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.
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.
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.
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.
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.
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.
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.
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