Course Of Medical Rehabilitation Research Articles

The effectiveness of neurorehabilitation in inpatient department

The objective of the study is to evaluate the effectiveness of rehabilitation treatment in patients with neurological pathology in inpatient department.Materials and methods. The study included 101 patients undergoing hospital treatment due to an existing neurological disease. The mean age was 52.41 ± 13.49 years. The condition of each patient upon admission and after the course of inpatient treatment was assessed using special tools – scales, tests, indices and questionnaires, such as the Rehabilitation Routing Scale and the modified Rankin scale, and according to the clinical specifics and needs of rehabilitation treatment – the Ashworth scale, Caprini Scale, Muscle Strength Grading Scale, National Institutes of Health Stroke Scale, HAS-BLED Scale, Berg Scale, Functional Independence Measure, Waterlow Score, Numeric Pain Rating Scale, Frenchay Arm Test, Rivermead Mobility Index, Hauser Index, EQ-5D, Barthel Index. The dynamics of recovery were calculated by comparing scores obtained using special instruments upon admission to rehabilitation treatment and after it.Results. By analyzing the results of the study, a positive dynamic of recovery was established, confirming the effectiveness of an inpatient course of neurorehabilitation, which is expressed in an improvement in the condition of patients when assessed using the designated tools for its objectification.Conclusions. The study confirms the effectiveness of an inpatient course of medical rehabilitation in restoring neurological deficits, increasing the activity of daily living, reducing the degree of social maladjustment and improving the rehabilitation prognosis.

Nutritional support in the complex of medical rehabilitation at the stage of adjuvant radiation therapy of breast cancer

BACKGROUND: Currently it is known that there exists the need for complex medical rehabilitation at the stage of adjuvant radiation treatment of breast cancer. However, data on the combined use of nutritional support and physical factors at this stage of oncological treatment are not available. AIM: Evaluation of the effectiveness of specialized therapeutic and preventive nutrition in patients with malignant breast diseases and a history of polychemotherapy at the stage of adjuvant radiation therapy in complex medical rehabilitation using low-temperature plasma and general magnetic therapy. MATERIALS AND METHODS: A prospective simple randomized study was conducted, which involved 60 patients at the stage of adjuvant radiation therapy for breast cancer. The main group (n=30) received a course of medical rehabilitation with the inclusion of nutritional support using specialized therapeutic and preventive nutrition LEOVIT ONCO®, as well as exposure to low-temperature plasma and general magnetotherapy. In the comparison group (n=30), the rehabilitation course included general magnetic therapy without therapeutic and preventive nutrition. All patients underwent individual physiotherapy exercises, and sessions with a medical psychologist. The results obtained were recorded using clinical and functional, laboratory, instrumental studies. RESULTS: It has been established that the use of specialized dietary products LEOVIT ONCO and physical factors is an effective method of rehabilitation. The use of nutritional support demonstrates the maintenance of the patient’s protein status, reduces intoxication, and reduces the negative impact of oxidative stress factors in the body at the stage of adjuvant radiation treatment. The inclusion of low-temperature plasma and general magnetic therapy in the rehabilitation program has a beneficial effect on hemomicrocirculation in the area of ionizing radiation exposure. CONCLUSION: The use of nutritional support and physical factors, as a component of complex medical rehabilitation, helps to maintain the optimal nutritional status of the patient, reduces the manifestations of skin radiation reactions, improves the psycho-emotional state of patients and the quality of life of patient.

Efficiency of the use of coordination training in the program of medical rehabilitation of patients after reverse shoulder endoprosthesis

The goal of this study. The goal is to evaluate the effectiveness of using upper limb coordination training after reverse shoulder arthroplasty.Material and methods. 30 patients were examined in Federal State Budgetary Institution «National Medical Research Center for Rehabilitation and Balneology» of the Ministry of Health of the Russian Federation. They were examined in a long-term period after reverse shoulder arthroplasty (in 3–4 months) and were divided into two groups: the main and the comparison groups. All patients were similar in terms of gender and age. Their clinical and functional parameters of the shoulder joint were also comparable. The patients in the comparison group were treated with laser therapy, electrotherapy, massage, group exercises to train the upper limb and mechanotherapy. The patients in the main group additionally underwent coordination training with biological feedback to the shoulder joint.The results of the study were evaluated according to the pain syndrome, functional activity of the shoulder joint, shoulder joint flexion angle and values of dynamic strength of the shoulder muscles. After the course of medical rehabilitation, the patients in both groups showed improvement of all clinical and functional parameters of the shoulder joint. There was a statistically significant improvement in the dynamic strength of the shoulder joint and reduction of pain syndrome in the patients in the main group.Conclusions. The inclusion of shoulder coordination training allows to improve the rehabilitation results for the patients who undergo reverse shoulder joint arthroplasty.

