Pub Date : 2023-12-25DOI: 10.38025/2078-1962-2023-22-4-41-49
N. G. Kulikova, A. D. Fesyun, T. Konchugova, D. Kulchitskaya, O. V. Yurova, Alexey Е. Kudryavtsev
INTRODUCTION. The development of peripheral polyneuropathy in cancer patients after chemotherapy has a high prevalence and represents an important medical and social problem. Currently, a number of physiotherapeutic methods are used to treat peripheral polyneuropathy induced by chemotherapy (PPIC). AIM. To study clinical efficacy of high-intensity pulsed magnetic therapy in patients with PPIC according to indicative quality of life indicators. MATERIALS AND METHODS. 90 patients with PPIC were included in the study. The mean age of the patients was 57.3 ± 5.3 years. Two groups were formed by randomization method: control group patients (n = 45) received standard drug therapy; main group patients (n = 45) received 10 high-intensity pulsed magnetic therapy (HIPMT) procedures every other day against the background of standard therapy. We analyzed clinical complaints, pain syndrome according to VAS, EORTC QLQ-CIPN20 scale scores, and quality of life indicators according to SF-36 questionnaire in patients with PPIC on day 20 after the start of clinical intervention. RESULTS. After the conducted course of high-intensity pulsed magnetic therapy there was a significant increase in the cohort of patients with a lower degree of severity of PPIC, the proportion of patients with PPIC belonging to subgroups 0–1 degree of severity increased by 6.6 % (p 0.01). Initial limb pain syndrome according to the VAS system in patients with PPIC in the main group decreased from 6.8 ± 1.2 to 2.4 ± 0.8 points (p 0.05). In the control group VAS changed from 7.0 ± 1.1 to 6.3 ± 0.9 scores (p 0.05), which was not statistically significant. It was found that inclusion of high-intensity pulsed magnetic therapy in the treatment program allows for more significant positive changes in sensory, motor and autonomous-vegetative manifestations of PPIC. According to the SF-36 scale, statistically significant differences were found in relation to physical functioning in patients of the main group. There was also an improvement in the indicators reflecting the social components of the quality of life in patients who received the course effect of (HIPMT) from 61 [58.6; 64.4] points to 66 [59.7; 70.0] points by 8.2 % (p 0.05). Psychological health in the main group improved by 17.02 % (p 0.01). In the control group, there were no significant shifts on any of the scales (p 0.05). CONCLUSION. The use of the high-intensity pulsed magnetic therapy procedures proved to be highly effective in correcting the main indicators of the quality of life of patients with PPIС.
{"title":"Quality of Life Estimate of Patients with Chemotherapy-Induced Distal Polyneuropathy after High-Intensity Pulsed Magnetic Therapy: a Randomized Clinical Study","authors":"N. G. Kulikova, A. D. Fesyun, T. Konchugova, D. Kulchitskaya, O. V. Yurova, Alexey Е. Kudryavtsev","doi":"10.38025/2078-1962-2023-22-4-41-49","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-4-41-49","url":null,"abstract":"INTRODUCTION. The development of peripheral polyneuropathy in cancer patients after chemotherapy has a high prevalence and represents an important medical and social problem. Currently, a number of physiotherapeutic methods are used to treat peripheral polyneuropathy induced by chemotherapy (PPIC). AIM. To study clinical efficacy of high-intensity pulsed magnetic therapy in patients with PPIC according to indicative quality of life indicators. MATERIALS AND METHODS. 90 patients with PPIC were included in the study. The mean age of the patients was 57.3 ± 5.3 years. Two groups were formed by randomization method: control group patients (n = 45) received standard drug therapy; main group patients (n = 45) received 10 high-intensity pulsed magnetic therapy (HIPMT) procedures every other day against the background of standard therapy. We analyzed clinical complaints, pain syndrome according to VAS, EORTC QLQ-CIPN20 scale scores, and quality of life indicators according to SF-36 questionnaire in patients with PPIC on day 20 after the start of clinical intervention. RESULTS. After the conducted course of high-intensity pulsed magnetic therapy there was a significant increase in the cohort of patients with a lower degree of severity of PPIC, the proportion of patients with PPIC belonging to subgroups 0–1 degree of severity increased by 6.6 % (p 0.01). Initial limb pain syndrome according to the VAS system in patients with PPIC in the main group decreased from 6.8 ± 1.2 to 2.4 ± 0.8 points (p 0.05). In the control group VAS changed from 7.0 ± 1.1 to 6.3 ± 0.9 scores (p 0.05), which was not statistically significant. It was found that inclusion of high-intensity pulsed magnetic therapy in the treatment program allows for more significant positive changes in sensory, motor and autonomous-vegetative manifestations of PPIC. According to the SF-36 scale, statistically significant differences were found in relation to physical functioning in patients of the main group. There was also an improvement in the indicators reflecting the social components of the quality of life in patients who received the course effect of (HIPMT) from 61 [58.6; 64.4] points to 66 [59.7; 70.0] points by 8.2 % (p 0.05). Psychological health in the main group improved by 17.02 % (p 0.01). In the control group, there were no significant shifts on any of the scales (p 0.05). CONCLUSION. The use of the high-intensity pulsed magnetic therapy procedures proved to be highly effective in correcting the main indicators of the quality of life of patients with PPIС.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"18 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158148","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}
Pub Date : 2023-12-25DOI: 10.38025/2078-1962-2023-22-4-96-104
O. Odarushchenko, Marianna A. Ansokova, L. A. Marchenkova, O. V. Yurova, A. D. Fesyun
INTRODUCTION. The COVID-19 pandemic has created threats and risks not only for the physical but for the mental health of people as well. To date, there is insufficient scientific data on anxiety, depression in patients who have undergone COVID-19, and the clinical effectiveness of comprehensive medical rehabilitation programs in patients with post-COVID disorders. AIM. Tostudy the clinical effectiveness of the use of audiovisual stimulation and cognitive behavioral psychotherapy in the complex rehabilitation of patients with post-COVID syndrome. MATERIALS AND METHODS. The study included 59 patients with the long COVID disorders from 1 to 6 months after the disease, of which 41 (69.5 %) women and 18 (30.5 %) men aged between 31 and 81, with the mean age being 59.73 ± 1.59 years. All the patients were randomized into two groups. Group I (main) included 29 patients, 9 men, 20 women, the mean age 60.72 ± 2.04 years, who underwent medical rehabilitation using audiovisual stimulation and cognitive behavioral psychotherapy techniques. The II (control group) included 30 patients, including 9 men, 21 women; the mean age was 58.63 ± 2.44 years, who underwentrehabilitation consisting of a standard set of measures. To objectify emotional disturbances, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program for assessing subjective comfort, situational and personal anxiety were used. Statistical data processing was carried out using the program “Statistica-10“. The degree of differences in quantitative indicators in the groups was assessed by the Wilconson test, the significance of differences between the groups after the treatment was made by the Mann-Whitney test (p). The assessment of qualitative indicators was carried out by analyzing multifield tables using the Pearson chi-square test. RESULTS. The use of audiovisual stimulation and cognitive behavioral psychotherapy in the complex rehabilitation of patients with long COVID disorder syndrome contributed to the regression of emotional disorders, as evidenced by statistically significant changes in indicators on the HADS, Spielberger-Khanin, State Scale (p 0.05). No signs of anxiety and depression were observed after the treatment in 27 (93.1 %) patients. Average (reference) levels of situational and personal anxiety were observed in 28 (96.6 %) and 21 (72.4%) patients, respectively. The subjective comfort index reached a high level in 19 (65.5 %) (p 0.0001) patients. DISCUSSION. The study showed that patients who had suffered COVID-19 and had long COVID disorders before the treatment were under the influence of a high-intensity stressful situation, experienced high-level anxiety and experienced severe psycho-emotional stress. The use of audiovisual stimulation and cognitive behavioral psychotherapy helped to increase the number of patients without anxiety and depressive symptoms (p 0.05), reduce the high level of situational and personal anxiety on the Spielberger-Khanin sca
{"title":"Audiovisual Stimulation and Cognitive Behavioral Psychotherapy Complex Application in the Rehabilitation of Patients with Long COVID: a Prospective Randomized Study","authors":"O. Odarushchenko, Marianna A. Ansokova, L. A. Marchenkova, O. V. Yurova, A. D. Fesyun","doi":"10.38025/2078-1962-2023-22-4-96-104","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-4-96-104","url":null,"abstract":"INTRODUCTION. The COVID-19 pandemic has created threats and risks not only for the physical but for the mental health of people as well. To date, there is insufficient scientific data on anxiety, depression in patients who have undergone COVID-19, and the clinical effectiveness of comprehensive medical rehabilitation programs in patients with post-COVID disorders. AIM. Tostudy the clinical effectiveness of the use of audiovisual stimulation and cognitive behavioral psychotherapy in the complex rehabilitation of patients with post-COVID syndrome. MATERIALS AND METHODS. The study included 59 patients with the long COVID disorders from 1 to 6 months after the disease, of which 41 (69.5 %) women and 18 (30.5 %) men aged between 31 and 81, with the mean age being 59.73 ± 1.59 years. All the patients were randomized into two groups. Group I (main) included 29 patients, 9 men, 20 women, the mean age 60.72 ± 2.04 years, who underwent medical rehabilitation using audiovisual stimulation and cognitive behavioral psychotherapy techniques. The II (control group) included 30 patients, including 9 men, 21 women; the mean age was 58.63 ± 2.44 years, who underwentrehabilitation consisting of a standard set of measures. To objectify emotional disturbances, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program for assessing subjective comfort, situational and personal anxiety were used. Statistical data processing was carried out using the program “Statistica-10“. The degree of differences in quantitative indicators in the groups was assessed by the Wilconson test, the significance of differences between the groups after the treatment was made by the Mann-Whitney test (p). The assessment of qualitative indicators was carried out by analyzing multifield tables using the Pearson chi-square test. RESULTS. The use of audiovisual stimulation and cognitive behavioral psychotherapy in the complex rehabilitation of patients with long COVID disorder syndrome contributed to the regression of emotional disorders, as evidenced by statistically significant changes in indicators on the HADS, Spielberger-Khanin, State Scale (p 0.05). No signs of anxiety and depression were observed after the treatment in 27 (93.1 %) patients. Average (reference) levels of situational and personal anxiety were observed in 28 (96.6 %) and 21 (72.4%) patients, respectively. The subjective comfort index reached a high level in 19 (65.5 %) (p 0.0001) patients. DISCUSSION. The study showed that patients who had suffered COVID-19 and had long COVID disorders before the treatment were under the influence of a high-intensity stressful situation, experienced high-level anxiety and experienced severe psycho-emotional stress. The use of audiovisual stimulation and cognitive behavioral psychotherapy helped to increase the number of patients without anxiety and depressive symptoms (p 0.05), reduce the high level of situational and personal anxiety on the Spielberger-Khanin sca","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159571","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}
Pub Date : 2023-12-25DOI: 10.38025/2078-1962-2023-22-4-14-22
Sergey S. Ananyev, Denis A. Pavlov, R. Yakupov, V. Golodnova, Mikhail V. Balykin
INTRODUCTION. The impairment of motor system function due to stroke often leads to patients’ dependence on external assistance. The technique of rhythmic transcranial magnetic stimulation (rTMS) is now widely used in the restoration of impaired central nervous system (CNS) function. In recent years, there has been information about the use of transcutaneous electrical spinal cord stimulation (TSCS) in the correction of motor functions in CNS disorders of various genesis. AIM. To evaluate the possibilities of combined use of transcranial magnetic and transcutaneous electrical stimulation of the spinal cord in the correction of locomotor functions in patients after ischemic stroke. MATERIALS AND METHODS. The conducted blind clinical randomized study involved patients who had an ischemic stroke. Study participants were randomly divided into control (n = 12) and experimental (n = 9) groups. Patients in the control group received standardized neurorehabilitation techniques. The participants of the experimental group were offered standardized neurorehabilitation techniques combined with rTMS and TSCS. High-frequency rTMS was performed in the projection of the sensory-motor cortex on the side of the lesion, in the area of innervation of the lower limb. During TSCS, a stimulating electrode was placed between Th11–Th12, indifferent electrodes were placed in the region of the iliac crests, and the lumbar enlargement of the spinal cord was stimulated. The dynamics of neurological deficit was assessed using the rehabilitation routing scale, the Rivermead mobility index, the Berg balance scale, and a six-point scale for assessing muscle strength. The excitability of the neural networks of the spinal cord was determined using TSCS at the T11–T12 level, with electromyographic recording of the evoked motor responses of the muscles of the lower extremities. RESULTS AND DISCUSSION. The combined use of rTMS and TSCS in the rehabilitation of patients in the acute period after ischemic stroke leads to an increase in the excitability of neuronal networks of the lumbar thickening of the spinal cord, a decrease in the activation thresholds of the RF, BF, TA and GM muscles of the affected limb (by 7.7 ma, 18.3 ma, 24.8 ma and 14.2 ma, respectively). Inclusion of rTMS and TSCS in the rehabilitation course leads to a significant improvement in the rehabilitation routing scale (by 2 points), Rivermead mobility index (by 5.8 points), statokinetic control functions (balance-Berg by 12 points) and an increase in lower limb muscle strength (flexors by 5.1 points, extensors by 6.2 points). CONCLUSION. The use of rTMS and TSCS can be used as an additional effect within the framework of rehabilitation measures in the acute period after ischemic stroke.
