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

Objective: To assess the severity of the phantom pain syndrome in patients with consequences of combat trauma before and after comprehensive therapy using the bioacoustic correction (BAC) method.

Material and methods: A number of male patients equal 15 aged 24-60 years with consequences of combat traumas and confirmed phantom pain syndrome were examined. Patients were given 10 BAC therapy procedures with an average duration of 20 minutes per day after a comprehensive diagnostic assessment of state. The dynamics of pain syndrome was evaluated by visual analogue scale.

Results: It has been shown that the BAC procedures contribute to a significant reduction of the phantom pain syndrome severity. The decrease of the phantom pain syndrome after the BAC procedures was maintained at least 6 months in the catamnesis. The probable mechanism of reducing the phantom pain syndrome in BAC procedures is adaptive reorganization of thalamocortical detectors of affected limbs by modulation of neuroplasticity processes.

Conclusion: The conducted preliminary studies have shown that the BAC therapy contributes to the reduction of the phantom pain syndrome intensity.

Objective: To analyze the effects and tolerability of physiotherapeutic methods with optical radiation (phototherapy) in acute respiratory diseases (ARD) on the basis of the modern scientific literature data and the results of doctors and patients survey.

Material and methods: An analysis of regulatory sources and modern scientific literature on the subject of research, survey of 200 patients with ARD and 100 primary care physicians of the Central Federal District on their sociomedical status and awareness of phototherapeutic treatment methods were conducted.

Results: Phototherapy in ARD have demonstrated chromogenic, immunostimulating, photosensitizing, vitamin-forming, trophostimulating, anti-inflammatory, analgesic, desensitizing, bactericidal and mycocidal, metabolic, coagulo-correcting therapeutic effects. Patients and doctors have been insufficiently aware of phototherapy methods and used them in practice relatively rare. A significant proportion of patients had ARD risk factors, namely teamwork, tobacco smoking and chronic diseases.

Conclusion: 1. The therapeutic effects of all types of phototherapy in acute respiratory infections are interrelated with their etiopathogenesis. 2. Patients and doctors are insufficiently informed and relatively rarely use phototherapy methods. 3. A significant proportion of patients have risk factors for acute respiratory infections: teamwork (88%), tobacco smoking (68%) and chronic diseases (52%).

Chronic kidney disease (CKD) is a global health problem, CKD is widespread in the world, on average it is detected in 10-13% of the adult population. Sedentary patients with CKD on dialysis have a higher risk of mortality. Despite the significant association of physical function with mortality in patients with CKD, physical function is not routinely assessed and exercise is not a component of the routine management of patients with CKD on dialysis.

Objective: The purpose of this study was to evaluate the effectiveness of the influence of motor rehabilitation methods on the prognosis of patients with chronic kidney disease (CKD) using hemodialysis (HD) from the standpoint of evidence-based medicine according to a scientometric analysis of the literature.

Material and methods: An analysis was carried out of systematic reviews (search depth 70 years) and network meta-analyses to assess the effectiveness of physical exercise, its intensity and duration, performed interdialytic and intradialytic in the rehabilitation of patients with CKD with renal failure requiring hemodialysis. We reviewed articles in foreign journals on the PubMed, Embase, CINAHL, Web of Science, Wan Fang data, Cochrane CENTRAL and Scopus platforms.

Results: The use of different types of physical exercise with varying intensities and durations both during and outside of dialysis in CKD patients requiring hemodialysis has shown that aerobic exercise, resistance exercise and a combination of both are most effective in improving their physical condition and quality life. Meta-analyses provide evidence to support the value of intradialytic exercise compared with interdialytic exercise for dialysis patients. It is also noted that moderate-intensity exercise can be performed in various forms, both during and outside of dialysis, and the data studied demonstrate that moderate-intensity exercise best improves physical function.

Conclusion: Future large RCTs should pay more attention to rehabilitation and exercise programs for CKD patients requiring HD. To encourage inactive patients with CKD to engage in physical exercise, educating them about the effects of exercise is imperative. Accumulating evidence suggests that rehabilitation of patients with visceral disorders, such as renal, cardiac, and pulmonary disorders, can not only improve physical performance and quality of life, but also improve survival. Modern comprehensive rehabilitation of patients with CKD is aimed at prolonging life, which represents a new concept in renal rehabilitation.

Chronic arterial insufficiency of lower limbs (CAILL) is a common cardiovascular disease that affects 200 million subjects worldwide: from 4 to 12% of people aged 55-70 years and 20% - over 70 years. The cause of blood circulation disorder in this disease is usually a complex of pathological changes including abnormality of vessel walls' anatomical structure or integrity, disorder of blood rheological properties and alterations of its thrombotic potential. Thus, the therapy of patients with CAILL aiming at hemostasis and, in particular, platelets' aggregation is one of the most urgent problems of medicine.

Objective: To study the effectiveness of blue range visible radiation combined with basic therapy to improve hemostasis in patients with CAILL.

