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[Prospects and modern possibilities of non-surgical treatment of intervertebral hernias with neurological manifestations. (Literature review)]. 神经系统椎间疝非手术治疗的前景与现代可能性。(文献综述)。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510202152
M A Koshkarev

The problem of non-specific pain in the spinal area is important today in society due to a number of reasons, including features of the modern human's lifestyle, tendency to increase in life expectancy and «aging» of population. There is a continuing debate about the sources of this pain and reasonableness of search for them. There is no doubt that discogenic pain prevails over other probable sources of pain in the spinal area and intervertebral hernias play the primary role here. Patients can immediately look for a solution to the problem by a neurosurgeon at the time of «intervertebral disc herniation» diagnosis establishment and in the presence of a pronounced reflex or radicular pain syndrome. It is the «intervertebral disc herniation» wording which often leads patients to a neurosurgeon. There are many methods of intervertebral hernias conservative treatment. This article is focused on the technology of spinal traction therapy, which has a scientific evidence base, including in the question of natural reduction of intervertebral hernias' dimensions. Cyclic local traction therapy is the latest and realizing all important principles of tractive impact on the spine method.

由于许多原因,包括现代人生活方式的特点、预期寿命增加的趋势和人口“老龄化”,脊柱区域的非特异性疼痛问题在当今社会很重要。关于这种痛苦的来源和寻找它们的合理性,人们一直在争论。毫无疑问,椎间盘源性疼痛比其他可能的脊柱疼痛来源更普遍,椎间疝在这里起主要作用。在“椎间盘突出”诊断建立时,患者可以立即向神经外科医生寻求解决问题的方法,并且存在明显的反射或神经根疼痛综合征。这是“椎间盘突出”的措辞,经常导致患者去看神经外科医生。椎间疝保守治疗的方法有很多。本文的重点是脊柱牵引治疗技术,它有一个科学的证据基础,包括在椎间疝的尺寸自然缩小的问题。循环局部牵引治疗是最新的实现牵引作用于脊柱的所有重要原理的方法。
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引用次数: 0
[Evaluation of the effectiveness and safety of aerobic cyclical trainings in children after surgical correction of congenital heart diseases and features of short-term adaptation depending on the type of pathology]. [评价先天性心脏病手术矫形后儿童有氧循环训练的有效性和安全性及不同病理类型的短期适应特征]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510201119
E M Savova, A Yu Zavarina, V N Shvedunova, M L Ermolenko, F A Barseyan, L I Yakubova, A A Tokovenko, D I Moiseeva

Aerobic cyclical trainings in children with congenital heart diseases (CHDs) are insufficiently covered in the literature. Nevertheless, they are the most effective and safe for improvement of aerobic capacity in case of individually adjusted intensity of the load and with a strict pulse control during the exercises.

Objective: To evaluate the effectiveness and safety of aerobic cyclical trainings on cycle ergometers in children in the long term after surgical correction of CHDs and to study the features of short-term adaptation of the child's body to exercises on stationary bicycles in setting of rehabilitation center depending on the type of CHD.

Material and methods: The study included 80 children with CHDs aged between 10 and 17 years in the long term after Fontan procedure, aortic valve replacement, surgical correction of aortic coarctation or septal defects hospitalized for rehabilitation course in 2023. Intensity of exercises on stationary bicycles was determined based on clinical examination results in the absence of contraindications. The trainings were performed under the control of electrocardiography, tonometry and oxygen saturation; the intensity of exercises was automatically adjusted depending on the reaction of the cardiovascular system to the load.

Results: Anthropometric and anamnestic data of the studied group were analyzed. Low physical activity was characteristic of most children with CHDs, that has affected the results of exercise tolerance test. A number of trainings equal from 6 to 9 (Me=6) were performed during the course of cardiac rehabilitation. A statistically significant increase in the load in training sessions during hospitalization, comparing the first exercise both with the last training (p=0.05) and with one with the maximum capacity (p<0.001), has been found. The dynamics of load in trainings according to the type of CHD was analyzed, including a deeper analysis of subgroups of children after Fontan procedure, as well as individual clinical examples of examinations and trainings of children with different CHDs in case of re-hospitalization were presented. No adverse events were noted during the study.

Conclusion: Aerobic cyclical trainings on cycle ergometer are safe for children with CHDs with adequately selected intensity of trainings. The performed study allowed to indicate the features of «urgent» adaptation to exercises on cycle ergometers in adolescents with different CHDs and to develop the theme of formation of adaptive mechanisms to physical load.

