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Vol 22, No 2 (2023)

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Original studies

Quality of life of the patients with chronic prostatitis under the influence of complex balneopeloid and enzyme therapy with Longidase

Mkrtchyan M.A., Gusova B.A., Emkuzhev K.E., Kaisinova A.S., Bobrik Y.V.

Abstract

BACKGROUND: In modern medicine, among the main indicators of the effectiveness of therapeutic measures, the quality of life of the patient is singled out, which allows determining the degree of recovery of physical and mental health after treatment of acute conditions.

AIM: to evaluate the effectiveness of complex balneopeloid and enzyme therapy with longidase according to the monitoring of the quality of life of the patients suffering from chronic bacterial prostatitis.

MATERIALS AND METHODS: There have been observed 54 patients with chronic prostatitis. They were divided into 2 groups by simple randomization: in the comparison group (n=26) the patients were prescribed exercise therapy, internal and external administration of mineral water of Zheleznovodsk type, peloidotherapy with silt sulfide mud topically, antibiotic therapy with ceftriaxone, phytomicroclysters; in the main group (n=28), the patients additionally underwent antibiotic and enzyme therapy by peripheral indirect lymphotropic therapy. The efficiency was assessed using validated Quality of Life questionnaires: Chronic Prostatitis Symptom Scale (NIH-CPS) and SF-36 General Health Questionnaire (Social Functioning-36).

RESULTS: The analysis of the clinical effect of the new treatment technology revealed its advantage over the standardized therapy, which is proven by the monitoring of QoL indicators for 1 year after the spa treatment: recovery of QoL in the main group immediately after the treatment occurred by 59.7% (p <0.01), 6 months later ― by 72.7% (p <0.01), with a slight decrease in the rate in 12 months ― by 64.9% (p <0.01). The dynamics of physical and mental health indicators on the SF-36 scale was also observed with the same degree of confidence: compared with the baseline, the average improvement was 25.5% (p <0.01), 33.6% (p <0.01) and 27.3% (p <0.01) respectively. In the comparison group, the dynamics of indicators for all NIH-CPSI and SF-36 scales was also significant, but lower than similar indicators in the main group by 23–25% on average (p <0.01) and 12–15%, respectively.

CONCLUSION: The results of the study indicate the high effectiveness of complex balneopeloid and lymphotropic therapy with the patients suffering from chronic prostatitis at the stage of spa treatment.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):73-79
pages 73-79 views

Experience in the use of cryotherapy in patients after total replacement

Kolbakhova S.N., Samoilov A.S., Fesyun A.D., Kulchitskaya D.B., Khaptagaev T.B., Strukov R.N., Koneva E.S., Portnov V.V.

Abstract

BACKGROUND: All over the world, total joint replacement is one of the most popular surgical technologies due to the widespread prevalence of joint diseases, as well as injuries. There is no doubt that rehabilitation is a necessary component of the complex treatment of the patient and plays an important role in the postoperative period. Physiotherapeutic methods of treatment occupy a special place in rehabilitation programs. Cryotherapy has been used for many years in the pathology of the musculoskeletal system and has proven its clinical effectiveness due to analgesic, anti-inflammatory and decongestant effects, which gives grounds for its use after surgical interventions.

AIM: Based on the above, the purpose of this study was to study the effectiveness and rationale for the use of cryotherapy in combination with therapeutic gymnastics procedures in patients after total knee replacement for the third the rehabilitation stage.

MATERIALS AND METHODS: The study included 60 patients after total knee replacement at the age of 57 to 79 years. All patients were admitted for outpatient treatment 3 months after surgery and were divided into 2 groups. The first group consisted of 30 patients who had therapeutic gymnastics classes with a physical therapy instructor (physical therapy), for a course of 10 daily procedures. The second group consisted of 30 patients who underwent a comprehensive rehabilitation program, including therapeutic gymnastics and air cryotherapy, for a course of 10 daily procedures.

RESULTS: In all patients, before the start of the rehabilitation course, the intensity of the pain syndrome according to VAS averaged 4.5±0.6 points; according to the 10-meter walking test, a decrease in the level of mobility was detected, in most patients, the sum of the points on the two parts of the KSS scale averaged 62.8±4.5; according to the results of laser Doppler flowmetry, 44% of the subjects revealed spastic, and in 56% ― spastic-stagnant type of microcirculation. After a course of complex rehabilitation treatment, a significantly more significant reduction in pain syndrome (according to VAS) and microcirculatory disorders (according to laser Doppler flowmetry), improvement in the function of the operated joint (according to the KSS scale) was revealed, compared with the use of physical therapy as a monomethod, which contributed to an increase in the level of mobility of patients.

CONCLUSION: The combined use of air cryotherapy and therapeutic gymnastics in patients after total knee replacement contributes to the formation of pronounced analgesic, anti-inflammatory and vasocorrecting effects, which allowed to increase the effectiveness of treatment at the 3rd stage of rehabilitation treatment.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):81-86
pages 81-86 views

Evaluation of the results of complex medical rehabilitation of patients with polyposis rhinosinusitis in the long-term period

Pelishenko T.G., Kruglova L.S., Nagornev S.N., Boyarintsev V.V.