{"title":"Transcranial Magnetic and Transcutaneous Spinal Cord Electrical Stimulation a Stroke-Patients Walking Correction: Blinded Clinical Randomised Study","authors":"Sergey S. Ananyev, Denis A. Pavlov, R. Yakupov, V. Golodnova, Mikhail V. Balykin","doi":"10.38025/2078-1962-2023-22-4-14-22","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-4-14-22","url":null,"abstract":"INTRODUCTION. The impairment of motor system function due to stroke often leads to patients’ dependence on external assistance. The technique of rhythmic transcranial magnetic stimulation (rTMS) is now widely used in the restoration of impaired central nervous system (CNS) function. In recent years, there has been information about the use of transcutaneous electrical spinal cord stimulation (TSCS) in the correction of motor functions in CNS disorders of various genesis. AIM. To evaluate the possibilities of combined use of transcranial magnetic and transcutaneous electrical stimulation of the spinal cord in the correction of locomotor functions in patients after ischemic stroke. MATERIALS AND METHODS. The conducted blind clinical randomized study involved patients who had an ischemic stroke. Study participants were randomly divided into control (n = 12) and experimental (n = 9) groups. Patients in the control group received standardized neurorehabilitation techniques. The participants of the experimental group were offered standardized neurorehabilitation techniques combined with rTMS and TSCS. High-frequency rTMS was performed in the projection of the sensory-motor cortex on the side of the lesion, in the area of innervation of the lower limb. During TSCS, a stimulating electrode was placed between Th11–Th12, indifferent electrodes were placed in the region of the iliac crests, and the lumbar enlargement of the spinal cord was stimulated. The dynamics of neurological deficit was assessed using the rehabilitation routing scale, the Rivermead mobility index, the Berg balance scale, and a six-point scale for assessing muscle strength. The excitability of the neural networks of the spinal cord was determined using TSCS at the T11–T12 level, with electromyographic recording of the evoked motor responses of the muscles of the lower extremities. RESULTS AND DISCUSSION. The combined use of rTMS and TSCS in the rehabilitation of patients in the acute period after ischemic stroke leads to an increase in the excitability of neuronal networks of the lumbar thickening of the spinal cord, a decrease in the activation thresholds of the RF, BF, TA and GM muscles of the affected limb (by 7.7 ma, 18.3 ma, 24.8 ma and 14.2 ma, respectively). Inclusion of rTMS and TSCS in the rehabilitation course leads to a significant improvement in the rehabilitation routing scale (by 2 points), Rivermead mobility index (by 5.8 points), statokinetic control functions (balance-Berg by 12 points) and an increase in lower limb muscle strength (flexors by 5.1 points, extensors by 6.2 points). CONCLUSION. The use of rTMS and TSCS can be used as an additional effect within the framework of rehabilitation measures in the acute period after ischemic stroke.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159557","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}
Pub Date : 2023-12-25DOI: 10.38025/2078-1962-2023-22-4-159-166
Andrej S. Terehov, M. Yakovlev
INTRODUCTION. Stress is one of the risk factors for chronic non-communicable diseases, such as cardiovascular diseases, autoimmune disorders, mental disorders, and neurotic conditions like depression and anxiety. Therefore, it is important to predict and correct stress-related problems early. AIM. To assess the impact of stress on the human body, a comprehensive review of both Russian and international sources was conducted across databases like PubMed, eLibrary, and CyberLeninka for the period 2011–2023. The search terms used included “stress effect”, “predictive model”, “mathematical modeling”, “stress”, “mathematical model”, and “stress-related diseases”. CONCLUSION. The literature review has revealed that chronic stress exerts a significant negative impact on the human body, verifiably leading to disorders of the digestive, nervous, endocrine, cardiovascular, and immune systems. At the current stage, stress diagnosis is conducted using both questionnaire methods and instrumental techniques, each having its respective advantages and limitations. Several scientific studies emphasize the importance of mathematical modeling as a tool for simulating the effects of stress on the body and analyzing the key mechanisms predisposing to the development of pathologies. The algorithms for constructing predictive models presented in this publication may serve as a foundation for the development of an automated expert advisory system.