有氧循环训练在儿童先天性心脏病(CHDs)是不够充分的覆盖在文献。然而,在个别调整负荷强度和运动过程中严格控制脉搏的情况下,它们是最有效和最安全的有氧运动能力的提高。目的:评价儿童冠心病手术矫正术后长期在脚踏车脚踏车上进行有氧循环训练的有效性和安全性,研究不同类型冠心病儿童在康复中心环境下对固定脚踏车运动的短期适应特点。材料与方法:本研究纳入80例10 - 17岁长期冠心病患儿,均为2023年接受Fontan手术、主动脉瓣置换术、主动脉缩窄或间隔缺损手术矫治后住院康复疗程的患者。在没有禁忌症的情况下,根据临床检查结果确定固定自行车运动的强度。训练在心电图、血压计和血氧饱和度控制下进行;运动强度会根据心血管系统对负荷的反应自动调整。结果:对实验组的人体测量和记忆资料进行分析。低运动量是大多数冠心病患儿的特点,这影响了运动耐量试验的结果。在心脏康复过程中进行6 ~ 9次(Me=6)的训练。在住院期间,与最后一次训练相比,第一次训练的负荷增加有统计学意义(p=0.05),与最大容量训练相比,负荷增加有统计学意义(p=0.05)。结论:在适当选择训练强度的情况下,在循环计力器上进行有氧循环训练对冠心病儿童是安全的。本研究旨在揭示不同冠心病青少年对循环测力仪运动的“紧急”适应特征,并提出对体力负荷的适应机制形成的主题。
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引用次数: 0
[Effectiveness of using non-drug technologies to increase stress resistance in persons with extreme work profile and susceptible for professional burnout]. [使用非药物技术提高极端工作人群抗压力能力和职业倦怠易感性的有效性]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510205291
N B Korchazhkina, A A Mikhailova, K V Kotenko, S N Nagornev, V K Frolkov, A I Kikot, E N Zhumanova, D I Kolgaeva, A V Badimova, I V Reshetova
<p><p>The high prevalence of professional burnout syndrome among medical workers significantly actualizes the search for the most effective methods aimed at reducing the severity of the negative consequences of professional stress. A certain perspective in solving this problem is associated with the course use of non-drug technologies, the sanogenetic potential of which ensures the implementation of high efficiency in the correction of the main manifestations of professional burnout. The complex use of therapeutic physical factors allows achieving a pronounced clinical result due to their synergistic interaction.</p><p><strong>Objective: </strong>Comparative analysis of the efficiency of the course use of non-drug technologies (physical exercises, psychocorrection, general air cryotherapy, general magnetic therapy, hypoxic-hyperoxytherapy, hydrogen therapy and their combinations) in the correction of stress resistance and manifestations of professional burnout in medical workers.</p><p><strong>Material and methods: </strong>The studies were conducted on the basis of the Federal State Budgetary Scientific Institution Russian Scientific Center of Surgery named after academician B.V. Petrovsky with the participation of 150 patients from among medical personnel aged 30 to 60 years. Using the simple fixed randomization method, all patients were divided into 6 groups: control (<i>n</i>=25), comparison groups 1-4 (<i>n</i>=25 each), and the main group (<i>n</i>=25). Patients in all groups received a course of physical exercises and psychological correction. For the control group, this type of correction was exhaustive. In comparison group 1, a course of general air cryotherapy was additionally carried out; comparison group 2 additionally received a course of general magnetic therapy procedures; comparison group 3 additionally received a course of hypoxic-hyperoxytherapy; comparison group 4 additionally received a course of hydrogen therapy; in the main group, patients received a course of complex exposure to therapeutic physical factors. The study design provided for a double examination of patients in all groups using the MBI questionnaire and the DASS and PSM-25 scales.</p><p><strong>Results: </strong>Conducting a course of correction of the state of professional burnout made it possible to establish that its effectiveness was largely determined by the type of physical factor used. Less pronounced changes were noted in the control group with the use of physical exercises and psychological correction. Additional course application of therapeutic physical factors in the monofactorial impact mode (general air cryotherapy, general magnetic therapy, hypoxic-hyperoxytherapy and hydrogen therapy; respectively comparison groups 1-4) was accompanied by an increase in the positive dynamics of the assessed indicators by 12-23%. The complex use of all physiotherapeutic effects, implemented in the main group, caused the development of the most pronounced correctiv
医务工作者中职业倦怠综合征的高流行率显著地实现了对旨在降低职业压力负面后果严重性的最有效方法的探索。解决这一问题的一定角度与非药物技术的过程使用有关,非药物技术的健康潜能保证了对职业倦怠主要表现形式的高效纠正。治疗性物理因素的复杂使用,由于它们的协同作用,可以实现显著的临床结果。目的:比较分析非药物技术(体育锻炼、心理矫正、普通空气冷冻疗法、普通磁疗、低氧-高氧疗法、氢疗法及其联合疗法)在纠正医务人员应激抵抗及职业倦怠表现中的效果。材料和方法:研究是在以B.V.彼得罗夫斯基院士命名的联邦国家预算科学机构俄罗斯外科科学中心的基础上进行的,来自30至60岁医务人员的150名患者参与了研究。采用简单固定随机化方法,将所有患者分为6组:对照组(n=25)、对照组1-4组(各n=25)和主要组(n=25)。各组患者均接受1个疗程的体育锻炼和心理矫正。对于对照组,这种类型的纠正是详尽的。比较1组在常规空气冷冻治疗的基础上加用1个疗程;对照组2在对照组基础上加用1个疗程的普通磁疗程序;比较3组患者在对照组基础上加用1个疗程的低氧-高氧治疗;比较4组患者在对照组基础上加用1个疗程的氢疗法;在主要组中,患者接受一个疗程的复杂暴露于治疗性物理因素。研究设计采用MBI问卷、DASS和PSM-25量表对所有组的患者进行双重检查。结果:通过对职业倦怠状态的矫正过程,可以确定其有效性在很大程度上取决于所使用的物理因素的类型。在使用体育锻炼和心理矫正的对照组中,注意到的变化不太明显。在单因素影响模式(普通空气冷冻疗法、普通磁疗、低氧-高氧疗法和氢疗法;分别为对照组1-4)的治疗性物理因素的附加疗程应用中,评估指标的积极动态增加了12-23%。所有物理治疗效果的复杂使用,在主要群体中实施,导致矫正效果的发展最为明显。结论:非药物技术的应用可以有效地矫正医务人员的抗应激性,体现医务人员的专业成就。最大的矫正效果,体现在物理因素的复杂使用上,是各种物理治疗技术协同作用的结果,以增强健康机制的形式实施,旨在使具有极端服务活动的个人的心理-情绪状态正常化。
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引用次数: 0
[Modern technologies of physical and rehabilitation medicine in the programs of sanatorium treatment and medical rehabilitation of military personnel in sanatorium organizations of the Ministry of Defense of the Russian Federation]. [俄罗斯联邦国防部疗养院组织军事人员疗养院治疗和医疗康复方案中的现代物理和康复医学技术]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort20251020315
S V Dolgikh, A A Kirsanova, D V Kovlen, V M Kuznetsov, A V Sobolev, A V Shakula, I G Mishenina