Abstract

BACKGROUND: Previous studies on the comparative evaluation of the effectiveness of the course application of therapeutic physical factors during the complex medical rehabilitation of patients with polypous rhinosinusitis showed a rather high efficiency of the additional use of complex physiotherapy (alternating magnetic field and low-intensity laser therapy) in enhancing the regression of the main clinical manifestations of polypous rhinosinusitis and improving the quality of life (QoL) of patients. Considering the chronic and often recurrent nature of polypous rhinosinusitis, along with the relief of the main clinical manifestations of the disease and improvement in the quality of life of patients after treatment, medical rehabilitation of patients should also cover the long-term period.

AIM: Evaluation of the results of complex medical rehabilitation of patients with polyposis rhinosinusitis in the long-term period (after 6, 12 and 18 months) and determination of the optimal time parameters for a repeated course of physiotherapy aimed at maintaining the achieved clinical effect and the level of quality of life of patients.

MATERIALS AND METHODS: The study was performed with the participation of 120 patients with moderate to severe polypous rhinosinusitis and uncontrolled course. All patients were divided into 4 groups by simple fixed randomization. The first group (control, 30 patients) received only basic therapy, including endonasal application of Nasonex 2 doses 2 times a day and daily twice daily lavage of the nasal mucosa. Patients of the second group (comparison group 1, 30 patients) were additionally injected subcutaneously with dupilumab at a dose of 300 μg once every two weeks. In the third group (comparison group 2, 30 patients), against the background of the administration of dupilumab, exposure to an alternating magnetic field was performed. using the apparatus MAGNIT Med TeCo. Patients of the fourth group (main group, 30 patients), in addition to the volume of treatment of patients of the third group, received low-intensity laser radiation of the red spectrum (633 nm) using the AZOR-2K-02 apparatus.

RESULTS: Positive dynamics in terms of assessed clinical indicators throughout the entire observation period was noted only in the comparison groups and the main group. The maximum severity of positive changes was determined in the main group after 6 and 12 months of rehabilitation, exceeding the achieved values in the group with dupilumab. The follow-up period made it possible to establish that 18 months after the start of rehabilitation, there were no significant differences between these groups. The dynamics of the parameters of the microcirculatory tissue system in the comparison groups and the main group in the long-term period indicated the formation of compensatory-adaptive processes aimed at eliminating congestion in the nasal mucosa and associated hypoxia, as well as the normalization of oxygen metabolism and trophism of tissues prone to chronic inflammation.

CONCLUSION: The results obtained convincingly prove the effectiveness of additional course use of an alternating magnetic field in combination with low-intensity laser therapy. The use of this technology, implemented against the background of ongoing biological therapy, shows its increased efficiency up to 12 months after the start of medical rehabilitation. It is advisable to conduct a second course of physiotherapy based on the complex use of an alternating magnetic field and low-intensity laser radiation 9–12 months after the start of medical rehabilitation.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):87-96
pages 87-96 views

Assessment of the effectiveness of the reconstraction of social-everyday skills on the hardware-training complex of audio-visual reconstruction of the environment of patients after acute cerebrovascular accident

Koneva E.S., Derevyashkina G.V., Shapovalenko T.V., Lyadov K.V., Mikhailova A.A., Portnov V.V.

Abstract

BACKGROUND: Motor disorders as a result of аcute cerebrovascular accident are the most common cause of disability and not only significantly reduce the quality of life of patients, but also cause restriction of social and household independence of patients in a familiar environment.

AIM: the evaluation of the effectiveness for restoring the social and domestic activity skill ― shopping in the supermarket in patients undergoing stroke in the right middle cerebral artery after course of the special apparat trainings with audio-visual reconstruction of the environment.

MATERIALS AND METHODS: The study included 65 participants, they were divided into 3 groups, the first and the second group ― the patients who undergoing the stroke (main and control groups): the main group of patients received a base standard rehabilitation program (kinesiotherapy, mechanotherapy on cyclic apparatгs, massage) and additional the social and domestic trainings with audio-visual reconstruction of the environment. The control group ― a base standard rehabilitation program. The duration of the rehabilitation course was 21 days. The third comparison group are the healthy participants, who were necessary for defining "etalon" options for training of socially important skill.