Assessment of the quality of life in complex medical rehabilitation of patients at the stage of chemoradiotherapy for head and neck cancer

BACKGROUND: At the stage of chemoradiotherapy of malignant neoplasms of the head and neck, in 90% of cases, the development of radiation dermatitis and mucositis is observed. The resulting acute radiation reactions negatively affect not only the quality of life of the patient, but also the planned treatment. A multidisciplinary approach with the inclusion of basic treatment, physical therapy, physical factors, psychological correction, and nutritional support is an effective strategy for improving the patient's quality of life at this stage of treatment. AIM: To assess the quality of life of patients in complex medical rehabilitation who underwent chemoradiotherapy for malignant neoplasms of the head and neck. MATERIALS AND METHODS: An interventional prospective randomized study was conducted with the participation of 60 patients with malignant neoplasms of the oral cavity, larynx, oropharynx, larynx undergoing chemoradiotherapy. The main group (n=30) received a course of medical rehabilitation: exposure to low-temperature argon plasma, general magnetic therapy, physical therapy, training on the support reaction on a barefoot platform, nutritional support and classes with a medical psychologist. In patients of the comparison group (n=30), plasma exposure was not included in the rehabilitation course. The effect of chemoradiotherapy for head and neck cancer on the patient's quality of life was assessed by the severity of pain syndrome, physical functioning, and limitations of daily activities using Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS) techniques, a questionnaire developed by C.D. Spielberger and adapted by Y.L. Khanin, the SF-36 questionnaire. RESULTS: After a course of chemoradiotherapy, patients began to complain of pain, burning in the mouth, complaints of dry mouth, pain when swallowing, eating, limited mouth opening, redness and peeling of the skin, voice changes, difficulty falling asleep, frequent awakenings at night, embarrassment of one’s appearance. In patients of both groups, there was a decrease in the level of reactive and personal anxiety, the increased level of anxiety and depression decreased by the end of the course of chemoradiotherapy with a decrease in indicators after 6 months. Despite the increase in pain intensity during chemoradiation treatment, an increase in vital activity indicator was recorded, as well as an indicator of self-assessment of one’s health by the end of the course of chemoradiation treatment. CONCLUSION: The resulting radiation mucositis and epidermitis at the stage of chemoradiotherapy for head and neck cancer lead to physical and psychological limitations, worsening the patient's quality of life, which determines the need to accompany this stage of treatment with comprehensive medical rehabilitation. The study of the dynamics of the parameters of the quality of life of patients is the basis for the selection of individual rehabilitation treatment programs.

Effectiveness of Complex Medical Rehabilitation of Patients with Postthrombophlebitic Syndrome of Lower Extremities and Obesity: a Randomized Clinical Study

INTRODUCTION. The relevance of the development of comprehensive rehabilitation programmes for patients with postthrombophlebitic syndrome (PTPS) is due to the high frequency of disability and a significant reduction in their quality of life. Since obesity and excessive body weight are proven risk factors for the development and progression of chronic vein diseases, weight reduction is one of the important tasks of rehabilitation measures in patients with PTPS and concomitant obesity.
 AIM. Comparative study of the influence of complex methods of medical rehabilitation, including various methods of laser blood irradiation (supravascular and intravenous), pulse magnetotherapy and dry carbon baths, on the dynamics of indicators of composite body composition according to bioimpedance measurements in patients with postthrombophlebitic syndrome of the lower extremities and obesity.
 MATERIALS AND METHODS. A randomized prospective study was conducted on the basis of the Department of Medical Rehabilitation of Patients with Somatic Diseases of National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of Russia. The study included 40 patients with PTS of the lower extremities and accompanying obesity, the average age of which was 58.3 [51.5; 68.0] year), randomized to two groups. The patients of the 1st group received Intravenous laser blood irradiation (ILIB) (“Lazmik”, Russia), impulse magnetotherapy and dry carbon baths, as well as therapeutic gymnastics in the hall. The patients of the 2nd group received a complex that included supravascular laser irradiation of blood (“Azor-2K”, Russia), pulse magnetic therapy, and dry carbon baths, as well as therapeutic gymnastics in the gym. Anthropometric measurements (body mass, malleolar volume) were used for the evaluation of anti-edema and lipolytic effects after a comprehensive course of medical rehabilitation, as well as bioimpedance measurement of body composition (“MEDASS”, Russia).
 RESULTS. In patients with PTS of the lower extremities and obesity, after carrying out a course of medical rehabilitation using preformed physical factors, including various methods of laser irradiation of the blood (supravascular and intravenous), a significant decrease in body weight indicators was observed (p 0.001), a decrease in BMI (p 0.001), total and extracellular fluid (p 0.001) without significant differences between groups. A significant decrease in the index of fat mass (kg) (p = 0.007) was found in patients of the main group.
 DISCUSSION. Maintaining a healthy body weight as well as combating obesity are first-line secondary prevention measures recommended for all patients with PTS of the lower extremities. For the control of the dynamics of the composite composition of the body, an effective and sensitive method is the method of bioimpedance measurement, which allows to estimate the reduction of extracellular fluid (anti-flow effect) and fat mass of the body (lipolytic effect).
 CONCLUSION. The method of bioimpedance measurement, used for the evaluation of the composite composition of the body, showed high sensitivity and allowed to establish the greater effectiveness of the developed complex, which includes ILIB with a wavelength of low-intensity laser radiation (NILI) of 635 nm in reducing fat mass.