The health resort organizations of the Ministry of Defense of Russia are an integral part of the general healthcare system of the Russian Federation. The main tasks facing military health resorts are health resort treatment and medical rehabilitation of military personnel, veterans of military service and their families. Along with natural factors, modern technologies of physical and rehabilitation medicine, including high-tech methods of influence, are used to perform these tasks.

Objective: Analysis of modern technologies of physical and rehabilitation medicine used in health resort organizations of the Ministry of Defense of Russia.

Material and methods: The study is based on the analysis of regulatory legal acts, studies and reports of health resort organizations of the Ministry of Defense of Russia for 2020-2024. The methodology included a retrospective analysis of statistical data, study of medical documentation and assessment of the effectiveness of rehabilitation technologies.

Results: During the period from 2020 to 2024, about 845 000 people were treated in military sanatoriums with a total bed capacity of about 17 thousand places. A significant change in the structure of the contingent was noted: the share of military personnel increased from 20.4% to 43.3%. The number of patients admitted for medical rehabilitation increased from 7.1% in 2020 to 24.7% in 2024. Modern rehabilitation technologies have been introduced, including robotic mechanotherapy, virtual reality, high-intensity laser therapy, transcranial magnetic stimulation. Particular attention was paid to the rehabilitation of patients with combat injuries, including limb amputations.

Conclusions: The use of modern technologies of physical and rehabilitation medicine in sanatorium and resort organizations of the Russian Ministry of Defense has increased the effectiveness of rehabilitation measures, reduced recovery times and improved the quality of medical care for military personnel.