{"title":"Mathematical Modeling of the Risks of Stress-Related Diseases: a Review","authors":"Andrej S. Terehov, M. Yakovlev","doi":"10.38025/2078-1962-2023-22-4-159-166","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-4-159-166","url":null,"abstract":"INTRODUCTION. Stress is one of the risk factors for chronic non-communicable diseases, such as cardiovascular diseases, autoimmune disorders, mental disorders, and neurotic conditions like depression and anxiety. Therefore, it is important to predict and correct stress-related problems early. AIM. To assess the impact of stress on the human body, a comprehensive review of both Russian and international sources was conducted across databases like PubMed, eLibrary, and CyberLeninka for the period 2011–2023. The search terms used included “stress effect”, “predictive model”, “mathematical modeling”, “stress”, “mathematical model”, and “stress-related diseases”. CONCLUSION. The literature review has revealed that chronic stress exerts a significant negative impact on the human body, verifiably leading to disorders of the digestive, nervous, endocrine, cardiovascular, and immune systems. At the current stage, stress diagnosis is conducted using both questionnaire methods and instrumental techniques, each having its respective advantages and limitations. Several scientific studies emphasize the importance of mathematical modeling as a tool for simulating the effects of stress on the body and analyzing the key mechanisms predisposing to the development of pathologies. The algorithms for constructing predictive models presented in this publication may serve as a foundation for the development of an automated expert advisory system.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159735","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}
Pub Date : 2023-12-25DOI: 10.38025/2078-1962-2023-22-4-50-59
I. Borodulina, G. Kovalev, I. Labetov, O. Volkova, D. Shkarupa
INTRODUCTION. Overactive bladder (OAB) is a symptom complex that includes urgency, frequent urination, imperative urinary incontinence and nocturia. The idiopathic form of OAB is associated with dysfunction of sensory signal transmission at the level of the peripheral and central nervous system, which leads to bladder hypersensitivity. The low level of patients’ compliance to OAB drug therapy and the high level of refusal to take drugs emphasize the urgency of finding new effective methods of influencing the lower urinary tract. Magnetic stimulation (MS) is a non-drug treatment for lower urinary tract dysfunction. AIM. To study the efficacy and safety of the sacral MS method in women with idiopathic detrusor overactivity (DO) and OAB symptoms. MATERIALS AND METHODS. A single blind prospective randomized comparative study included 55 female patients with urodynamically confirmed idiopathic DO. The patients were divided by simple randomization into the main group (n = 29), which received MS 3 times a week for 5 weeks with a frequency of 5 Hz per sacral root area (S2–S4), and the placebo group (n = 26), in which sham stimulation was performed. RESULTS AND DISCUSSION. The study revealed that sacral MS is reliably effective against the clinical symptoms of OAB in idiopathic DO. The dynamics of clinical symptoms is confirmed by changes in urodynamic parameters. The effect of sacral MS significantly exceeds placebo. MS is a safe procedure and is well tolerated by patients. CONCLUSION. The sacral MS method, the effectiveness of which has been proven in comparison with placebo, is recommended to be included in the treatment regimen of patients with idiopathic OAB. The mechanism of action of sacral MS is associated with the activation of sympathetic and inhibition of parasympathetic influences, as well as changes in supraspinal control and cerebral activity.
简介。膀胱过度活动症（OAB）是一种症状复杂的疾病，包括尿急、尿频、急迫性尿失禁和夜尿症。特发性膀胱过度活动症与外周和中枢神经系统的感觉信号传递功能障碍有关，从而导致膀胱过度敏感。患者对 OAB 药物治疗的依从性较低，拒服药物的比例较高，因此迫切需要找到新的有效方法来影响下尿路。磁刺激（MS）是治疗下尿路功能障碍的一种非药物疗法。 目的研究骶磁刺激法对特发性逼尿肌过度活动（DO）和 OAB 症状女性的有效性和安全性。 材料和方法：这是一项单盲前瞻性随机对比研究，共纳入 55 名经尿动力学证实的特发性排尿过动症女性患者。患者被简单随机分为主要组（n = 29）和安慰剂组（n = 26），主要组接受 MS 治疗，每周 3 次，持续 5 周，每个骶根区域（S2-S4）的频率为 5 赫兹；安慰剂组接受假刺激。 结果与讨论研究显示，骶管 MS 对特发性 DO 的 OAB 临床症状具有可靠的疗效。尿动力学参数的变化证实了临床症状的动态变化。骶管 MS 的效果明显优于安慰剂。MS 是一种安全的治疗方法，患者的耐受性良好。 结论。与安慰剂相比，骶管MS法的有效性已得到证实，建议将其纳入特发性尿崩症患者的治疗方案中。骶管 MS 的作用机制与交感神经的激活和副交感神经的抑制以及脊髓上控制和大脑活动的变化有关。
{"title":"Peripheral Sacral Magnetic Stimulation in Patients with Idiopathic Overactive Bladder: a Single Blind Prospective Randomized Comparative Clinical Study","authors":"I. Borodulina, G. Kovalev, I. Labetov, O. Volkova, D. Shkarupa","doi":"10.38025/2078-1962-2023-22-4-50-59","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-4-50-59","url":null,"abstract":"INTRODUCTION. Overactive bladder (OAB) is a symptom complex that includes urgency, frequent urination, imperative urinary incontinence and nocturia. The idiopathic form of OAB is associated with dysfunction of sensory signal transmission at the level of the peripheral and central nervous system, which leads to bladder hypersensitivity. The low level of patients’ compliance to OAB drug therapy and the high level of refusal to take drugs emphasize the urgency of finding new effective methods of influencing the lower urinary tract. Magnetic stimulation (MS) is a non-drug treatment for lower urinary tract dysfunction. AIM. To study the efficacy and safety of the sacral MS method in women with idiopathic detrusor overactivity (DO) and OAB symptoms. MATERIALS AND METHODS. A single blind prospective randomized comparative study included 55 female patients with urodynamically confirmed idiopathic DO. The patients were divided by simple randomization into the main group (n = 29), which received MS 3 times a week for 5 weeks with a frequency of 5 Hz per sacral root area (S2–S4), and the placebo group (n = 26), in which sham stimulation was performed. RESULTS AND DISCUSSION. The study revealed that sacral MS is reliably effective against the clinical symptoms of OAB in idiopathic DO. The dynamics of clinical symptoms is confirmed by changes in urodynamic parameters. The effect of sacral MS significantly exceeds placebo. MS is a safe procedure and is well tolerated by patients. CONCLUSION. The sacral MS method, the effectiveness of which has been proven in comparison with placebo, is recommended to be included in the treatment regimen of patients with idiopathic OAB. The mechanism of action of sacral MS is associated with the activation of sympathetic and inhibition of parasympathetic influences, as well as changes in supraspinal control and cerebral activity.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158762","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}
Pub Date : 2023-11-28DOI: 10.38025/2078-1962-2023-22-3-75-81
G. V. Odintsova, Nina O. Den'gina, A. Koloteva
INTRODUCTION. For a long time, persons with epilepsy have been told to stay away from physical activity and sports to prevent seizure triggers. However, in recent years, evidence has accumulated to the contrary, suggesting that sports may help with preventing seizures. AIM. To examine the level of physical activity and sports among patients of the Russian Epileptology Center. MATERIALS AND METHODS. We conducted a study on physical activity in patients with childhood epilSepsy and in patients currently suffering from epilepsy in 2018–2019 at Polenov Neurosurgical Institute. They answered 3 blocks of questions: first block — physical activity and sporting activity during the school years, second block — current assessment of motor activity, third block — effect of physical activity on the course of the disease (triggering/reduction of seizure frequency. RESULTS. Fifty patients with a verified diagnosis of epilepsy were enrolled in the study. According to study findings, 30 % of patients with childhood-onset epilepsy were not allowed to participate in physical activity when they were in school, and the majority of them were forced to give up their sports after developing epilepsy. It was also found that when the seizures were controlled, the children tried to match their peers in terms of physical activity and participated in classes despite being exempted from physical education and some continued to play sports. The results showed that in 70 % of the cases physical activity did not have negative effect on the course of the disease and in 26 % of the cases the patients reported a positive effect of regular physical activity on the course of the disease. CONCLUSION. Therefore, patients continued to exercise despite severe limitations in the compensated course of the disease, as physical activity with the right type and level of sport has a positive effect on the somatic and psychological state of patients with epilepsy and physical activity is chosen.