A modern approach to the rehabilitation of patients with fractures of the bones of the lower extremities

BACKGROUND: General injury rates tend to increase in most federal districts of Russia. The patients with fractures of the bones of the lower extremities reaches for 8.525% of the total number of patients with fractures. Fractures of the bones of the lower extremities are characterized by long period of reparation, persistent contractures, a violation of the congruence of the articular surfaces, and changes in the biomechanics of walking. Only full course of rehabilitation can eliminate the these complications and restore the previous motor activity.
 АIMS: The study aimed to analyze the structure of injuries in patients of the traumatology department and to present and the results of the recovery of patients with fractures of the bones of the lower extremities using and algorithm of organization of medical rehabilitation in the case study.
 MATERIALS AND METHODS: A retrospective analysis of statistical data on 995 patients of the traumatology department № 1 of the Kazan City Clinical Hospital, who underwent 981 operations, was carried out. Randomly selected two groups of patients ― I main (n=45) and II control (n=45). Patients of group II after the treatment at the trauma center underwent outpatient medical rehabilitation, group I received inpatient medical rehabilitation in the rehabilitation department of the Kazan City Clinical Hospital № 7. In a hospital setting, a comprehensive rehabilitation program included physiotherapy exercises, CPM-veloergometry, exercises on rehabilitation simulators, the PNF kinesiotherapy technique, etc.
 RESULTS: A more pronounced statistically significant positive dynamics at the end of the course of medical rehabilitation was noted in patients of group I (reduction of pain syndrome, increased joint mobility, degree of dependence on others, increased mobility index, the ability to dress independently, maintain body position in space, reduced dysfunction in lifting and carrying objects, walking disorders, and caring for body parts). The dynamics of motor function and psycho-emotional sphere also improved to a greater extent in patients of group I.
 CONCLUSIONS: The effectiveness of the presented algorithm of organization of medical rehabilitation of patients with fractures of the bones of the lower extremities is confirmed by the results of present study. It is revealed that patients in the I (main) group showed more significant improvement in functions, activity and participation, a decrease of disability, reduce of pain, anxiety and depression, as well as an increase of the level of quality of life compared to patients of group II (control), who did not receive comprehensive medical rehabilitation in the hospital (p 0.1).

Knee range of motion as a marker of the effectiveness of medical intervention in multiple sclerosis

To measure the knee range of motion (ROM) in the sagittal plane by video analysis in patients with multiple sclerosis (MS) after a course of medical rehabilitation and determine the minimal clinically important differences (MCID). We examined 45 patients (37 women, 8 men) with relapsing-remitting (n=38) and secondary-progressive MS before and after a course of medical rehabilitation. Gait parameters were recorded on video analysis system Physiomed Smart («Physiomed», Germany, the Davis protocol). The course of complex medical rehabilitation contributes to an increase knee ROM in MS patients in a wide range of disability (EDSS <6.5 points). MCID is estimated as 7.14° in mild (EDSS ≤4.0) and as 7.67° in moderate (EDSS=4.5-5.5) gait impairment. The results will assist clinicians and researchers in interpreting the significance of observed kinematic changes in the knee joint in MS patients after medical intervention.

Application of Remote Patient Monitoring Technology in Medical Rehabilitation Programs

