according to the degree of severity of cardiogenic and vertebrogenic pain syndrome has revealed a simple method of pathogenetically based differentiation selection for individual rehabilitation program of patient development.

Dynamically developing sphere of physical and rehabilitative medicine raises an important issue on implementation of technologies with proven effectiveness to recover neuromuscular, skeletal and movement-related functions, activity and partipation of traumatological patients into rehabilitation practice. The aim of this review is the consistent information analysis and synthesis of evidence-based researches of current effective methods in the context of medical rehabilitation after endoprosthesis of lower limbs' major joints, as well as the provision of structured information that helps to influence on decision-making for doctors of physical and rehabilitative medicine and other professionals who take part in multidisciplinary interaction.

One of the tasks of restorative medicine is the rehabilitation of the body that has suffered from injuries, diseases or adverse environmental effects, and the restoration of the functional reserves of the human body. Currently, a search is underway for new treatment technologies, including the use of wound dressings with specified functional qualities.

Objective: To characterize the effect of a wound dressing based on an ion-track membrane modified with collagen and chitosan nanofibers on the efficiency of skin restoration in experimental animals after a severe thermal burn.

Material and methods: Polyethylene terephthalate film perforated with heavy metal ions (Xe, Kr) on a nuclear particle accelerator was used as a base. The biopolymer layer was applied from the solution using electrospinning. Thermal (120° C, 60 min) treatment was used to stabilize the biolayer. Using light and fluorescence microscopy, the morphometric characteristics of the cells were assessed, and flow cytometry and commercial kits were used to evaluate the expression of cell differentiation markers (CD16, CD14, CD163, CD206). Modeling of a severe thermal burn was performed on laboratory rats.

Results: The main structural element of the biolayer is spontaneously intertwined fibers, 170±40 nm thick. The results of studies conducted in vitro using fibroblasts and monocytic cells of human peripheral blood allow us to draw the following conclusion: the hybrid biomaterial BioTM has qualities that meet the requirements for wound dressings, namely gas permeability, biocompatibility and the ability to inhibit immune-inflammatory cellular reactions. In vivo, it was shown that the hybrid biomaterial BioTM promotes skin restoration in experimental rats after thermal injury. Moreover, the effectiveness of the BioTM biomaterial exceeds therapy using Levomekol ointment.

Conclusions: Thus, based on the results obtained, the following conclusion can be made: the wound coating based on the track membrane and the biocomposite layer inhibits spontaneous activation of monocytes and their differentiation into a proinflammatory phenotype. When integrating the bioplastic material with the synthetic membrane, the functional properties of both types of materials are preserved, which makes it possible to obtain a new type of wound coating with a high regenerative potential that exceeds the effectiveness of traditional burn therapy.

Objective: Scientific substantiation of the advisability of including Nordic walking and simultaneous physiotherapy based on the Tilain-EM device in the complex treatment of chronic prostatitis.

Material and methods: 124 men at the age of 24-51 years old with chronic prostatitis (CP) were divided into three groups by simple randomization: the main group (n=42) was prescribed a complex treatment (basic medications, Nordic walking and simultaneous physiotherapy); the group of comparison (n=42) had basic therapy and Nordic walking; the control group (n=40) received only basic therapy. The dynamics of clinical manifestations of CP (according to specialized NIH-CPSI and IPSS scales) and laboratory parameters (prostatic secretion) was assessed.

Results: The conducted study showed that the use of complex therapy for CP results in a significant regression of clinical symptoms of the disease and an improvement of laboratory data.

Conclusion: A new treatment complex for patients with CP has been developed based on the use of Nordic walking and simultaneous physiotherapy from the Tilain-EM device against the background of standard drug therapy. The proposed complex therapy allows to influence not only the leading etiopathogenetic aspects, but also eliminates one of the main risk factors for the development and recurrence of the disease.

Chronic migraine and cervicalgia have a significant impact on the quality of life of patients. Traditional treatment methods do not always provide long-term improvement, which necessitates the search for alternative methods of therapy. Electrotherapy and botulinum therapy are considered as promising methods for reducing pain and improving the general condition of patients.

Objective: Comparative evaluation of the effectiveness of electrotherapy and botulinum therapy on muscle tone and pain syndrome in patients with chronic migraine and cervicalgia.

Material and methods: The study included 61 patients with chronic migraine and cervicalgia, divided into two groups. Patients of the first group (n=31) received a course of electrotherapy (TENS), patients of the second group (n=30) - botulinum therapy. The pain threshold was assessed by the method of algometry before and one month after treatment in key muscle groups (sternocleidomastoid and trapezius muscles).

Results: Under the influence of electrotherapy and botulinum therapy, a significant reduction in pain syndrome was noted. However, patients who received electrotherapy had a more pronounced decrease in muscle tone and pain in all muscle groups studied, which was confirmed by a significant increase in the pain threshold (by 53-71%) compared to botulinum therapy (by 26-38%).

Conclusion: Electrotherapy and botulinum therapy are effective methods of treating chronic migraine and cervicalgia, but electrotherapy showed more pronounced results in reducing muscle tone and pain. These studies confirm the feasibility of using electrotherapy as a preferred method of treating this category of patients.

Objective: To evaluate the efficiency of treatment complexes based on magnetic-laser therapy with electrical stimulation and dry salt baths in the rehabilitation treatment of patients with chronic prostatitis.