{"title":"Physical Activity and Exercise in Patients with Epilepsy: a Single-Centre Uncontrolled Retrospective Cohort Study","authors":"G. V. Odintsova, Nina O. Den'gina, A. Koloteva","doi":"10.38025/2078-1962-2023-22-3-75-81","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-3-75-81","url":null,"abstract":"INTRODUCTION. For a long time, persons with epilepsy have been told to stay away from physical activity and sports to prevent seizure triggers. However, in recent years, evidence has accumulated to the contrary, suggesting that sports may help with preventing seizures. AIM. To examine the level of physical activity and sports among patients of the Russian Epileptology Center. MATERIALS AND METHODS. We conducted a study on physical activity in patients with childhood epilSepsy and in patients currently suffering from epilepsy in 2018–2019 at Polenov Neurosurgical Institute. They answered 3 blocks of questions: first block — physical activity and sporting activity during the school years, second block — current assessment of motor activity, third block — effect of physical activity on the course of the disease (triggering/reduction of seizure frequency. RESULTS. Fifty patients with a verified diagnosis of epilepsy were enrolled in the study. According to study findings, 30 % of patients with childhood-onset epilepsy were not allowed to participate in physical activity when they were in school, and the majority of them were forced to give up their sports after developing epilepsy. It was also found that when the seizures were controlled, the children tried to match their peers in terms of physical activity and participated in classes despite being exempted from physical education and some continued to play sports. The results showed that in 70 % of the cases physical activity did not have negative effect on the course of the disease and in 26 % of the cases the patients reported a positive effect of regular physical activity on the course of the disease. CONCLUSION. Therefore, patients continued to exercise despite severe limitations in the compensated course of the disease, as physical activity with the right type and level of sport has a positive effect on the somatic and psychological state of patients with epilepsy and physical activity is chosen.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"150 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139224621","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}
Pub Date : 2023-11-28DOI: 10.38025/2078-1962-2023-22-3-40-48
T. Konchugova, Tatyana V. Apkhanova, D. Kulchitskaya, A. D. Fesyun, M. Yakovlev, E. M. Styazkina, Olga M. Musaeva, Valentina А. Morunova, O. V. Yurova, Elena A. Rozhkova, Elena S. Berezkina
INTRODUCTION. Previous studies have established the association of venous thrombosis risk factors with inflammation, and the important role of inflammatory mediators as prognostic markers of recanalization of veins after deep vein thrombosis and the progression of postthrombophlebitic syndrome (PTPS). Pro-inflammatory cytokines, as key inflammatory mediators, are part of several cascades of pathophysiology in venous thrombosis, as well as predictors of the occurrence and prolongation of acute thrombosis and its resolution. To date, new oral anticoagulants are used, but their use in medical practice does not lead to a decrease in the number of patients with PTPS. AIM. To study the dynamics of proinflammatory cytokine levels under the influence of a complex non-drug method including intravenous laser irradiation of blood (ILBI) in patients with PTPS. MATERIALS AND METHODS. We conducted a randomized study that included 60 patients aged 58.3 ± 12.56 years with lower extremity PTPS (CVI C4–C5 according to CEAP clinical classification) divided into 2 groups. The subjects of the 1st group (main, n = 30) received: ILBI, pulsed magnetotherapy and dry-air carbon dioxide baths. After a complex of physiotherapy procedures, patients underwent therapeutic gymnastics in the gym according to the Brunner U. method. Subjects of the main group received the above rehabilitation complex against the background of phlebotonics (combination of diosmin and hesperidin) and the use of knitwear of 2–3 compression classes. Patients of the 2nd group (control group, n = 30) received standard elastic compression (2–3 compression class), similar drug therapy with phlebotonics and therapeutic gymnastics in the gym according to the method of Brunner U. RESULTS. After the course of rehabilitation, the patients of the main group showed positive dynamics of the main clinical symptoms of the disease, a decrease in malleolar volume, correction of microcirculatory disorders and activity of proinflammatory cytokines, accompanied by an improvement in transcapillary metabolism and tissue hypoxia. In patients of the control group, only a decrease in the number of leukocytes and fibrinogen in peripheral blood was recorded, while no changes in the expression of proinflammatory cytokines were observed. In this group of subjects, there was a positive trend in the regression of edema in terms of malleolar volume. CONCLUSION. As a result of the application of the proposed rehabilitation complex, which includes, along with the traditionally used physical factors (pulsed magnetotherapy, dry-air carbon dioxide baths and therapeutic gymnastics) ILBI procedures, not only decongestant, hypocoagulating effects, positive dynamics of the main clinical symptoms of the disease were noted, but also correction of microcirculatory disorders and the level of pro-inflammatory cytokines was achieved, accompanied by an improvement in transcapillary metabolism and trophic tissues.