AIM. To develop an original information technology for remote monitoring and to conduct a scientific justification for its use for monitoring and evaluating the motor regimen and the main physiological parameters of patients in a rehabilitation center. MATERIAL AND METHODS. The original architecture of the software and hardware complex was used (certificate of state registration of the computer program No. 2022611766 of February 1, 2022), allowing to the attending physician’s PC and wearable devices (smart watches) of the patient with the function of the 24-hour registration of motor activity and heart rate indicators of users. The study involved 21 patients, who underwent medical rehabilitation courses in a round-the-clock hospital. 11 patients underwent cardiorehabilitation programs for the diagnosis of chronic coronary heart disease, myocardial infarction in the past (I25.2 according to ICD-10); 10 patients due to a condition after COVID-19 (U09.9 according to ICD-10). RESULTS AND DISCUSSION. When comparing the motor characteristics of the 2 study groups, it was found that the average number of steps per day was 9004.6 in the group of patients with a diagnosis of I25.2, which equals the distance of 6.6±2.63 km, and 10072.4 steps per day and 7.45±3.12 km in the group with a diagnosis of U09.9, respectively (p&lt;0.001). In both groups, during the course of medical rehabilitation, as a rule, 3 peaks of an increase in motor load were observed – on days 2-3, 5-6 and 8. The period of physical activity in group I25.2 averaged 5:45±0:33 hours, and in group U09.9 – 5:30±0:23 hours. The total density of motor load in both groups corresponded to ≈ 35-36%. However, the average time of motor load spent on active physical rehabilitation procedures in the group with a diagnosis of I25.2 was 1:45±0:17 hours, and in the group U09.9 only 1:05±0:14 (p&lt;0.01). In this connection, the motor density of the motor load of rehabilitation measures in the groups corresponded to 26.6% and 19.8%. CONCLUSION. The software package for remote monitoring of the motor regime and the main physiological parameters of patients has demonstrated the possibility of its use in medical practice, namely for patients at the 2nd stage of medical rehabilitation in a round-the-clock hospital and can be recommended for inclusion in programs of spa treatment.

Recovery of anti-gravity muscles in patients with consequences of limb injury

BACKGROUND: Over the past years, injuries have been consistently included in the first seven leading classes in the structure of general morbidity, and in the distribution of the number of people aged 18 years and over who were first recognized as disabled, they are included in the first six causes of disability.&#x0D; AIM: to study the clinical efficacy and safety of the author's technique, in patients after injuries of the lower and upper extremities at the second stage of medical rehabilitation.&#x0D; MATERIALS AND METHODS: The study included 105 patients who had suffered injuries. 37 (35.2%) men, 68 (64.8%) women. The patients were randomly divided into 2 observation groups: the main group (n=53), whose patients, in addition to the standard rehabilitation program, were trained on the biofeedback simulator Tergumed Pegasus 3D (Germany), a course of 710 procedures, and the control group (n=52), whose patients underwent a course of medical rehabilitation only according to the standard program of the 2nd stage, lasting 1014 days. The complex rehabilitation treatment of patients included standard drug therapy, massage courses, physiotherapy, group exercise therapy. Treatment outcomes were assessed using the VAS (Visual Analog Scale), HAQ (Health Assessment Questionnaire), Lequesne index, and 20-m walking time scales. Data analysis included comparison of dependent series of variables and descriptive statistics methods. The type of data distribution (parametric or nonparametric) was assessed using the ShapiroWilk and KolmogorovSmirnov tests. The statistical significance of differences between dependent groups was assessed using the Wilcoxon and MannWhitney tests. The value of p=0.05 was taken as the level of statistical significance.&#x0D; RESULTS: All measured indicators improved significantly (p 0.001). In the main group, compared with the control group, there was a statistically significant increase in walking speed, and there was a tendency to a more pronounced positive change in the Lequesne and HAQ indices, the level of pain according to VAS, compared with the control group.&#x0D; CONCLUSION: Our proposed method of training with the participation of antigravity muscles trunk is effective for patients after limb injuries at the 2nd stage of medical rehabilitation.

Medical rehabilitation technology for patients after high-tech joint and spine surgeries

Approximately 6 thousand endoprosthesis surgeries of hip, knee and spine stabilization are annually performed in older patients in the Irkutsk region. Patients require a second stage of medical rehabilitation — in a specialized rehabilitation unit. The article presents the technology of medical rehabilitation, which is used for this group of patients, including assessment of rehabilitation prognosis, application of physical rehabilitation methods, correction of somatic pathology and psychological status. Aim: to improve the immediate and long-term results of hip and knee endoprosthetics, spine stabilization surgeries by developing a system of rehabilitation measures based on individual patient parameters and aimed at optimal restoration of function. Materials and Methods. The focus of the investigation was on the patients from the Medical Rehabilitation Department, Clinical Hospital of the ISC SB of the RAS. Patients affected with coxarthrosis, gonarthritis, osteochondrosis of the spine, who had undergone joint replacement or stabilizing spinal surgery in the Medical Rehabilitation Department of Irkutsk Scientific Center of Surgery and Traumatology, 5–7 days before transfer to the Medical Rehabilitation Department of Clinical Hospital of the ISC SB of the RAS. The subjects also underwent clinical, paraclinical, locomotive, physical examination and laboratory test; physical activity assessment and estimation of indicators of the integral rehabilitation scale, the medical rehabilitation scale and the physical activity scale were performed as well. In the course of medical rehabilitation, patients received physiotherapeutic appointments, physiotherapy exercises, correction of somatic pathology, and correction of psychological status. Results. In 2020–2021, 240 older patients were treated in the Medical Rehabilitation Department after large joints arthroplasty and spinal reconstructive surgeries. The technology of medical rehabilitation was used for these patients. As a result, pain syndrome was eliminated, contracture of the operated joint was stopped, locomotor function improved, patients' physical activity and self-care ability were optimized, and somatic disorders were corrected. In addition, our own scales have been developed and improved: the Integral Rehabilitation Orthopedic Scale, the Individual Physical Activity Scale. Conclusion. Implementation of this rehabilitation technology has significantly optimized the outcomes of large joints arthroplasty or spinal reconstructive surgeries.