俄罗斯国防部的疗养机构是俄罗斯联邦一般医疗保健系统的组成部分。军队疗养地面临的主要任务是军人、退役军人及其家属的疗养和医疗康复。除了自然因素外,现代物理和康复医学技术,包括高科技的影响方法,都被用于执行这些任务。目的:分析俄罗斯国防部疗养机构采用的现代物理康复医学技术。材料和方法:该研究基于对俄罗斯国防部2020-2024年疗养组织的监管法律行为、研究和报告的分析。方法包括统计数据的回顾性分析、医学文献研究和康复技术有效性评估。结果:2020 - 2024年,军队疗养院共收治84.5万人,总床位约1.7万张。注意到特遣队的结构发生了重大变化:军事人员的比例从20.4%增加到43.3%。医疗康复住院人数从2020年的7.1%增加到2024年的24.7%。现代康复技术已被引入,包括机器人机械治疗、虚拟现实、高强度激光治疗、经颅磁刺激。特别注意战斗受伤病人,包括截肢病人的康复。结论:俄罗斯国防部疗养院和度假机构使用现代物理和康复医学技术,提高了康复措施的有效性,缩短了康复时间,提高了军事人员的医疗质量。
{"title":"[Modern technologies of physical and rehabilitation medicine in the programs of sanatorium treatment and medical rehabilitation of military personnel in sanatorium organizations of the Ministry of Defense of the Russian Federation].","authors":"S V Dolgikh, A A Kirsanova, D V Kovlen, V M Kuznetsov, A V Sobolev, A V Shakula, I G Mishenina","doi":"10.17116/kurort20251020315","DOIUrl":"https://doi.org/10.17116/kurort20251020315","url":null,"abstract":"<p><p>The health resort organizations of the Ministry of Defense of Russia are an integral part of the general healthcare system of the Russian Federation. The main tasks facing military health resorts are health resort treatment and medical rehabilitation of military personnel, veterans of military service and their families. Along with natural factors, modern technologies of physical and rehabilitation medicine, including high-tech methods of influence, are used to perform these tasks.</p><p><strong>Objective: </strong>Analysis of modern technologies of physical and rehabilitation medicine used in health resort organizations of the Ministry of Defense of Russia.</p><p><strong>Material and methods: </strong>The study is based on the analysis of regulatory legal acts, studies and reports of health resort organizations of the Ministry of Defense of Russia for 2020-2024. The methodology included a retrospective analysis of statistical data, study of medical documentation and assessment of the effectiveness of rehabilitation technologies.</p><p><strong>Results: </strong>During the period from 2020 to 2024, about 845 000 people were treated in military sanatoriums with a total bed capacity of about 17 thousand places. A significant change in the structure of the contingent was noted: the share of military personnel increased from 20.4% to 43.3%. The number of patients admitted for medical rehabilitation increased from 7.1% in 2020 to 24.7% in 2024. Modern rehabilitation technologies have been introduced, including robotic mechanotherapy, virtual reality, high-intensity laser therapy, transcranial magnetic stimulation. Particular attention was paid to the rehabilitation of patients with combat injuries, including limb amputations.</p><p><strong>Conclusions: </strong>The use of modern technologies of physical and rehabilitation medicine in sanatorium and resort organizations of the Russian Ministry of Defense has increased the effectiveness of rehabilitation measures, reduced recovery times and improved the quality of medical care for military personnel.</p>","PeriodicalId":39492,"journal":{"name":"Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury","volume":"102 3","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Static delay exercises for improvement of proprioception and movements control in children with impaired intelligence (on the example of walking pattern correction)]. [静态延迟练习对智力受损儿童本体感觉和运动控制的改善(以行走模式矫正为例)]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510201132
D V Fedulova, K A Berdyugin

Children with mental retardation, due to the inertia of cortical processes, have changes in the motor sphere development, which are reflected in both mechanisms of motion control and postural disorders of the musculoskeletal system.

Objective: To evaluate the effectiveness of static delay exercises in improving motor control and development of proprioception in children with mental retardation.

Material and methods: The study involved 80 children aged 12-14 years. For comparison, 4 groups of 20 patients in each were formed: the 1st, the 2nd groups - children with a mild degree of impaired intelligence; the 3rd, the 4th groups - healthy children. Completion of two courses of exercises throughout the academic year was proposed to experimental groups. The emphasis of static exercises performed with rubber expander was focused on strengthening the core muscles as a main segment, providing the body's stability and participation in locomotions.

Results: Significant differences in the changes of the indicators of dynamic and biomechanical disorders of movement patterns in children with impaired intelligence, primarily related to the improvement of movement coordination and motor act regulation mechanisms were identified.

Conclusion: Static delay exercises are effective for improving proprioception and movements control in children with impaired intelligence. Correctional work should be continued.