RESULTS: As a result of the study in both groups (main and control) as compared with the initial findings the lowering of the heaviness ischemic stroke outcome (NIHSS): 6.2±0.4 in the first group and 6.8±0.7 in the second group vs. 4.2±0.2 and 5.9±0.8 (р ≤0.05). By comparison the first and the second groups with the health participants were defined the statistically significant changes of the studing time options in the main group during making these skills: take the bag and sling it through the shoulder, open the pockets of the bag (2 pockets), take the jacket from the clothes hanger and put on. Although in patients of the first group after restoring threatment course with using method of functional spatially-oriented rehabilitation it was authentic lesser disturbance of everyday life activity: in estimating Bartel Index 61.3±4.9 vs. 43.75±5.1 (initial) (р ≤0.05), what was signuficantly higher be comparison with control group results. In estimating functional independence by Modified Scale FIM: 71.4±4.9 in the main group vs. 53.7±3.1 (initial) (р ≥0.05), what was although significantly higher in comparison with the second group. By HADS it was lowering of the anxiety symptoms in the first group from 13.02±1.9 till 10.12±1.2 (р ≤0.05) as compared with the control group where the level of anxiety was staying quietly high and was 12.6±0.6 by comparison the initial findings 13.14±1.5 (р ≥0.05).

CONCLUSION: The obtained resalts point at the effectiveness of using functional spatially-oriented rehabilitation in restoring threatment programs for patient undergoing stroke for elevation of the independence level in real life terms. An additional point is that this kind training promote significantly positive influence on the patient’s motivation for actualization of active movement to improvement of the social and domestic adaptation.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):97-104
pages 97-104 views

Review

The application of force plates and the community of experts in Russian dissertations for 2016–2022

Kubryak O.V., Mezenchuk A.I., Pak S.A.

Abstract

In 90 Russian dissertation studies with the usage of force plates, which were performed in 48 scientific organizations, more than 20 thousand healthy participants and patients took part. They were supervised by 89 specialists, who, together with 167 official opponents and representatives of 43 leading organizations, can be classified as the corps of experts in this scientific field. The appropriate list is presented for the first time.

Dissertation samples were distributed manly between clinical specialties (over 70%) and pedagogical specialties (approximately 20%). 14 different models (brands) of force plates were used in the dissertations. 6 of them were foreign, and the most frequently used ― in 55 dissertations ― were Russian force plates of three brands registered as medical devices, of which only one was an officially approved Measurement Device.

In the analysis of the data obtained using the force plates, the dissertators applied 30 quantitative indices, of which "length", "speed" and "area" of the statokinesiogram were the most frequently used.

The averaged characteristics of candidate and doctoral works in terms of the number of participants or patients included in the study, the number of sources, conclusions, etc. were represented. Interpretation of quantitative characteristics and content of dissertation works concerns comparison with the data of the analysis for the previous decade, and helps to reveal the features and the prospects of the stabilometry application.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):105-114
pages 105-114 views

Recent aspects of medical rehabilitation for combat trauma

Pogonchenkova I.V., Shchikota A.M., Kashezhev A.G., Kotelnikova A.V., Makarova M.R., Filippov M.S.

Abstract

The realities of the new times determine the need to update approaches to the organisation and The realities of the new times determine the need to actualise approaches to the organisation and conduct of rehabilitation measures for military personnel and civilians injured during combat operations.

The article presents a review of modern views on the peculiarities of combat trauma and the dynamics of the nature and type of injuries over the past few decades, the basic principles of comprehensive rehabilitation of the wounded, including medical, professional and socio-psychological aspects. The importance of personalisation of rehabilitation programmes, use of multidisciplinary approach, involvement of the patient's family in the process is reflected. The main disorders arising in persons with combat trauma are characterised in the categories of the International Classification of Functioning. The analysis of the use of modern means and methods of medical rehabilitation: physical training with the use of virtual reality environment and innovative technologies based on the principle of biofeedback, robotic mechanotherapy, hydrokinesiotherapy and other physiotherapeutic methods, the role of remote telemedicine technologies in controlling the effectiveness and safety of the rehabilitation process is highlighted.

An integrated approach to rehabilitation, taking into account modern peculiarities of combat trauma, makes it possible to ensure maximum effectiveness of rehabilitation measures, reduce the number of persons with persistent dysfunctions, prevent psycho-emotional disorders and promote maximum social and professional integration of the wounded.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):115-127
pages 115-127 views

Articles

The use of the SIMONA 111 integrated monitoring system in assessing the dynamics of rehabilitation treatment of patients with past coronavirus pneumonia. Clinical observations

Kostenko A.A., Koneva E.S., Maliutin D.S., Tsvetkova A.V., Bisheva D.R.

Abstract

The new coronovirus infection affects not only physical health, but also causes significant damage to the mental state of the population. Therefore, the stage of rehabilitation treatment makes it necessary to combine various treatment methods for the most effective restoration of the quality of life and psychological comfort of patients.

This article presents clinical observations as part of a study of rehabilitation methods after a new coronavirus infection brought on the basis of Sechenov University and Medsi Clinical Hospital No. 1. A distinctive feature of rehabilitation was the use of hypoxic/hyperoxy therapy in combination with the main course of rehabilitation treatment and the SIMONA 111 integrated monitoring system as a method of control, treatment analysis and a way of visual interaction with patients. This approach allowed not only to obtain objective data on the dynamics of treatment, but also to establish better contact with the patient.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2023;22(2):129-135
pages 129-135 views


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