Material and methods: The number of male patients with CAILL equal 63 aged 43-57 years was examined. Blood flow parameters on a fixed part of femoral artery outside the occlusion area were registered based on subjective criteria, number of painless steps and ultrasound doppler flowmetry according to the Fontaine-Pokrovsky classification. The second degree of ischemia was diagnosed in 38 patients, the third degree - in 25 patients. All patients received basic pharmacotherapy. Patients were divided into 2 groups by simple randomization method: control group included 18 patients with II degree of ischemia and 12 patients with III degree of ischemia who received basic pharmacotherapy combined with photohemotherapy (PHT). A set of commonly used laboratory methods for examination of blood coagulation system was applied to assess the effectiveness of PHT. The number of apparently healthy people equal 26 was examined to evaluate normal value of hemostasiological parameters.

Results: Basic pharmacological treatment had a certain positive effect on studied hemostasis parameters and its thrombotic component. However, they did not differ statistically significantly from similar parameters before treatment on the 14th day after treatment. As a result of comprehensive therapy the changes in hemostasis system had identical and statistically significant in percentage terms changes compared to norm and baseline in patients' subgroups of study group with II and III degrees of ischemia. In addition, most hemostasis parameters in patients with II degree of ischemia were close to those of apparently healthy volunteers. Hemostasis parameters in patients with III degree of ischemia decreased to the levels of patients with II degree of ischemia before treatment.

Conclusion: The use of basic pharmacological therapy with optical exposure to blood by blue light allows to correct hemostasis and its thrombotic component in patients with CAILL.

Within the framework of the «Health of Healthy» concept (A.N. Razumov) a medical, psychological and pedagogical «Sonatal-pedagogy» system (M.L. Lazarev) aimed at harmonizing the mental and physical development of children from the prenatal age has been developed In Russia. The system has been tested since 1983 on population of more than 70 thous. children. The results showed its high effectiveness and safety (in relation to pregnancy, childbirth, breastfeeding, somatic health, psychomotor development and children's abilities). Scaling of the Sonatal-pedagogy, in particular the system of prenatal education, will contribute to the sanitation of the Russian gene pool, demography improvement and formation of responsible parenthood.

Functional gastrointestinal disorders, which had an impact on the dentofacial system (pain, loose teeth and falling out of them) in patients who have had COVID-19, drew the close attention of specialists of different profiles. The pathogenesis of worsening post-COVID edentulism is insufficiently studied, as many issues of adequate therapy remain unsolved, in which the role of non-drug technologies in the treatment of dental patients who have suffered from COVID-19 is extremely high.

Objective: To describe the mechanism of action and clinical effectiveness of the developed combined physiotherapy method, including the induced technique of piracetam iontophoresis on the frontooccipital technic and acupuncture laser therapy in dental patients with complaints of edentulism progression after COVID-19 on the basis of the analysis of single studies on the post-COVID loss of teeth treatment.

Material and methods: A number of patients equal 120 who complained of tooth loss after COVID-19 during the past 6 months were examined. The following initial and end points were considered: dental bleeding and inflammation scores, vascular and endothelial dysfunction markers - levels of intercellular adhesion molecules and their receptors (SlCAM-1, SVCAM-1, VEGF-A, ET-1) before and after treatment.

Results: Negative correlation between VEGF-A (pg/ml) concentration in peripheral blood serum and sVCAM-1 (ng/ml) level in the examined patients (r=0.4830, p<0.05) and strong inverse correlation between slCAM-1 (ng/ml) level and sVCAM-1 (r=0.7696, p<0.01) have been established. More significant effects after application of the combined induced method on the head's structures and laser acupuncture have been noted than after acupuncture laser exposure and after inducing technique separately, namely in the form of dental inflammation score correction by 1.76 times (p<0.001), decrease of bleeding score by 2.6 (p<0.05), decrease of concentration of SVCAM-1 by 1.7 times and SlCAM-1 by 2 times (p<0.001), increase of endothelin level by 1.7 times as well as the initial low VEGF-A (pg/ml) by 1.5 times (p<0.01).

Conclusion: The developed physiotherapeutic complex, which includes laser acupuncture physiotherapy and induced technique of 5% piracetam iontophoresis, can potentially be considered as a physioprophylactic and therapeutic model of post-COVID edentulism.

Objective: To develop and try out a convenient and accessible for use technology for testing the pulmonary function in children and adults, including in patients with chronic bronchopulmonary pathology.

Material and methods: The article presents the results of Lazarev sound-breathing test (LST) in different cohorts of children and adults, including pregnant women and children suffering from chronic bronchopulmonary diseases, in particular cystic fibrosis.