智力低下儿童由于皮质过程的惯性,运动球发育发生改变,这既体现在运动控制机制上,也体现在肌肉骨骼系统的体位障碍上。目的:评价静态延迟练习对智力低下儿童运动控制和本体感觉发育的改善作用。材料与方法:研究对象为80名12-14岁的儿童。为了进行比较,我们分为4组,每组20例:第一组、第二组为轻度智力障碍儿童;第三,第四组是健康儿童。实验组被建议在整个学年完成两门练习课程。用橡胶膨胀器进行的静态练习的重点是加强核心肌肉作为主要部分,提供身体的稳定性和参与运动。结果:智力障碍儿童运动模式的动力和生物力学障碍指标的变化存在显著差异,主要与运动协调和运动行为调节机制的改善有关。结论:静态延迟练习能有效改善智力障碍儿童的本体感觉和运动控制能力。惩教工作应继续进行。
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引用次数: 0
[Diagnosis of causes and choice of aromatherapy in complex treatment of myofascial pain syndromes caused by psycho-emotional disorders]. [心理情绪障碍所致肌筋膜疼痛综合征综合治疗的病因诊断及芳香疗法的选择]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510204120
M D Didur, T V Konchugova, N V Rasputin, A A Bozhchenko, A M Golubeva, V V Vasiliev

Myofascial pain syndromes have a significant share in the practice of a doctor engaged in rehabilitation medicine: the proportion of patients suffering from this pathology reaches 40%. At the same time, the causes of pain syndromes cannot always be established due to a number of objective difficulties, for example, in view of uncontrolled self-medication with systemic analgesics, nonsteroidal and steroid anti-inflammatory drugs, as well as uncontrolled and unskilled use of physiotherapy procedures, the availability of which has increased dramatically recently due to the commercialization of restorative medicine. The above has determined the relevance of our original clinical study, the purpose of which was to determine the possibility of a therapeutic and diagnostic algorithm using the method of functional (manual) muscle testing when choosing essential oils for aromatherapy in order to restore the regulation of muscle contraction and eliminate negative emotions based on the results of examination of patients with various myofascial pain syndromes and lesions of the autonomic nervous system that occur against the background of psycho-emotional disorders. As a result of our research, we have identified a number of reasons for the development of objective symptoms of myofascial pain syndromes in patients, the leading of which, in our opinion, are primary disorders in the emotional sphere, leading to distress. At the same time, multicomponent personalized aromatherapy can significantly eliminate excessive emotional reaction in the patient. Thus, the method of functional (manual) muscle testing makes it possible to quickly identify a violation of muscle contraction in a particular patient with myofascial pain syndrome and establish its cause, and personalized multicomponent aromatherapy is an effective method of physiotherapy for it. The original material presented by the team of authors is supported by a set of necessary citations and valid statistical data with correct references to primary sources, the regulatory framework and representative literature on the topic of this clinical scientific study.

肌筋膜疼痛综合征在从事康复医学的医生的实践中占有相当大的份额:患有这种病理的患者比例达到40%。与此同时,由于一些客观困难,不能总是确定疼痛综合征的原因,例如,考虑到不受控制的全身镇痛药、非甾体和类固醇抗炎药的自我用药,以及不受控制和不熟练地使用物理治疗程序,最近由于恢复性药物的商业化,物理治疗程序的可用性急剧增加。以上决定了我们最初的临床研究的相关性,其目的是确定在选择芳香疗法精油时使用功能(手动)肌肉测试方法的治疗和诊断算法的可能性,以便根据对各种肌筋膜疼痛综合征和自主神经系统病变的患者的检查结果恢复肌肉收缩的调节并消除负面情绪,这些患者发生在心理情绪障碍的背景下。作为我们研究的结果,我们已经确定了患者肌筋膜疼痛综合征客观症状发展的一些原因,在我们看来,其中的主要原因是情绪领域的原发性疾病,导致痛苦。同时,多组分个性化芳香疗法可以显著消除患者过度的情绪反应。因此,功能性(手动)肌肉测试方法可以快速识别特定肌筋膜疼痛综合征患者的肌肉收缩破坏并确定其原因,个性化多组分芳香疗法是一种有效的物理治疗方法。作者团队提交的原始材料由一组必要的引用和有效的统计数据支持,并正确参考了主要来源、监管框架和本临床科学研究主题的代表性文献。
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引用次数: 0
[Comparative analysis of the effectiveness of modern physiotherapeutical methods of dorsalgia treatment]. 【现代物理治疗方法治疗背痛症疗效对比分析】。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510202135
V I Mizin, O A Nedopekina

Objective: To analyze the treatment possibilities of modern methods of physiotherapy as part of the rehabilitation treatment in dorsalgia (DA).