Influence of physiotherapy on the electrical excitability of the shoulder muscles in the early postoperative period after radical surgical treatment of breast cancer

BACKGROUND: Combined treatment of cancer patients includes a large number of aggressive therapies that lead to a complex of functional disorders. There are no publications on the influence of physical factors on the electrical excitability of the muscles of the shoulder girdle and upper limb from the side of surgery in the early period after surgical treatment of breast cancer.&#x0D; AIM: To determine the physical factor that will most significantly affect the electrical excitability of the muscles of the shoulder girdle and upper limb on the side of the operation after radical surgical treatment of breast cancer.&#x0D; MATERIAL AND METODS: A randomized, placebo-controlled study was conducted in 100 patients in the early postoperative period (24 days after surgery) for breast cancer. All patients underwent medical rehabilitation: individual physiotherapy exercises, balance therapy, sessions with a medical psychologist, physiotherapy treatment with a monofactor. The main group included 34 patients who included an extended method of fluctuorization in the course of medical rehabilitation and additionally underwent fluctuorization of the muscles of the forearm, group 2 (comparisons, n=33) the extended method of local magnetotherapy was included in the rehabilitation program and group 3 (comparisons, n=33) in addition to rehabilitation, general magnetic therapy procedures were performed. Patients underwent a study of the excitability of the neuromuscular system on the apparatus of stimulation and electrotherapy ASEtM-01/6 "Elesculap Med TeKo".&#x0D; RESULTS: It was found that fluctuating currents turned out to be more effective in the early stages, which pathogenetically contribute to the restoration of conduction along the peripheral nerves and the activation and contractility of the muscle fiber. A delayed effect of local and general magnetic therapy on improving the contractility of the muscles of the upper limb and the conductivity of the peripheral nerve fiber was noted.&#x0D; CONCLUSION: The inclusion of monophysical factors in the course of standard medical treatment, a course of physical therapy, exercises on a stabiloplatform and individual psychotherapy in the early stages (on days 24) after surgery contributed to the improvement in the functioning of the upper limb and the restoration of the electrical excitability of the muscles and nerves of the operated limb.

General magnetic therapy and electrostatic field after radical surgical treatment of breast cancer at the 1st stage of medical rehabilitation

BACKGROUND: Various methods of physical therapy have been proposed for the rehabilitation of patients with breast cancer. However, a staged approach to prescribing physiotherapeutic factors in the early period after surgical treatment of breast cancer has not been developed enough.&#x0D; AIMS: to develop a staged approach to the appointment of physiotherapeutic factors at different times after surgical treatment of breast cancer.&#x0D; MATERIALS AND METHODS: Examination and treatment of 64 patients aged 30 to 70 years after surgical treatment for breast cancer were carried out. All patients underwent medical rehabilitation: individual exercise therapy, balanstherapy, sessions with a medical psychologist, course exposure to an alternating low-frequency electrostatic field and general magnetotherapy. The main group consisted of 33 patients who underwent a 2-stage course of medical rehabilitation: the 1st course on days 24 after the operation and the 2nd course after 11.5 months against the background of adjuvant radiation therapy. The control group 31 women, underwent physiotherapy placebo procedures.&#x0D; RESULTS: I was found that two-stage physical rehabilitation improves the quality of life, reduces swelling, increases the range of motion, decreases pain, decreases the number of postoperative complications, and shortens the duration of lymphorrhea.&#x0D; CONCLUSION: The inclusion of exposure to an alternating low-frequency electrostatic field and general magnetotherapy in the early stages (24 days) and 11.5 months after surgical treatment has broad functionality and allows you to obtain a pronounced functional and stable clinical result.

