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[Physical therapy during the Great Patriotic War]. 【伟大卫国战争时期的物理治疗】。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310004114
G A Suslova, V V Kiryanova, I M Sarchimelia

The article presents an analysis of the application of physical therapy methods during the Great Patriotic War in the Soviet Union. It was observed that physical therapy, combined with surgical and other methods, significantly improves the efficacy of patients' treatment, including with battle injuries, as well as with injuries of other etiology, such as frostbite, and also contributes to reducing the incidence of disabilities among the injured. The features of the physical therapy methods' organization sequently from 1941 to 1945, and also the results of active development of physical medicine, have been characterized. The features of physical therapy methods' application both on different bases of healthcare delivery (hospital bases, in the rear) and with regard to various types of pathology have been shown. The importance of involving physical therapy methods in curative measures from the early stages of treatment has been noted.

本文分析了物理治疗方法在苏联卫国战争中的应用。据观察,物理治疗与手术和其他方法相结合,显著提高了患者的治疗效果,包括战伤以及冻伤等其他病因的损伤,也有助于降低受伤者的残疾发生率。阐述了1941-1945年物理治疗方法的组织特点,以及物理医学积极发展的结果。物理治疗方法在不同的医疗保健基础(后方的医院基础)和各种类型的病理学中的应用特点已经得到了展示。人们注意到,从治疗的早期阶段就将物理治疗方法纳入治疗措施的重要性。
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引用次数: 0
[Efficacy evaluation of symptom-complex physiotherapy in polymorbidity based on randomized comparative studies]. [基于随机对照研究的症状复合物理治疗治疗多病的疗效评价]。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310005114
U Nurzhan Uulu, M A Sagymbaev

The problem of comprehensive physical therapy in polymorbidity (PM) identifies among the most urgent difficulties of modern rehabilitation medicine. It is known that PM are more common than it is generally accepted, and their impact on the endpoints of rehabilitative treatment is more significant. Yet, many problems of PM have not been investigated and properly solved.

Objective: To evaluate the efficacy of comprehensive physical therapy (CPT) in PM in the age aspect on the basis of correlation analysis and ANOVA indicators (OR, RR, Q, x2, r2), as well as evidence-based medicine (EBM), in particular randomized comparative study (RCS).

Material and methods: A number of patients with PM equal 554 underwent CPT, of which 204 (36.8%) were male and 350 (63.2%) female. The identified age cohorts were following: the 1st group - 188 (33.9%) patients aged from 45 to 59; the 2nd group - 366 (66.1%) patients aged from 60 to 74. The ratio of middle-aged and elderly patients was 1.9:1.

Results: The efficacy of CPT in patients with PM was judged, first of all, by documentary (medical histories and medical records of patients) and mathematical data (OR, RR, Q, x2, r2). The evidence level of CPT effect was determined on the basis of the analysis of the particular method's study results.

Conclusion: The incidence of positive CPT result in middle-aged patients was higher than in elderly. The positive strong statistical correlation between comprehensive physical therapy and the endpoint in most classes of diseases of patients with PM. The comparative assessment of CPT efficacy based on the EBM principles revealed the advantages of their use for elderly patients relative to middle-aged group.

综合物理治疗多病(PM)的问题确定了现代康复医学最紧迫的困难之一。众所周知,PM比一般认为的更为常见,其对康复治疗终点的影响更为显著。然而,项目管理的许多问题尚未得到调查和妥善解决。目的:通过相关分析和方差分析指标(OR、RR、Q、x2、r2)以及循证医学(EBM),特别是随机比较研究(RCS),评价综合物理治疗(CPT)治疗PM在年龄方面的疗效。材料与方法:PM = 554例患者行CPT,其中男性204例(36.8%),女性350例(63.2%)。确定的年龄队列如下:第一组- 188例(33.9%)患者,年龄从45岁到59岁;第二组患者366例(66.1%),年龄60 ~ 74岁。中老年患者比例为1.9:1。结果:CPT对PM患者疗效的判断,首先通过文献资料(患者病史、病历)和数学数据(OR、RR、Q、x2、r2)进行。CPT效应的证据水平是在分析特定方法研究结果的基础上确定的。结论:中年患者CPT阳性的发生率高于老年患者。综合物理治疗与PM患者绝大多数疾病类型的终点呈正相关。基于循证医学原理的CPT疗效对比评估显示其在老年患者中使用的优势。
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引用次数: 0
VII Scientific and Practical Conference "Razumovskie Readings". "Resorts of Russia - a key element of the nation's health and stability of the country's economic potential" 第七届科学与实践会议“拉祖莫夫斯基读物”。“俄罗斯度假胜地——国家健康和稳定经济潜力的关键因素”
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort20231000528
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引用次数: 0
[Reflexology in patient rehabilitation with postoperative pain. (Literature review)]. [反射疗法在术后疼痛患者康复中的应用。(文献综述)]。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort2023100061103
O I Zagorulko, L A Medvedeva, Yu B Tsedinova, K V Kotenko