Material and methods: An examination of 104 patients with DA, who underwent rehabilitation treatment with physiotherapy methods, was performed. Impact of shockwave therapy (SWT), high-intensity laser therapy (HILT) and pharmacopuncture (PP) and combinations of these physiotherapeutical factors were assessed according to the criteria of the International Classification of Functioning, Disability and Health (ICF).

Results: Dynamics of 15 domains of ICF, including the dynamics of the leading ICF domain in DA - b28013 «Pain in back», was studied. Reliable rehabilitation predictions for the positive dynamics of ICF b28013 «Pain in back» domain in patients with DA have been established in the form of equations of SWT, HILT and PP or their combined application impact regression. Effects of the studied physiotherapy variants were compared.

Conclusion: SWT is the most effective of the applied monotherapy in relation to the dynamics of b28013 «Pain in back» domain, HILT - on the second place and PP - on the third place. The greatest effect of treatment in relation to the dynamics of b28013 «Pain in back» domain from the combined use of physiotherapeutic factors is provided by SWT+HILT combination, SWT+HILT+PP - on the second place and SWT+PP combination - on the third place, HILT+PP combination - on the fourth place.

目的:分析现代物理治疗方法作为背痛症康复治疗的一部分的治疗可能性。材料和方法:对104例经物理治疗方法康复治疗的DA患者进行检查。根据国际功能、残疾和健康分类(ICF)的标准评估冲击波治疗(SWT)、高强度激光治疗(HILT)和药物穿刺(PP)以及这些物理治疗因素的组合的影响。结果:研究了15个ICF域的动态,包括DA - b28013«Pain in back»的ICF域的动态。对于DA患者ICF b28013«背部疼痛»域的积极动态,可靠的康复预测已经以SWT、HILT和PP的方程或它们的联合应用影响回归的形式建立起来。比较不同物理疗法的疗效。结论:对于b28013“背部疼痛”域的动力学,SWT是应用单一疗法中最有效的,HILT -排在第二位,PP -排在第三位。联合使用物理治疗因素对b28013“背部疼痛”领域的动力学影响最大的是SWT+HILT组合,SWT+HILT+PP -排在第二位,SWT+PP组合排在第三位,HILT+PP组合排在第四位。
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引用次数: 0
[Influence of physical therapy on intestinal microbiota, blood pressure control and systemic inflammation level: a randomized controlled study of 84 patients with arterial hypertension]. [物理治疗对肠道菌群、血压控制和全身炎症水平的影响:84例动脉高血压患者的随机对照研究]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510202111
T I Petelina, K S Avdeeva, L L Valeeva, S G Bykova, E V Zueva, E F Dorodneva
<p><strong>Objective: </strong>To analyze the clinical and organ-protective effects of different 12-month therapeutic intervention schemes, including a balanced diet enriched with dietary fibers, course application of prebiotics, PT courses, in presence of basic antihypertensive therapy in patients with arterial hypertension (AH) of the 1st-3rd degree.</p><p><strong>Material and methods: </strong>The study included 84 patients with AH of the 1st-3rd degree, randomized to 4 groups. Basic antihypertensive pharmacological therapy was prescribed in the 1st group (control; 22 patients with AH; mean age 51.82±11.89 years); balanced diet with dietary fibers in addition to antihypertensive therapy - in the 2nd group (21 patients; mean age 52.90±9.97 years; balanced diet with dietary fibers and prebiotic (Plantago ovata Forssk) in addition to antihypertensive therapy - in the 3rd group (20 patients; mean age 47.65±11.56 years); pharmacological therapy and balanced diet with dietary fibers and PT course - in the 4th group (21 patients; mean age 53.52±9.50 years). The groups were comparable in age, degree of AH, pharmacological therapy and presence of concomitant pathology. We conducted a laboratory study of the biosamples of blood and faeces at the time of hospitalization. The following parameters were