Application of Physical Factors at the First Stage of Medical Rehabilitation after Radical Surgical Treatment of Breast Cancer

There are a large number of publications confirming the clinical safety of the of physiotherapy application in patients with malignant neoplasms of the breast, but scientific studies on the physical factors complex use in medical rehabilitation of this group of patients in the early postoperative period have not been published yet. Aim. To determine the effectiveness of fluctuating currents in combination with pneumocompression, general magnetotherapy, local magnetotherapy, low-temperature argon plasma applied for patients after radical surgical treatment of breast cancer in the early postoperative period. Material and methods. A prospective, simple, randomized study involving 190 women diagnosed with breast cancer in the early postoperative period after radical Madden mastectomy or radical breast resection (2–4 days) was performed, the average age was 58±10.61 years. The control group consisted of patients included in the course of rehabilitation (exercise therapy, balance therapy and classes with a medical psychologist) fluctuating currents. Low-temperature argon plasma, intermittent pneumocompression, general and local magnetotherapy were added to fluctuations for patients in the main groups. Results and discussion. The analysis of the clinical and functional data showed that in the early postoperative period for breast cancer against the background of the standard drug therapy and the course of medical rehabilitation, the combination of fluctuating currents with intermittent pneumocompression, general and local magnetotherapy significantly reduced the degree of the upper limb edema and the volume of lymphorrhea. The addition of general and local magnetotherapy affects the decrease in the indicators of the shoulder girdle and forearm muscles electrical excitability. Low temperature argon plasma improves the regeneration of the postoperative suture and reduces swelling and inflammation in this area. The dynamics of the decrease in the level of anxiety and depression, pain syndrome and the general condition of cancer patients are most pronounced in the groups that additionally received magnetotherapy. The volume and quality of movements, muscle strength significantly increased in all groups without differences in results. The action of magnetic fields contributes to the increase of tissue oxygenation, due to which an anti-inflammatory and decongestant effect is realized. Fluctuation of the shoulder girdle and forearm muscles leads to normalization of the functional electrical excitability of the muscles by surgical treatment, which allows to restore the motor stereotype of the limb in a short time, and intermittent pneumocompression affecting the skin and tissue structures of the lower extremities and trunk improves the overall lymph flow, which does not lead to stagnation of lymph in the operated area. Conclusion. Thus, the combined application of physical factors against the background of the standard drug therapy and the course of medical rehabilitation significantly improves the result and recovery time after surgical treatment of the breast cancer in the early postoperative period. A comprehensive approach to medical rehabilitation at the I stage led to the preservation of results in the long-term period 1.5 and 6 months after the operation without adverse events.

Possibilities of syndrome-oriented medical rehabilitation in diseases of the respiratory organs in the resort of the Southern coast of Crimea

Aim. To evaluate the possibilities of physiotherapeutic syndrome-oriented medical rehabilitation (MR) for lung diseases (LD) in the climatic resort of the Southern Coast of Crimea (SCC). Materials and methods. In a single-center retrospective observational study, an analysis was made of the rehabilitation effects of physiotherapeutic interventions in a contingent of 100 patients with LD. Examination and treatment of patients was carried out in accordance with the standard of health resort care for patients with LD. Additionally, psychological studies and therapeutic effects were carried out by transcranial electrical stimulation, dynamic electrical nerve stimulation, mud therapy with Saki therapeutic mud, aromatherapy with sage oil and breathing training with a breathing simulator “New Breath”. The assessment of the values of 23 domains of “International Classification of Functioning, Disability and Health” (ICF) was carried out according to the methodology developed in the “ARI n.a. I.M.Sechenov”. The values of domains at the beginning and at the end of the MR course were evaluated, as well as the dynamics of domains (equal to the result of subtracting the values of the domain at the end of the course from the value at the beginning of the course). Mathematical analysis of the obtaineddata was carried out using the methods of multivariate statistics. Results. A statistically significant (at p &lt; 0.05) positive dynamics of a number of domains was established, indicating the success of a comprehensive course of MR, including domains b2401, b410, b420, b450, b455, b4552, b4601 and an integrated assessment of the functional state (IAFS). The 18 equations of the positive effect of course doses of physiotherapeutic procedures (alternating magnetic field, DENS, ultrasound therapy, halotherapy, inhalation therapy, aromatherapy, pelopathy, short-wave ultraviolet irradiation and massage) on the effectiveness of MR for 12 domains and for IAFS were obtained. Conclusion. The use of ICF domains as rehabilitation syndromes is substantiated. The complex of physiotherapeutic influences used in the treatment of patients with LD in the SCC climatic resort has significant potential for successful syndrome-oriented MR.