Postoperative pain is a pressing medical problem, as it significantly reduces the quality of life of patients after surgical treatment. Chronic postoperative pain further disables patients and impairs their functional activity. Being a widespread interdisciplinary problem, postoperative pain requires the integration of various pain management methods in complex multimodal pain management in the acute period and treatment programs for its chronicity. The paper examines the possibilities of reflexology methods for the relief of acute and treatment of chronic postoperative pain. Integration of reflex effects from the first days after surgery makes it possible to more effectively and safely solve the problems of acute and chronic postoperative pain.

术后疼痛是一个紧迫的医学问题,因为它大大降低了手术治疗后患者的生活质量。长期的术后疼痛会进一步削弱患者的能力,影响他们的功能活动。作为一个广泛存在的跨学科问题,术后疼痛需要在急性期的复杂多模式疼痛治疗和慢性期的治疗方案中整合各种疼痛治疗方法。本文探讨了反射疗法缓解急性疼痛和治疗慢性术后疼痛的可能性。从术后第一天起就结合反射作用,可以更有效、更安全地解决急性和慢性术后疼痛问题。
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引用次数: 0
[Instrumental physiotherapy for treatment of patients with chronic prostatitis: analysis of evidential researches]. 器械物理疗法治疗慢性前列腺炎:循证研究分析
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310003158
D B Kulchitskaya, A D Fesyun, V A Kiyatkin, T V Konchugova

Currently important task of modern medicine is the development of personalized comprehensive physiotherapy technologies for the treatment of patients with chronic prostatitis (CP).

Objective: To analyze scientific data about efficacy of physiotherapy methods for the treatment of CP.

Material and methods: The number of publications equal 55 about evaluation of therapeutic effects of instrumental physiotherapy in patients with CP have been conducted. The search was done in electronic databases (PEDro, PubMed, EMBASE, eLIBRARY), systematic reviews databases (Cochrane library) for the last 20 years by keywords in Russian and English: «хронический простатит» (chronic prostatitis), «электротерапия» (electrotherapy), «магнитотерапия» (magnetotherapy), «лазерная терапия» (laser therapy), «ударно-волновая терапия» (shock wave therapy), «ультразвук» (ultrasound).

Results: The clinical effects and suggested action mechanisms of instrumental physiotherapy methods in patients with CP were presented.

Conclusion: Based on the results of the randomized placebo-controlled trials, presented in the review, it can be concluded, that certain physiotherapeutic interventions, such as transcutaneous electrical nerve stimulation, extracorporal shock wave therapy, ultrasound, impulsive magnetotherapy lead to decrease of prostatitis symptoms.

目前现代医学的重要任务是开发个性化的综合理疗技术来治疗慢性前列腺炎(CP)。目的:分析物理治疗方法治疗CP疗效的科学资料。材料与方法:对器械物理治疗CP疗效评价的文献发表55篇。搜索是在电子数据库(佩德罗,PubMed和EMBASE, eLIBRARY),系统评价数据库(Cochrane图书馆)在过去的20年俄语和英语的关键词:«хроническийпростатит»(慢性前列腺炎),«электротерапия»(电疗法),«магнитотерапия»(magnetotherapy)«лазернаятерапия»(激光疗法),«ударно——волноваятерапия»(冲击波疗法),«ультразвук»(超声波)。结果:介绍了器械物理治疗方法在CP患者中的临床疗效及可能的作用机制。结论:根据综述中随机安慰剂对照试验的结果,可以得出结论,某些物理治疗干预措施,如经皮神经电刺激、体外冲击波治疗、超声、脉冲磁疗等,可导致前列腺炎症状的减轻。
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引用次数: 0
[High-intensity laser therapy in clinical medicine: scientometric analysis of evidence of effectiveness]. [临床医学中的高强度激光治疗:有效性证据的科学计量学分析]。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310001118
G N Ponomarenko

Introduction: High-intensity laser technologies are widely used in modern restorative medicine, and indications for their use are expanding annually. These technologies are effective, potentially safe methods of treating many diseases. with pronounced therapeutic effects.