evaluated: metabolites of intestinal microbiota - short-chain fatty acids (SCFA) in the faeces (gas chromatography (GC) with mass spectrometry /GC with plasma ionization detection), endotoxin (chromogenic method based on enzymatic reaction, LAL test set); level of proinflammatory markers - proinflammatory cytokines (interleukin (IL)-1β, IL-6, IL-8, FNO-α (enzyme-linked immunoassay, «sandwich»-method, IMMULITE 2000 (USA)), hsCRP, homocysteine (Stat Fax 4200, USA). We performed: 24-hour monitoring of blood pressure (BP) (BPLaB apparatus, OOO «Petr Telegin», Russia) according to the standard protocol; study of elastic properties of the vascular wall by sphygmography (Vasera VS-1000 Series apparatus, Fukuda Denishi, Japan) with assessment of the following indicators: PWV - pulse wave velocity and CAVI - parameter of the vascular wall rigidity stiffness by the arteries of elastic type.</p><p><strong>Results: </strong>Analysis of the obtained data has shown that there was a significant reduction in waist and hips volume in patients of the 2nd, 3rd and 4th groups (<i>p</i>=0.049, <i>p</i>=0.001, <i>p</i>=0.025 and <i>p</i>=0.007, <i>p</i>=0.001, <i>p</i>=0.051, respectively). The following changes have been registered: significant reduction of endotoxin levels in all groups; increase in C3 and C4 (propionic and butyric acid) SCFA levels in the group with prebiotic (<i>p</i>=0.001 and <i>p</i>=0.025, respectively) and in the group with PT (<i>p</i>=0.036 and <i>p</i>=0.008, respectively); significant reduction of IL-1β (<i>p</i>=0.038), hsCRP (<i>p</i>=0.013) levels in the group with PT; mean daily heart rate decrease (<i>p</i>=0.052), variability of systolic BP(24)
目的:分析1 ~ 3度动脉性高血压(AH)患者在基础降压治疗的基础上,采用富含膳食纤维的均衡饮食、应用益生元疗程、PT疗程等12个月不同治疗干预方案的临床和器官保护作用。材料与方法:84例1 ~ 3度AH患者随机分为4组。第一组患者给予基础降压药物治疗(对照组;AH 22例;平均年龄51.82±11.89岁);在抗高血压治疗的基础上均衡饮食和膳食纤维——第二组(21例;平均年龄52.90±9.97岁;除了抗高血压治疗外,第三组(20例患者)还提供膳食纤维和益生元(车前草)的均衡饮食;平均年龄47.65±11.56岁);第四组(21例)采用药物治疗和膳食纤维均衡饮食加PT疗程;平均年龄53.52±9.50岁)。两组在年龄、AH程度、药物治疗和伴随病理方面具有可比性。我们对住院时的血液和粪便生物样本进行了实验室研究。评估肠道菌群代谢产物——粪便中的短链脂肪酸(SCFA)(气相色谱-质谱/气相色谱-等离子体电离检测)、内毒素(基于酶促反应的显色法,LAL测试集);促炎标志物水平-促炎细胞因子(白细胞介素(IL)-1β, IL-6, IL-8, FNO-α(酶联免疫分析法,“三明治”法,IMMULITE 2000(美国)),hsCRP,同型半胱氨酸(Stat Fax 4200,美国)。我们进行了:24小时血压监测(BPLaB仪器,OOO«peter Telegin»,俄罗斯),按照标准方案;通过血压计(Vasera VS-1000系列仪器,Fukuda Denishi,日本)研究血管壁的弹性特性,并评估以下指标:PWV -脉冲波速度和CAVI -弹性型动脉血管壁刚度参数。结果:对获得的数据进行分析,第2、3、4组患者的腰臀体积明显减小(p=0.049, p=0.001, p=0.025, p=0.007, p=0.001, p=0.051)。记录了以下变化:所有组的内毒素水平显著降低;益生元组(p=0.001和p=0.025)和PT组(p=0.036和p=0.008) C3和C4(丙酸和丁酸)SCFA水平升高;PT组IL-1β (p=0.038)、hsCRP (p=0.013)水平显著降低;益生元组的平均每日心率降低(p=0.052),收缩压变异性(24),PT组的收缩压(24)(p=0.043)和舒张压(24)(p=0.028);仅在pt组PWV和CAVI显著降低。内毒素血症和促炎标志物水平的降低、SCFA水平的升高、血压谱个体参数的正常化以及血管壁弹性的改善趋势表明,在所有的研究小组中,所有的额外干预方案都有积极的效果,在接受PT的患者组中更为明显。膳食纤维均衡饮食和PT疗程对肠道微生物群校正的积极协同作用。AH的全身炎症水平和动脉僵硬已被证实。
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引用次数: 0
[Extraction and analysis of cardiorespiratory exercise test data for personalization and monitoring of rehabilitation process effectiveness]. [心肺运动试验数据的提取与分析,用于个性化康复过程有效性监测]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510205266
T Yu Kulagina, S V Yelantsev, M D Zakatov, A V Egorov, V A Sandrikov

All over the world, there is a high difficulty in extracting data related to cardiopulmonary exercise testing (CPX) for analysis for methodological purposes.

Objective: Of the research is to create the foundations of a system for extracting, integrating and consolidating load testing data, including an information model.