{"title":"Cytokine Activity Indicators Dynamics after Non-Drug Rehabilitation including Intravenous Laser Blood Irradiation in Patients with a Lower Limb Post-Thrombophlebitic Syndrome: a Randomized Study","authors":"T. Konchugova, Tatyana V. Apkhanova, D. Kulchitskaya, A. D. Fesyun, M. Yakovlev, E. M. Styazkina, Olga M. Musaeva, Valentina А. Morunova, O. V. Yurova, Elena A. Rozhkova, Elena S. Berezkina","doi":"10.38025/2078-1962-2023-22-3-40-48","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-3-40-48","url":null,"abstract":"INTRODUCTION. Previous studies have established the association of venous thrombosis risk factors with inflammation, and the important role of inflammatory mediators as prognostic markers of recanalization of veins after deep vein thrombosis and the progression of postthrombophlebitic syndrome (PTPS). Pro-inflammatory cytokines, as key inflammatory mediators, are part of several cascades of pathophysiology in venous thrombosis, as well as predictors of the occurrence and prolongation of acute thrombosis and its resolution. To date, new oral anticoagulants are used, but their use in medical practice does not lead to a decrease in the number of patients with PTPS. AIM. To study the dynamics of proinflammatory cytokine levels under the influence of a complex non-drug method including intravenous laser irradiation of blood (ILBI) in patients with PTPS. MATERIALS AND METHODS. We conducted a randomized study that included 60 patients aged 58.3 ± 12.56 years with lower extremity PTPS (CVI C4–C5 according to CEAP clinical classification) divided into 2 groups. The subjects of the 1st group (main, n = 30) received: ILBI, pulsed magnetotherapy and dry-air carbon dioxide baths. After a complex of physiotherapy procedures, patients underwent therapeutic gymnastics in the gym according to the Brunner U. method. Subjects of the main group received the above rehabilitation complex against the background of phlebotonics (combination of diosmin and hesperidin) and the use of knitwear of 2–3 compression classes. Patients of the 2nd group (control group, n = 30) received standard elastic compression (2–3 compression class), similar drug therapy with phlebotonics and therapeutic gymnastics in the gym according to the method of Brunner U. RESULTS. After the course of rehabilitation, the patients of the main group showed positive dynamics of the main clinical symptoms of the disease, a decrease in malleolar volume, correction of microcirculatory disorders and activity of proinflammatory cytokines, accompanied by an improvement in transcapillary metabolism and tissue hypoxia. In patients of the control group, only a decrease in the number of leukocytes and fibrinogen in peripheral blood was recorded, while no changes in the expression of proinflammatory cytokines were observed. In this group of subjects, there was a positive trend in the regression of edema in terms of malleolar volume. CONCLUSION. As a result of the application of the proposed rehabilitation complex, which includes, along with the traditionally used physical factors (pulsed magnetotherapy, dry-air carbon dioxide baths and therapeutic gymnastics) ILBI procedures, not only decongestant, hypocoagulating effects, positive dynamics of the main clinical symptoms of the disease were noted, but also correction of microcirculatory disorders and the level of pro-inflammatory cytokines was achieved, accompanied by an improvement in transcapillary metabolism and trophic tissues.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226884","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}
Pub Date : 2023-11-28DOI: 10.38025/2078-1962-2023-22-3-49-58
I. P. Yastrebtseva, E.A. Biryukov, Victoria V. Belova, L. Deryabkina
AIM. To evaluate the effectiveness of using a rehabilitation glove in patients with central paresis of the arm and motor aphasia due to ischemic stroke, and also to study the rate of motor production in the upper limb in these patients. MATERIALS AND METHODS. We examined 49 patients with hemiparesis and motor aphasia in the early recovery period of ischemic stroke in the left middle cerebral artery. Depending on the fact of conducting training with the use of a rehabilitation glove, patients were randomly distributed into two groups (1, where this training option was implemented, and 2 — without it), comparable in the severity of motor and speech disorders. Within each of them, patients were additionally divided into subgroups, depending on the degree of paresis in the distal part of the affected upper limb: L-mild (in group 1L — 18 people, 2L — 16) and U-moderate (in group 1U — 8, and 2U — 7 patients). On days 1 and 10 of training, all patients underwent functional testing. Treatment and rehabilitation were carried out according to the order of care. Patients of groups 1L and 1U additionally received a course of 10 sessions, including 2 exercises of 15 minutes each for a paretic arm 5 times a week. RESULTS. Patients of groups 1L and 1U demonstrated statistically significant improvements in the Medical Research Committee Scale, the ARAT Arm Motor Activity Test, the Wasserman Speech Impairment Rating Scale, and the Montreal Cognitive Function Rating Scale. According to amplitude indicators, there was a tendency towards their increase in all groups. A decrease in the number of errors and an increase in the percentage of correct task completion accompanied the development of a motor act. They stabilized in patients with mild paresis of the hand by 5–6 sessions and in patients with moderate paresis by 6–7 sessions. CONCLUSION. In patients with mild to moderate paresis of the right hand in combination with motor aphasia in the early recovery period of ischemic stroke, when using a rehabilitation glove, there was an improvement in the strength and motor activity of the paretic hand, cognitive functions and speech. Stabilization of task performance indicators should be taken into account when determining the duration of training and timely correction of the motor rehabilitation program.