Purpose of research: Analysis of scientific evidence of the effectiveness and safety of high-intensity laser therapy in patients with various diseases.

Material and methods: A comprehensive scientometric analysis of evidence-based studies of the effectiveness and safety of high-intensity laser therapy methods was carried out according to electronic databases (Google scholar, PEDro, PubMed, Cochrane DATABASE) for the period from 2006 to 2021.

Results: High-intensity laser therapy has a wide range of significantly pronounced therapeutic effects. and it is an effective method of treating patients with various diseases. Various technologies and methods of its application are widely used in various fields of clinical medicine. Individually developed therapy protocols are needed, with optimal exposure parameters for each patient, intervals between procedures.

Conclusion: It is advisable to develop more reliable and standard evaluation criteria, regular generalization and analysis of existing evidence, careful planning and implementation of further large-scale randomized controlled trials to study the effects of high-intensity laser radiation both as a single effect and as part of combinations with other treatment methods. The effectiveness of combination therapy requires further analysis in the course of conducting new benign clinical trials.

高强度激光技术在现代恢复性医学中得到广泛应用,其应用适应症每年都在扩大。这些技术是治疗许多疾病的有效、潜在安全的方法。具有显著的治疗效果。研究目的:分析高强度激光治疗各种疾病的有效性和安全性的科学证据。材料和方法:根据2006年至2021年的电子数据库(Google scholar、PEDro、PubMed、Cochrane DATABASE),对高强度激光治疗方法有效性和安全性的循证研究进行了全面的科学计量学分析。结果:高强度激光治疗范围广,疗效显著。是治疗各种疾病的有效方法。其应用的各种技术和方法被广泛应用于临床医学的各个领域。需要单独开发治疗方案,为每个患者提供最佳暴露参数,手术间隔。结论:应制定更可靠、更规范的评价标准,定期对现有证据进行归纳和分析,认真规划和实施进一步的大规模随机对照试验,以研究高强度激光辐射作为单一效果和与其他治疗方法联合使用的效果。联合治疗的有效性需要在开展新的良性临床试验过程中进一步分析。
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引用次数: 1
[Realization of medical and medical psychological rehabilitation in sanatorium-resort organizations of Ministry of Defence of the Russian Federation]. [在俄罗斯联邦国防部疗养院度假组织中实现医疗和医疗心理康复]。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort20231000415
S V Dolgikh, A A Kirsanova, D V Kovlen, A V Sobolev

Current conditions of military service demand higher standards of servicemen health status, whose professional activity in extreme combat conditions is accompanied by the impact of many adverse environmental factors on the body. One of the priority tasks of medical service of Armed Forces of the Russian Federation in 2023 yr. is to improve the system of curative and preventive measures in medical and medical psychological rehabilitation to recover health and increase working capacity of servicemen. The article includes an overview of measures given to servicemen for medical and medical psychological rehabilitation in sanatorium-resort organizations of Ministry of Defence in the Russian Federation for the period from 2013 to 2022 yrs.

当前的服役条件对军人的健康状况提出了更高的要求,他们在极端作战条件下的职业活动伴随着许多不利环境因素对身体的影响。2023年,俄罗斯联邦武装部队医疗服务的优先任务之一是改善医疗和医疗心理康复的治疗和预防措施体系,以恢复健康并提高军人的工作能力。文章概述了2013年至2022年期间,俄罗斯联邦国防部疗养院度假组织为军人提供的医疗和医疗心理康复措施。
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引用次数: 0
[The use of oscillatory respiratory therapy with positive expiratory pressure (PEP-therapy) to restore the functional state of the lungs in patients after cardiac surgery]. [使用呼气正压振荡呼吸疗法(PEP疗法)恢复心脏手术后患者的肺功能状态]。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310006121
A A Eremenko, T P Zyulyaeva, A P Alferova, D V Fomina, M S Grekova, O O Grin, S S Dmitrieva, A V Molochkov, A P Gens, K V Kotenko

Postoperative pulmonary complications in cardiac surgery patients occur in 10-35% of cases, depending on differences in their definition, patient characteristics and type of surgical intervention, most of them are associated with ineffective coughing and evacuation of bronchial secretions.