Material and methods: Automatic generation of multidimensional data samples for specific nosologies and their sets, groups of patients when performing stress tests with the generation of a larger amount of data in the pathology of the cardiovascular system, small circle of blood circulation.

Results: The analysis of cardiorespiratory testing, stress echocardiography and electrocardiography (graphic, digital, text) was performed. The results of the patient's medical record (text, digital, graphic) are analyzed.

在世界范围内,提取与心肺运动测试(CPX)相关的数据用于方法学分析是一个很高的困难。目的:为负载测试数据提取、集成和整合系统的建立奠定基础,并建立信息模型。材料与方法:自动生成针对特定病种及其组、组患者的多维数据样本,在进行压力测试时可以生成大量的心血管系统、小循环血液的病理数据。结果:进行心肺功能检查、应激超声心动图及心电图(图形、数字、文字)分析。对患者病历(文本、数字、图形)的结果进行分析。
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引用次数: 0
[Psychotherapeutic component in the treatment of acute and prevention of chronic postoperative pain]. [心理治疗在治疗急性和预防术后慢性疼痛中的作用]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/kurort202510205244
E A Tyurina, M A Elfimov, S A Fedorov, V A Shahnovich, S A Kovalev, O I Zagorulko

The development of postoperative pain syndrome (POPS) and its chronification in patients who have undergone surgical interventions remains an underestimated problem in modern clinical practice. Inadequate diagnosis and prevention of acute pain chronification significantly worsen the quality of life of patients.

Objective: To investigate the effectiveness of cognitive-behavioral therapy (CBT) combined with pharmacotherapy in the treatment of POPS and the prevention of its chronification.

Material and methods: The study included 62 patients who underwent cardiac surgery. Patients in the main group (n=31) received standard therapy combined with CBT sessions, which included cognitive restructuring, behavioral activation, and exposure therapy.

Results: After three months of treatment, pain intensity, as well as levels of anxiety, depression, and pain catastrophizing, were significantly lower in the main group compared to the control group. The rate of pain chronification was also significantly lower in the group that received CBT.

Conclusion: Thus, the integration of psychotherapeutic methods in the treatment of POPS is an effective strategy that improves surgical outcomes and reduces the risk of pain chronification.

在现代临床实践中,术后疼痛综合征(POPS)的发展及其慢性化在接受手术干预的患者中仍然是一个被低估的问题。不充分的诊断和预防急性疼痛慢性化显著恶化患者的生活质量。目的:探讨认知行为疗法(CBT)联合药物治疗持久性有机污染物(POPS)的疗效及预防其慢性化的效果。材料和方法:本研究包括62例接受心脏手术的患者。主组患者(n=31)接受标准治疗结合CBT治疗,包括认知重构、行为激活和暴露治疗。结果:治疗3个月后,主组患者的疼痛强度、焦虑、抑郁、疼痛灾难化水平均明显低于对照组。接受CBT治疗组的疼痛慢性化率也显著降低。结论:综合心理治疗方法治疗持久性有机污染物是一种有效的策略,可以改善手术效果,降低疼痛慢性化的风险。
{"title":"[Psychotherapeutic component in the treatment of acute and prevention of chronic postoperative pain].","authors":"E A Tyurina, M A Elfimov, S A Fedorov, V A Shahnovich, S A Kovalev, O I Zagorulko","doi":"10.17116/kurort202510205244","DOIUrl":"https://doi.org/10.17116/kurort202510205244","url":null,"abstract":"<p><p>The development of postoperative pain syndrome (POPS) and its chronification in patients who have undergone surgical interventions remains an underestimated problem in modern clinical practice. Inadequate diagnosis and prevention of acute pain chronification significantly worsen the quality of life of patients.</p><p><strong>Objective: </strong>To investigate the effectiveness of cognitive-behavioral therapy (CBT) combined with pharmacotherapy in the treatment of POPS and the prevention of its chronification.</p><p><strong>Material and methods: </strong>The study included 62 patients who underwent cardiac surgery. Patients in the main group (<i>n</i>=31) received standard therapy combined with CBT sessions, which included cognitive restructuring, behavioral activation, and exposure therapy.</p><p><strong>Results: </strong>After three months of treatment, pain intensity, as well as levels of anxiety, depression, and pain catastrophizing, were significantly lower in the main group compared to the control group. The rate of pain chronification was also significantly lower in the group that received CBT.</p><p><strong>Conclusion: </strong>Thus, the integration of psychotherapeutic methods in the treatment of POPS is an effective strategy that improves surgical outcomes and reduces the risk of pain chronification.</p>","PeriodicalId":39492,"journal":{"name":"Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury","volume":"102 5. Vyp. 2","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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