{"title":"The Results of Targeted Training in the Rehabilitation of Patients with a Combination of Motor and Speech Disorders","authors":"I. P. Yastrebtseva, E.A. Biryukov, Victoria V. Belova, L. Deryabkina","doi":"10.38025/2078-1962-2023-22-3-49-58","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-3-49-58","url":null,"abstract":"AIM. To evaluate the effectiveness of using a rehabilitation glove in patients with central paresis of the arm and motor aphasia due to ischemic stroke, and also to study the rate of motor production in the upper limb in these patients. MATERIALS AND METHODS. We examined 49 patients with hemiparesis and motor aphasia in the early recovery period of ischemic stroke in the left middle cerebral artery. Depending on the fact of conducting training with the use of a rehabilitation glove, patients were randomly distributed into two groups (1, where this training option was implemented, and 2 — without it), comparable in the severity of motor and speech disorders. Within each of them, patients were additionally divided into subgroups, depending on the degree of paresis in the distal part of the affected upper limb: L-mild (in group 1L — 18 people, 2L — 16) and U-moderate (in group 1U — 8, and 2U — 7 patients). On days 1 and 10 of training, all patients underwent functional testing. Treatment and rehabilitation were carried out according to the order of care. Patients of groups 1L and 1U additionally received a course of 10 sessions, including 2 exercises of 15 minutes each for a paretic arm 5 times a week. RESULTS. Patients of groups 1L and 1U demonstrated statistically significant improvements in the Medical Research Committee Scale, the ARAT Arm Motor Activity Test, the Wasserman Speech Impairment Rating Scale, and the Montreal Cognitive Function Rating Scale. According to amplitude indicators, there was a tendency towards their increase in all groups. A decrease in the number of errors and an increase in the percentage of correct task completion accompanied the development of a motor act. They stabilized in patients with mild paresis of the hand by 5–6 sessions and in patients with moderate paresis by 6–7 sessions. CONCLUSION. In patients with mild to moderate paresis of the right hand in combination with motor aphasia in the early recovery period of ischemic stroke, when using a rehabilitation glove, there was an improvement in the strength and motor activity of the paretic hand, cognitive functions and speech. Stabilization of task performance indicators should be taken into account when determining the duration of training and timely correction of the motor rehabilitation program.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139227276","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}
Pub Date : 2023-11-28DOI: 10.38025/2078-1962-2023-22-3-82-89
D. S. Kan’shina, M. Surma, Yuri N. Orlov, M. Podgurskaya, Daria V. Vasilyeva, S. S. Nikitin
INTRODUCTION. The literature describes numerous cases of mononeuropathy of the hypoglossal nerve, as a complication of various diseases, as well as after operations for symptomatic and asymptomatic stenoses in the carotid system. For a correctly selected treatment method, it is necessary to carry out a differential diagnosis between damage to the hypoglossal nerve and the cortico-lingual tract. Currently, standard diagnosis of hypoglossal nerve lesions using electroneuromyography is difficult due to methodological limitations associated with its anatomical features and variability. AIM. To demonstrate the feasibility of recording motor-wave (M-wave) in response to electrical hypoglossal nerve (HN) stimulation and motor evoked potential (MEP) in response to transcranial magnetic stimulation from the muscles of the tongue using the St. Mark’s electrode. MATERIALS AND METHODS. A prospective study was conducted on 10 healthy volunteers. To register the M-wave during electrical stimulation of HN and MEP during transcranial magnetic stimulation (TMS) from the muscles of the tongue, a St. Mark’s electrode was used. Registration was carried out sequentially from two sides of the tongue. RESULTS. In all subjects, M-wave and MEP were recorded from the muscles of the tongue from 2 sides. The average latency was in line with previously reported data in the literature. The variability of the difference in the amplitudes of the lingual motor responses was more than 50 % between the healthy volunteers. DISCUSSION. The results obtained were compared with earlier publications where normative indicators were approved. The amplitudes of the M-wave during stimulation of the HN at the proximal and distal points did not differ significantly from the literature data; the amplitude of the MEP in our study turned out to be higher, which was explained by the increased tension of the tongue muscles during the study. It was also noted that the M-wave can be recorded only at the proximal or only at the distal points of stimulation. CONCLUSION. Evaluation of conduction along the peripheral segment of the hypoglossal nerve and the cortico-lingual pathway during the abduction of muscle responses using the St. Mark’s electrode is a simple and perceptible approach to assess the functional state of the nervous structures of HN. Method for registering M-wave and MEP with the St. Mark’s electrode is safe, informative and convenient.
导言。文献中描述了大量舌下神经单神经病变的病例，这些病例是各种疾病的并发症，以及颈动脉系统无症状和无症状狭窄手术后的并发症。为了正确选择治疗方法，有必要对舌下神经损伤和皮质舌束损伤进行鉴别诊断。目前，由于舌下神经的解剖特征和可变性所带来的方法学限制，使用电切镜对舌下神经病变进行标准诊断十分困难。 目的证明使用圣马克电极记录舌下神经（HN）电刺激反应的运动波（M波）和经颅磁刺激反应的运动诱发电位（MEP）的可行性。 材料和方法：对 10 名健康志愿者进行了前瞻性研究。为了记录 HN 电刺激时的 M 波和舌头肌肉经颅磁刺激 (TMS) 时的 MEP，使用了圣马克电极。注册从舌头的两侧依次进行。 结果所有受试者的舌头两侧肌肉都记录到了 M 波和 MEP。平均潜伏期与之前文献报道的数据一致。健康志愿者之间舌头运动反应振幅差异的变异性超过 50%。 讨论。所获得的结果与之前发表的已批准标准指标的出版物进行了比较。在刺激 HN 近端和远端时，M 波的振幅与文献数据没有显著差异；我们的研究中 MEP 的振幅更高，这是因为在研究过程中舌头肌肉的张力增加了。我们还注意到，只有在近端或远端刺激点才能记录到 M 波。 结论。使用圣马克电极评估舌下神经外周段和皮质-舌通路在肌肉外展反应时的传导情况，是评估 HN 神经结构功能状态的一种简单而可感知的方法。使用圣马克电极记录 M 波和 MEP 的方法安全、信息量大且方便。
{"title":"Hypoglossal Nerve and Cortico-Lingual Pathway Examination using the St. Mark’s Еlectrode: a Prospective Study","authors":"D. S. Kan’shina, M. Surma, Yuri N. Orlov, M. Podgurskaya, Daria V. Vasilyeva, S. S. Nikitin","doi":"10.38025/2078-1962-2023-22-3-82-89","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-3-82-89","url":null,"abstract":"INTRODUCTION. The literature describes numerous cases of mononeuropathy of the hypoglossal nerve, as a complication of various diseases, as well as after operations for symptomatic and asymptomatic stenoses in the carotid system. For a correctly selected treatment method, it is necessary to carry out a differential diagnosis between damage to the hypoglossal nerve and the cortico-lingual tract. Currently, standard diagnosis of hypoglossal nerve lesions using electroneuromyography is difficult due to methodological limitations associated with its anatomical features and variability. AIM. To demonstrate the feasibility of recording motor-wave (M-wave) in response to electrical hypoglossal nerve (HN) stimulation and motor evoked potential (MEP) in response to transcranial magnetic stimulation from the muscles of the tongue using the St. Mark’s electrode. MATERIALS AND METHODS. A prospective study was conducted on 10 healthy volunteers. To register the M-wave during electrical stimulation of HN and MEP during transcranial