ЗАСТОСУВАННЯ КІНЕЗІОТЕЙПУВАННЯ У ПРАКТИЦІ ФІЗИЧНОЇ РЕАБІЛІТАЦІЇ ТА АДАПТИВНОГО ФІЗИЧНОГО ВИХОННЯ

To study the effectiveness of kinesiotherapy in medical rehabilitation of patients with isolated fractures of the forearm bones.The aim of the study. The study was conducted in 44 patients aged 19-85 years with isolated fractures of the forearm bones, who underwent surgical treatment with osteosynthesis. In the control group (n=21), a standard course of medical rehabilitation was conducted in the postoperative period, which included massage, physiotherapy exercises and magneototherahy. In the main group (n=23), in the postoperative period, the kinesiotherapy of the shoulder and forearm was performed against the background of a standard course of medical rehabilitation. Kinesio tapes were used on the 2nd day after the operation and applied for 72 hours, after which they were changed to new ones. The duration of the study was 12 months. The severity of the pain syndrome, the amplitude of the movement of the wrist joint and the rotational movements of the forearm, the strength of the fist grasp, the function of the upper limb, the quality of life of the patients were evaluated. Results of the research. The use of kinesiotherapy in the period from 1 month after the operation significantly reduced the subjective severity of the pain syndrome by an average of 22.7 %, reduced the number of patients with persistent edema by 1.75 times and increased the number of patients without edema by 2.3 times compared with application of a standard course of medical rehabilitation. The parameters of the amplitude of motion in the wrist joint, rotational movements, and the dynamometry of the fist grasp in patients of the main group were slightly higher than those in the control group throughout the observation period. In the long-term period, the number of patients with excellent treatment outcomes in the main group was 1.5 times higher than in the control group, the number of patients with satisfactory results was 1.3 times lower than in the control group. Conclusions. Kinesiotaping is a promising, simple, non-traumatic method that does not cause side effects and complications, significantly reduces the pain syndrome, improve the quality of life of patients, this method helps earlier relief of postoperative edema and fuller recovery of clinical and functional condition of the radial-carpal joint. Kinesiotaping can be used as one of the methods in the complex recovery of patients with isolated fractures of the forearm with the physical rehabilitation and adaptive physical education.

Rehabilitation of young children with movement disorders and epilepsy: rational approach and efficacy

Introduction. Epilepsy is one of the most common chronic nervous system disorders. Epilepsy in a child requiring physical, psychological and speech therapy significantly reduces its scope and decreases the likelihood of recovery.&#x0D; The aim of the study was to assess the efficacy and safety of a rehabilitation programme for young children with movement disorders and concomitant epilepsy.&#x0D; Materials and methods. Simple randomization was used to divide 123 children aged 924 months into four groups: three main groups and one comparison group. Patients in group 1 received traditional massage, excluding the cervical region, as their rehabilitation. Patients in group 2 received kinesiotherapy (Vojta therapy) in addition to traditional massage. Children in group 3 participated in a comprehensive programme, including traditional massage and kinesiotherapy (Vojta therapy). Children in the control group did not receive rehabilitation.&#x0D; Results. A statistically significant improvement in the psychomotor development parameters was observed after a course of medical rehabilitation. It was more significant when the epileptic focus was localized in the right hemisphere or the patient had generalized epilepsy. The outcome was less favourable in multifocal epilepsy and when the epileptic focus was present on the convex surface of the left hemisphere. The third group noted a statistically significant improvement in the GMFCS scores by the end of the comprehensive rehabilitation course. There were no epileptic seizures seen on repeat EEG recordings during the medical rehabilitation and one month after its completion.&#x0D; Conclusion. A comprehensive approach to planning a course of rehabilitation ensures its efficacy. The location of the epileptic focus and the distribution of epileptic activity along the convex surface of the brain determines the outcome of medical rehabilitation. An increased epileptiform activity index on EEG without signs of clinical deterioration requires more careful patient monitoring but, nevertheless, is not a reason to completely cancel rehabilitation measures.

Psychoemotional motivation of motor act development (pilot study)

BACKGROUND: In clinical practice, video motion analysis is widely used. It is known that such a higher mental function as creative thinking manifests itself in the motor activity of the body, as a result of which the movement becomes expressive. Since the quality of the images presented affects the organization of movement, it is presumably possible to characterize this psychosomatic connection through an assessment of the expressiveness of movement.&#x0D; AIMS: fixation in graphic and digital format of expressive movement, as well as the identification of spatio-temporal criteria for the quantitative assessment of expressiveness.&#x0D; MATERIAL AND METHODS: The experiment involved 3 healthy volunteers with different levels of acting training. The structure of expressive movement was presented in a graphic and digital format, which made it possible to calculate spatio-temporal indicators and give an objective quantitative assessment of the quality of expressiveness of movements of the participants in the experiment.&#x0D; RESULTS: It has been established that expressive movements arise with the integration of the following components: motor abilities and motor experience, movement image, plastically expressive structure of movement construction. In addition, expressive movements affect deep psychological functions: imagination, creative thinking, emotional control, etc.&#x0D; CONCLUSION: The inclusion in the course of medical rehabilitation of patients with various pathologies of the direction of ergotherapy, based on the analysis and assessment of the expressiveness of movement, will contribute to the complex restoration of the connection between consciousness and movement, correction of psychosomatic deviations, the expansion of movement patterns, improvement of body feeling and movement control.