Results: A direct dependence of the LST indicators' level from the age of children and adolescents has been obtained. An orientational table of age-related changes in the LST indicators in children aged 3-7 years was developed. It has been proven that LST can be used to register the improvement of pulmonary ventilation function in children as a result of specially organized health activities (respiratory gymnastics with elements of respiratory music therapy, etc.). The increase of LST has been obtained with regular exercises on «Sonatal» method (in some cases, the test was increased from 100 to 200%). A direct correlation of LST with hardware diagnostic methods (spirography, peakflowmetry) has been established. The closest links have been established between the LST indicator and vital capacity (VC), peak expiratory flow (PEF), maximum expiratory flow (MEF) at 50% of exhalation (MEF₅₀). In children with low LST values, the correlation coefficient of this indicator with PEF amounted to 0.90, with MEF₅₀ -0.86, with MEF₇₅ - 0.76. The correlation of LST with VC and forced VC was r=0.52 and r=0.45, respectively. Children suffering from cystic fibrosis have shown a decrease of indicators with regard to the indicators of healthy children of the same age. The mean LST values for students aged 17-25 years roughly corresponded to 16-year-old adolescents, indicating that the test values stabilize with the end of body's growth (16-18 years).

Conclusion: It has been shown that LST is an accessible and reliable marker for assessing the state of pulmonary ventilation function in healthy and sick children (pre-school and school age) and some cohorts of adults (students, pregnant women), including in health-resort treatment settings.

Objective: Assessment of the quality of life of patients after dental surgeries using kinesiotaping and infrared laser therapy.

Material and methods: The study included 63 patients with symmetrical, equal in volume planned surgical interventions in the oral cavity, who were divided into 3 groups depending on the rehabilitation method: in group 1, patients underwent a course of low-intensity laser therapy, in group 2 - a course of kinesiotaping, and in group 3 - a complex use of low-intensity laser therapy and kinesiotaping. The quality of life of patients after oral surgery was assessed using the OHIP-14 questionnaire before and after rehabilitation measures.

Results: The average preoperative scores in all groups were equal and amounted to 14 points according to OHIP-14 (high quality of life indicator). In group 1, when using a course of laser therapy, the OHIP-14 indicators were: on the 1st day after surgery 20.2±1.48 points, on the 3rd day 18.8±1.75 points, on the 7th day 16.4±0.99 points; in group 2 - 19.96±1.31, 18.6±1.53, 16.3±1.01 points, respectively; in group 3 - 19.42±0.94, 18.1±1.47, 15.9±0.73 points, respectively. On the 14th day, the indicators in all groups were equal to the preoperative ones.

Conclusion: The complex use of laser therapy and kinesiotaping most significantly improves the quality of life of patients after oral surgery.

Sanogenetic effects of physical factors that have an activating effect on the adaptation-compensatory mechanisms of the body are known. On the other hand, their comparative effect on the pathogenetic links of the disease has been proven. It is advisable to use them in comorbid pathology of the digestive system to increase the effectiveness of rehabilitation measures.

Objective: To study the effectiveness of the developed complex of exercise therapy (ET) in outpatient medical rehabilitation programmes for patients with colorectal cancer (CRC) in combination with chronic pancreatitis (CP).

Material and methods: There have been observed 84 patients with CRC after surgical treatment in combination with CP. The patients were divided into 2 groups by simple randomization: the comparison group (CG; 40 people) underwent a diet therapy, standard exercise therapy, psychocorrection, pharmacotherapy (Pinaveria bromide), and internal intake of mineral waters of low mineralization; in the main group (MG; 44 people) the patients had rehabilitation therapy according to the original method (RU 143601 from 20.05.2024). The effectiveness of the outpatient rehabilitation was assessed by indicators of the quality of life (Gastroenterological Quality of Life Questionnaire GSRS and European Quality of Life Questionnaire EQ-5D), bioelectrical activity of rectus abdominis muscles.

Results: After implementing the rehabilitation course, it was stated on repeated electromyography that the total amplitude of bioelectrical activity of the rectus abdominis muscle with the patients of the MG has improved relative to the initial value by 1.9 (p<0.01) with between-group differences (p<0.05). A positive dynamics of GSRS quality of life indicators showed that a more significant (p<0.05) decrease in the intensity of clinical manifestations was observed in the MG. According to the EQ-5D questionnaire, the quality of life indicators according to the scales «Mobility», «Pain and discomfort» and «Anxiety and depression» also improved more significantly in the MG with between-group differences (p<0.05).

Conclusion: The inclusion of the original exercise therapy technique in the outpatient medical rehabilitation programmes for CRC after surgical treatment in combination with CP helps to restore the impaired functions of the digestive organs and improve their quality of life.

The article presents the main stages of formation and development of the Department of Physical and Rehabilitation Medicine of the I.I. Mechnikov NWSMU of the Ministry of Health of Russia, describes in detail the contribution department staff in a specific historical period, the formation and development of scientific medical schools, among the research areas of which were physical methods of treatment. The important role of the staff of the department during the Great Patriotic War and their significant contribution not only to the treatment of the wounded and sick in besieged Leningrad, but also in the training of highly qualified medical personnel for military hospitals and hospitals are shown. The post-war period of the department's development is described in detail, as well as the important role of its staff in the study of patterns and trends in the development of restorative medicine and medical rehabilitation, the formation of a new organization of specialized medical care, in which, based on the most significant achievements of fundamental sciences, the interrelation of therapeutic and rehabilitation processes was reflected, which served as the basis for their unification into a new section of medical science - physical and rehabilitation medicine.