Material and methods: There have been observed 74 men with chronic abacterial prostatitis at the age of 34-46 years old. The patients were divided into groups using the simple randomization method depending on the therapy. The patients of the main group (n=25) were prescribed procedures of dry salt baths in combination with magnetic-laser exposure and electrical stimulation on a physiotherapeutic software complex according to the developed method in addition to the basic complex. The patients of the group of comparison (n=25) were prescribed dry salt baths against the background of the basic complex according to the developed method. The patients of the control group (n=24) had a basic complex that included therapeutic gymnastics, microclysters with decoction of medicinal herbs, vibration massage of the prostate gland, therapeutic nutrition, drinking mineral water, therapeutic walking and climate therapy. The course of rehabilitation treatment was 18 days.

Results: It was found that the patients of the main group improved indices of regional hemodynamics, echographic picture, functional state of the prostate gland, psychoemotional status of the patients and reduced significantly the severity of pain syndrome after the course of rehabilitation treatment with less significant dynamics of similar parameters in the compared group, while maintaining the results in the long term, in contrast to the control group.

Conclusion: The inclusion of the combined use of dry salt baths and magnetic-laser exposure with electrical stimulation according to the developed method in the complex of rehabilitation treatment of patients with chronic prostatitis significantly increases the effectiveness while maintaining the results in the long term.

Objective: To evaluate the effectiveness of a treatment complex including magnetophoresis with the drug «Argensept» and tear therapy in patients with mild to moderate dry eye syndrome.

Material and methods: The study was conducted on 50 people (100 eyes) diagnosed with mild to moderate dry eye syndrome (H04.1 according to ICD-10). The average age of the patients was 43.3 years. The patients were divided into 2 groups. The first group (main group) - 25 patients (50 eyes) who underwent a treatment complex, including magnetophoresis with the drug «Argensept» and tear replacement therapy. The second group (comparison group) - 25 patients (50 eyes) who underwent only tear replacement therapy. The healthy group consisted of 20 volunteers without pathology of the organ of vision (40 eyes). To assess the effectiveness of the treatment before and after treatment, all patients underwent a standard ophthalmological examination, including checking visual acuity, tonometry, biomicroscopy, ophthalmoscopy, as well as special research methods to determine the level of tear production, stability of the tear film: Schirmer's test, Norn's test, determination of the height of the tear meniscus by optical coherence tomography. To assess the intensity of complaints, subjective condition and quality of life before and after treatment, a survey was conducted using the OSDI (Ocular Surface Desease Index) questionnaire.

Results: After the course of treatment, in the group of patients who underwent a treatment complex including magnetophoresis with the drug «Argensept» and tear replacement therapy, all the studied indicators (Schirmer's test, Norn's test, lacrimal meniscus height (LMH) and the OSDI (Ocular Surface Desease Index) questionnaire) approached normal values, while in patients who received only tear replacement therapy, the Schirmer's test indicator was 23.8% lower than in practically healthy volunteers; the Norn's test indicator was 37.2% lower than the values of healthy volunteers; the height of the lacrimal meniscus (HML) was significantly increased and amounted to 243.2±4.79 μm, but did not reach the values of practically healthy individuals (292±7.8 μm) and the OSDI questionnaire score slightly decreased (to 14.4±0.87 points) and corresponded to the values of mild dry eye syndrome.

Conclusion: The use of a therapeutic complex including magnetophoresis with the drug «Argensept» and tear-removal therapy in patients with mild to moderate dry eye syndrome contributes to a significant increase in the level of tear production and stability of the tear film, a significant reduction in complaints, improvement in the subjective state and an increase in the quality of life.

One of the most probable and controversial hypotheses regarding the etiology of essential arterial hypertension, is the increase in arterial pressure due to intracranial ischemia, for various reasons, particularly because of cervical osteochondrosis. The daily arterial blood pressure dynamics is of interest when attempting non-pharmacological induced correction of arterial pressure by manual and physical effects on the cervical spine.

Objective: To evaluate daily arterial pressure dynamics in patients with essential arterial hypertension who received non-pharmacological treatment by manual-physical action on the cervical spine (A.J. Shishonin method).

Material and methods: The main group consisted of 120 patients (61 men and 59 women, mean age 59.3±8.5 and 59.8±8.2 years respectively) with pre-hypertension or hypertension 1st degree (systolic AD in the range from 135 to 159 mm Hg. or diastolic AD from 85 to 99 mm Hg. All patients had signs of impaired blood flow through the vertebral arteries in the ultrasound (US) examination. The control group (comparison group) was formed from patients comparable by sex and age. The participants of the study groups had a low propensity to use pharmaceuticals and refused to take medicines. Patients of the studied (main) group were submitted to manual-physical correction with effect, mainly, on the cervical spine by method A.Yu. Shishonina. The technique consists of two stages: 1) manual action to improve blood; 2) exercise to form a muscular corset to maintain the effect. Patients in the control group did not receive targeted therapy. All patients were analyzed daily blood pressure profile through daily 24-hour arterial pressure monitoring technique.

Results: As a result of the therapy, a reliable decrease in the mean daily systolic arterial pressure of 140.1±3.9 mm Hg was recorded up to 129.2±3.8 mm Hg (p<0.05), as well as day and night systolic arterial pressure. Verified reduction of variability of systolic and diastolic arterial pressure in the process of manual-physical correction, both during day and night. The reliable movement of the index of time of hypertension during the day is recorded only for systolic arterial pressure, which decreased from 43.0±3.4 to 24.1±2.5% (p<0.01). Also, after the course of manual-physical correction in patients of the studied group is recorded a reliably lower rate of morning diastolic arterial pressure rise, differing by 40% - with 9.7±1.1 mm Hg per hour to 5.5±1.3 mm Hg per hour (p<0.01) and systolic arterial pressure from 14.4±1.9 to 7.3±1.9 (p<0.01).

Conclusion: Manual-physical correction in patients with degenerative-dystrophic lesions of the spine, has a hypotensive effect on most known indicators of 24-hour arterial pressure monitoring arterial pressure monitoring.