magnetic stimulation (TMS) from the muscles of the tongue, a St. Mark’s electrode was used. Registration was carried out sequentially from two sides of the tongue. RESULTS. In all subjects, M-wave and MEP were recorded from the muscles of the tongue from 2 sides. The average latency was in line with previously reported data in the literature. The variability of the difference in the amplitudes of the lingual motor responses was more than 50 % between the healthy volunteers. DISCUSSION. The results obtained were compared with earlier publications where normative indicators were approved. The amplitudes of the M-wave during stimulation of the HN at the proximal and distal points did not differ significantly from the literature data; the amplitude of the MEP in our study turned out to be higher, which was explained by the increased tension of the tongue muscles during the study. It was also noted that the M-wave can be recorded only at the proximal or only at the distal points of stimulation. CONCLUSION. Evaluation of conduction along the peripheral segment of the hypoglossal nerve and the cortico-lingual pathway during the abduction of muscle responses using the St. Mark’s electrode is a simple and perceptible approach to assess the functional state of the nervous structures of HN. Method for registering M-wave and MEP with the St. Mark’s electrode is safe, informative and convenient.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139224361","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}
Pub Date : 2023-11-28DOI: 10.38025/2078-1962-2023-22-3-17-28
G. Makshakov, Anna P. Mazur, M. O. Sadovskikh, Ksenia V. Voinova, Anastasia Yu. Chernenko, I. Kalinin, Evgeniy P. Yevdoshenko
INTRODUCTION. Progressive resistance training (PRT) has been recognized as an effective tool in the rehabilitation of patients with multiple sclerosis (MS), however its comparative efficacy remains has yet to be determined. AIM. In this study, we aimed to evaluate the efficacy and safety of the self-guided in-patient progressive resistance power training (PRT) program for improving gait and balance in patients with MS compared with the standard rehabilitation program. MATERIALS AND METHODS. 60 patients with MS were equally randomized into control group (CG) and the PRT group (PG). Training was performed 5 times/week, for 4 weeks in both groups. The primary endpoint was the percentage of patients with improvement in the 6-minute walking test above a minimal clinically significant difference in both groups. Tests of walking speed and balance (Timed 25-foot walking test (T25FW), Timed up-and-go (TUG) test, walking speed), mean voluntary muscle contraction on dominant and non-dominant legs as well as quality of life tests (cognitive and physical domains) at week 4 were used as secondary endpoints. RESULTS. In PG, 17/27 (63 %) patients reached the primary endpoint compared to 11/23 (48 %) in KG, which did not make a statistically significant difference (p = 0.89). Patients showed significant improvement in the T25FW test and TUG test in PG, but not in CG one. Muscle strength improved in both groups, however patients in PG showed mostly improvement in non-dominant leg and more on knee flexors and feet extensors, while patients in the CG showed improvement in hip flexors on both legs. Quality of life parameters improved in both groups. There were no statistically significant differences between the groups at all the endpoints studied at week 4. DISCUSSION. In both groups, significant increases in distance and walking speed prevented reaching the primary endpoint. PRT has been shown to provide a statistically significant improvement in short-distance walking speed, which may have been due to a positive effect on the rate of force development, increasing walking speed and improving walking balance. The increase in muscle strength occurred in trained muscle groups and had differences between the study groups. This result could be obtained both due to the direct training of certain muscle groups, and due to the phenomenon of contralateral transfer. CONCLUSION. Progressive resistance training may have some beneficial differences compared to non-progressive training that need to be elucidated further.
{"title":"Rehabilitation of Gate and Balance Disorders in Multiple Sclerosis using Progressive Resistance Power Training: a Randomized Controlled Study","authors":"G. Makshakov, Anna P. Mazur, M. O. Sadovskikh, Ksenia V. Voinova, Anastasia Yu. Chernenko, I. Kalinin, Evgeniy P. Yevdoshenko","doi":"10.38025/2078-1962-2023-22-3-17-28","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-3-17-28","url":null,"abstract":"INTRODUCTION. Progressive resistance training (PRT) has been recognized as an effective tool in the rehabilitation of patients with multiple sclerosis (MS), however its comparative efficacy remains has yet to be determined. AIM. In this study, we aimed to evaluate the efficacy and safety of the self-guided in-patient progressive resistance power training (PRT) program for improving gait and balance in patients with MS compared with the standard rehabilitation program. MATERIALS AND METHODS. 60 patients with MS were equally randomized into control group (CG) and the PRT group (PG). Training was performed 5 times/week, for 4 weeks in both groups. The primary endpoint was the percentage of patients with improvement in the 6-minute walking test above a minimal clinically significant difference in both groups. Tests of walking speed and balance (Timed 25-foot walking test (T25FW), Timed up-and-go (TUG) test, walking speed), mean voluntary muscle contraction on dominant and non-dominant legs as well as quality of life tests (cognitive and physical domains) at week 4 were used as secondary endpoints. RESULTS. In PG, 17/27 (63 %) patients reached the primary endpoint compared to 11/23 (48 %) in KG, which did not make a statistically significant difference (p = 0.89). Patients showed significant improvement in the T25FW test and TUG test in PG, but not in CG one. Muscle strength improved in both groups, however patients in PG showed mostly improvement in non-dominant leg and more on knee flexors and feet extensors, while patients in the CG showed improvement in hip flexors on both legs. Quality of life parameters improved in both groups. There were no statistically significant differences between the groups at all the endpoints studied at week 4. DISCUSSION. In both groups, significant increases in distance and walking speed prevented reaching the primary endpoint. PRT has been shown to provide a statistically significant improvement in short-distance walking speed, which may have been due to a positive effect on the rate of force development, increasing walking speed and improving walking balance. The increase in muscle strength occurred in trained muscle groups and had differences between the study groups. This result could be obtained both due to the direct training of certain muscle groups, and due to the phenomenon of contralateral transfer. CONCLUSION. Progressive resistance training may have some beneficial differences compared to non-progressive training that need to be elucidated further.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139224780","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}
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