Randomized Application of Low-Frequency Electrostatic Field and General Magnetic Therapy after Surgical Treatment of Breast Cancer

Background: Various methods of physical therapy are widely used in the rehabilitation of patients with cancer (magnetotherapy, pneumocompression, electrotherapy, laser therapy). The goal of such rehabilitation is to minimize side effects and complications after radical treatment. However, a staged approach to the appointment of physiotherapeutic factors in the early period after surgical treatment of breast cancer has not been developed enough. Aim: To develop a staged approach to the appointment of physiotherapeutic factors at different times after surgical treatment of breast cancer. Design: a randomized-placebo-controlled study. Location: the clinic named after professor Yu. N. Kasatkin of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation, Moscow. Population: Examination and treatment of 78 patients aged 30-70 after surgery for breast cancer were performed. The main group of 39 patients underwent a 2-stage course of medical rehabilitation: the first course on days 2-4 after surgery and the second course after 1-1.5 months against the background of adjuvated radiation therapy. The control group of 39 patients underwent physiotherapy placebo procedures. Methods: All the patients underwent medical rehabilitation: individual exercise therapy, balance-therapy, sessions with a medical psychologist, course exposure to an alternating low-frequency electrostatic field and general magnetic therapy. Results: two-stage physical rehabilitation improves the quality of life, decreases swelling, increases the range of motion, decreases pain, decreases the number of postoperative complications, and shortens the duration of lymphorrhea. Conclusions: It is advisable to include general magnetic therapy procedures and exposure to an alternating low-frequency electrostatic field in combination with physiotherapy exercises, balance-therapy and individual lessons from a medical psychologist in rehabilitation courses. Clinical Rehabilitation Impact: Prescribing two courses of medical rehabilitation after breast cancer surgeries in the early stages (on days 2-4) and 1-1.5 months after surgery contributed to a decrease in pain and postoperative edema, and an increase in the range of motion in the shoulder joint, preventing severe lymphostasis and improving the quality of life.

Application of categories of the International classification of functioning in the organization of medical rehabilitation of patients who have suffered a new coronavirus infection COVID-19

The objective was to determine the most significant categories of ICF that allow us to provide objective information about the biopsychosocial state of patients who have suffered a new coronavirus infection COVID-19 and to choose the most effective methods of rehabilitation based on the rehabilitation diagnosis of each group of patients.Methods and materials. On the basis of the clinic of the Pavlov University, a course of medical rehabilitation was conducted for 2 weeks for patients who had suffered a new coronavirus infection in severe and moderate degree of course. 2 groups were formed: EG1-25 people participating in the rehabilitation program with the use of physical exercises and EG2 — 39 people with the use of physical exercises and physiotherapy. A categorical rehabilitation profile of patients by ICF domains was compiled.Results. As a result of the application of the medical rehabilitation program, a statistically significant improvement in the indicators in EG 2 was revealed. The respiratory function (the Barbell test) improved by 14.6%, the functional state of the cardiovascular system according to the DBP indicator by 3.9%. The analysis of the results of the ICF category «activity and participation» revealed a statistically significant improvement in the motor test parameters (6MSHT) in both groups: by 11.9 % in EG2 and by 20.6 % in EG1.Conclusions. The results of the study indicate the positive impact of the proposed program of medical rehabilitation and confirm the relevance of the problem, unsolved problems and prospects for scientific research on this topic.

Binaural Acoustic Beats in the Psychological Rehabilitation of Patients with Impaired Motor Functions

The course of diseases associated with movement disorders violates the possibility of independent existence of the individual and is accompanied by the formation of symptoms of increased anxiety, depression and catastrophizing. Over the last years, in addition to psychopharmacological drugs, non-drug methods have been actively included in the complex of treatment and rehabilitation for this patients’ group allowing them to influence the patient’s psyche by neuro-biological activation of sanogenesis links. Aim. To study the possibility of using resonance-acoustic vibration (PRAV) programs in the “relaxation” mode when organizing psychological support for patients with movement disorders in the course of medical rehabilitation. Materials and methods. The study included 93 patients with movement disorders of two nosological groups: movement disorders against the stroke (n=57) and motor disorders against the degenerative-dystrophic diseases of large joints and spine of large joints and spine (n=36), undergoing a standard inpatient course of medical rehabilitation. Results. The dynamics of the emotional state, the intensity of the pain syndrome, characteristics of the cognitive sphere (memory, attention) as a result of psychological correction using PRAV were analyzed. The positive effect of the inclusion of the binaural beats complex in the psychological correction of the patients with impaired motor functions state of health as well as an indifferent response to the attempt to correct memory and attention were determined. Conclusion. It testifies that the application of the method is appropriate in correcting the emotional state, general well-being, overcoming fear of movement and is not effective for pain and recovery of cognitive functions.