Objective: To determine the effectiveness of stimulating the evacuation of bronchial secretions with the help of oscillating PEP therapy carried out during the first three days.

Material and methods: A randomized prospective study of 60 adult patients after elective cardiac surgery was performed (Clinical Trials.gov. protocol number NCT05159401). Oscillatory PEP-therapy was performed in 30 patients using Acapella DHGreen device (SmithMedicalASD, USA) 10-12 hours after tracheal extubation 3 times a day for 3 days after surgery. The control group (30 patients). The inclusion criteria: age over 18 years, spontaneous breathing after tracheal extubation, clear consciousness and productive contact with the patient, the ability to maintain adequate gas exchange on the low-flow oxygen inhalation, adequate analgesia (<2 points of VAS). Exclusion criteria: the need for re-intubation and mechanical ventilation, non-invasive mask ventilation, high-flow oxygen therapy, acute cerebrovascular accident, ongoing bleeding, cardiac insufficiency (inotropic index >10), shocks syndrome of various etiologies, the use of any extracorporeal support, any neuromuscular disorders, pneumothorax, hydro-or hemothorax. Before each session and 20 minutes after its end, when breathing air, blood oxygen saturation was recorded using a pulse oximeter (SpO2), the maximum inspiratory capacity (MIC) was measured using a Coach-2 incentive spirometer from SmithsMedical and spirometry with a portable ultrasonic spirometer Spiro Scout (Schiller, Switzerland). For the purposes of this work, the total index of the spirometry maximum inspiratory capacity (SMIC) was used - the sum of the respiratory volume and the reserve volume of inspiration in ml.

Results: Difficulties in evacuation of sputum were noted in 90% of patients. Three-day sessions of oscillating PEP- therapy are accompanied by a significant improvement in the passage of sputum, as evidenced by a 3-fold increase in the number of patients with productive cough. The increase in MIC in the main group was 46.9% and 21.3%, respectively (p=0.042), and the number of patients with values greater than MICo. 1500 ml increased from 23.3% to 7.6% (p<0.001). The effectiveness of oscillatory PEP-therapy is confirmed by a 7-fold decrease in the frequency of radiological changes in the lungs at the end of sessions (p<0.001), while in the control group the frequency of their occurrence practically did not change and remained at a high level. The total number of patients with respiratory insufficiency (SpO2≤92%) decreased by 8.6 times after comp

心脏手术患者术后肺部并发症的发生率为10%-35%,这取决于其定义、患者特征和手术干预类型的不同,其中大多数并发症与支气管分泌物的无效咳嗽和排空有关:材料与方法:对 60 名住院患者进行随机前瞻性研究:对 60 名择期心脏手术后的成年患者进行了随机前瞻性研究(临床试验网,协议编号 NCT05159401)。30 名患者在术后 3 天内使用 Acapella DHGreen 设备(SmithMedicalASD,美国)在气管拔管后 10-12 小时进行振荡 PEP 治疗,每天 3 次。对照组(30 名患者)。纳入标准:年龄在 18 岁以上,气管拔管后有自主呼吸,意识清楚,能与患者进行有效接触,在低流量氧气吸入时能维持充分的气体交换,有充分的镇痛(10),各种病因引起的休克综合征,使用任何体外支持,任何神经肌肉疾病,气胸,水肿或血胸。每次治疗前和结束后 20 分钟,呼吸空气时使用脉搏血氧仪(SpO2)记录血氧饱和度,使用 SmithsMedical 公司生产的 Coach-2 激励式肺活量计测量最大吸气量(MIC),使用便携式超声波肺活量计 Spiro Scout(瑞士席勒公司)测量肺活量。在这项工作中,使用的是肺活量测定最大吸气容量总指数(SMIC)--以毫升为单位的呼吸量和储备吸气量之和:90%的患者排痰困难。在接受为期三天的 PEP 振荡疗法后,患者的排痰情况明显改善,有痰咳嗽患者的人数增加了三倍。在完成所有 PEP- 疗法疗程后,主要组的 MIC 分别增加了 46.9% 和 21.3%(p=0.042),而 MICo 值大于 1500 毫升的患者人数从 23.3% 增加到 7.6%(pp2≤92%),减少了 8.6 倍(p=0.001),但与对照组相比没有统计学意义上的显著差异:结论:心脏手术患者的振荡 PEP 治疗对痰液排出、通气参数和氧合肺功能有积极影响。该疗法的耐受性良好,无相关并发症。
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引用次数: 0
[Alopecia and COVID-19: possible etiopathogenetic variants and therapeutic approach]. [脱发与COVID-19:可能的发病变异及治疗方法]
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310005156
I A Gritskova, I G Ponomarenko, I V Cherkashina

Sudden hair thinning, phantom trichalgia in the early and late rehabilitation period after novel coronavirus infection (COVID-19) are the most common complaints of patients, that can be considered by both dermatocosmetologist and medical rehabilitation specialist. A telogen hair loss was found in 19.8% of patients, whereby 27.3% of patients suffering from hair loss during disease and 72.7% - at 3rd-6th month after recovery. Most commonly, hair loss is non-structural and associated with an abnormal ovulatory cycle shift and diffuse asynchronous loss of hair follicles in telogen phase, as well as with an increase of total predisposed to loss hair follicles number. Nevertheless, the analysis of clinical observations of patients with post-COVID hair loss has shown that this disorder is registered not only in telogen phase. There is a rapid disease progression up to the final stages in the presence of verified androgenetic alopecia diagnosis. The cases of alopecia areata and cicatricial alopecia, associated with previous COVID-19, also were registered. Androgenetic alopecia is the first (30.7%) and diffuse alopecia is the second (19.8%) by degree of incidence. The relapses or much less frequently the onsets of alopecia areata and the unexplained pronounced pain at the hair roots in parietal region (7.8%) are in the third place. The article presents in detail the possible reasons and mechanisms of hair loss associated with COVID-19, determines necessary examinations with consideration to the scientific analysis of domestic and foreign literature sources.

新型冠状病毒感染(COVID-19)后康复早期和后期患者最常见的主诉是突发性头发稀疏、幻头痛,这是皮肤科美容医师和医学康复专家都可以考虑的问题。在19.8%的患者中发现休止期脱发,其中27.3%的患者在疾病期间出现脱发,72.7%的患者在康复后的第3 -6个月出现脱发。最常见的是,脱发是非结构性的,与休止期排卵周期的异常变化和毛囊的弥漫性非同步脱落有关,也与总毛囊数量的增加有关。然而,对新冠肺炎后脱发患者的临床观察分析表明,这种疾病不仅存在于休止期。有一个快速的疾病进展,直到最后阶段的存在证实雄激素性脱发的诊断。还登记了与既往COVID-19相关的斑秃和瘢痕性脱发病例。雄激素源性脱发发生率最高(30.7%),弥漫性脱发次之(19.8%)。斑秃复发或少发,以及顶区发根不明原因的明显疼痛(7.8%)排在第三位。本文详细介绍了与新冠肺炎相关的脱发的可能原因和机制,并通过科学分析国内外文献来源,确定了必要的检查。
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引用次数: 0
[Current approaches to the use of robotic devices in rehabilitation complex of children with cerebral palsy]. [目前在脑瘫儿童康复复合体中使用机器人设备的方法]。
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.17116/kurort202310005136
T F Golubova, S V Vlasenko, I I Marusich, M D Otinov, F S Vlasenko, E A Osmanov

Cerebral palsy is a neurological disease that is associated with multiple motor impairments and dysfunctions in children. The effective recovery of motor activity in both the upper and lower limbs is an important condition for the patient's social independence throughout his life. Robotic systems are new devices which are becoming increasingly popular as a part of the treatment of cerebral palsy. They have become a good addition to comprehensive rehabilitation therapy, including conducted at the sanatorium-resort stage. Further research is needed to clarify and prove the extent to which these devices help in treatment of children with cerebral palsy.

脑瘫是一种与儿童多种运动障碍和功能障碍相关的神经系统疾病。有效地恢复上肢和下肢的运动活动是患者终生社会独立的重要条件。作为脑瘫治疗的一部分,机器人系统是越来越受欢迎的新设备。它们已经成为综合康复治疗的一个很好的补充,包括在疗养胜地阶段进行的治疗。需要进一步的研究来澄清和证明这些装置在多大程度上有助于治疗脑瘫儿童。
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引用次数: 0
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