Effectiveness Of Medical Rehabilitation Research Articles

Dynamics of indicators of motor functions on the background of physical rehabilitation in children of early age with epilepsy and motor disorders

Epilepsy is a chronic brain disease and one of the most common neurological diseases in the world, manifested by sudden seizures due to increased paroxysmal activity of neurons. There are no published studies aimed at assessing the dynamics of motor development in young children suffering from epilepsy with motor disorders.Purpose. The paper aimed at studying the dynamics of motor function indicators in patients with epilepsy on the background of movement disorders during three courses of rehabilitation treatment.Material and methods. We studied 123 young children with epilepsy and motor disorders. Age ranged from 9 months to 24 months. All patients were divided into 3 groups: group 1 patients who received only general massage, group 2: patients who received Vojta therapy, group 3: patients who received massage and Vojta therapy. The duration of remission for clinical seizures in all groups was at least 3 months, remission for video EEG monitoring in all patients was 23 months. Three courses of medical rehabilitation were carried out with an interval of 2 to 5 months for 1015 sessions of 2530 minutes daily. The dynamics of motor development of patients and the effectiveness of medical rehabilitation were assessed using the GMFCS scale, before and after each course of medical rehabilitation.Results. After the first course of rehabilitation, almost no improvement was observed and was unreliable, while after the second course there was a significant positive trend, especially pronounced in group 3. At the same time, the growth of the scale indicators in the period from the end of the first course to the end of the third was almost linear.Conclusion. The data obtained indicate the presence of a certain rigidity of the motor system of such patients, which determines the minimum dynamics after the first course of rehabilitation. Only starting from the second course, we begin to notice a linear improvement in the indicators of motor functions. The preferred duration of the interval between courses, in our opinion, is not less than two and not more than three months.

The effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports

The purpose of the study: to study the effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports.Materials and methods: examined 48 male patients aged 25.9 ± 2.1 years with traumatic disease of the lumbar spinal cord. All examined were divided into 2 groups: patients of the main group (19 people) against the background of standard therapy received a course of active medical rehabilitation (AMR), including mechanotherapy and electrical stimulation with biofeedback under the control of electromyography (EMG) of the muscles of the lower extremities and back. Patients in the comparison group (29 people) received standard therapy. After the AMR course, a comprehensive examination was performed, including the data of the questionnaires: the ASIA classification (American Spinal Injury Association), the FIM (Functional Independence Measure) scale of functional independence, the modified functional assessment scale of activity and quality of life VFM (Valutazione Funzionale Mielolesi), State-Trait Anxiety Inventory, the Beck depression scale; electroneurophysiological studies on the Neurosoft Neuro-EMG-Micro device, heart rate variability (HRV) on the Neurosoft Poly-Spectrum computer electrocardiograph, indicators of free movement with concentric and eccentric muscle contractions on EN-TreeM.Results: polysympathetic reflex excitability (PRV) significantly decreased in patients of the main group. There was also an improvement in vegetative reactivity (coefficient 30/15 is 1.45; p <0.001) during the orthostatic test, indicating normalization of parasympathetic regulation and heart rate. The assessment on the ASIA scale revealed an improvement in sensory function by 13.4 % and motor function by 17.4 %. On the VFM scale, an increase in indicators was observed by 14.7 % and on the FIM scale by 11.5 %. When assessing the psycho-emotional sphere on the Spielberger-Khanin scale, a significant decrease in the level of reactive anxiety was noted by 10.9 %, and the level of depression by 30.5 %. A significant increase in muscle strength by 18.1 % (p < 0.001) was also observed during concentric contractions, the average power increased by 83.1 % (p < 0.001), the average amplitude increased by 68.7 % (p < 0.001), the average speed by 27.2 % (p=0.002). When analyzing the indicators after the treatment, significant differences were obtained between the main and the comparison group (p < 0.001).Conclusion: the use of biofeedback technologies under the control of electromyography leads to an increase in the effectiveness of medical rehabilitation and improves the quality of life in Paralympians with traumatic spinal cord disease.

Sound stimulation in medical rehabilitation of children with megaureter

This article discusses the issues of medical rehabilitation of children with megaureter. Objective of the study: scientific substantiation of the use of sound stimulation in the medical rehabilitation of children with megaureter. Materials and research methods: clinical observations and special studies were carried out in dynamics in 40 children, aged 1 to 7 years, with megaureter after ureteral surgery. Of these, 20 children made up the main group (received sound stimulation) and 20 children — the comparison group (without physiotherapy). Based on the studies carried out, the inclusion of sound stimulation in medical rehabilitation of children with megaureter has been scientifically substantiated. The inclusion of sound stimulation in the medical rehabilitation program for children with megaureter contributed to a decrease in the activity of inflammation in the renal parenchyma. Medical rehabilitation with the inclusion of physiotherapy technologies had a beneficial effect on the urodynamics of the urinary tract and renal blood flow. The effectiveness of medical rehabilitation with the inclusion of sound stimulation accounted for 80.0%, while in the comparison group (without physiotherapy), it was 60.0%.

Evaluation of the effectiveness of a new physiotherapy technology in the comprehensive medical rehabilitation program for patients recovered from coronavirus pneumonia

Relevance. In the context of the ongoing pandemic of new coronavirus infection, the development and implementation of new methods for medical (pulmonary) rehabilitation of patients is an urgent scientific and practical task. Intention. To assess the effectiveness and substantiate the possibility of using a new physiotherapeutic technology based on bioacoustic stimulation of the respiratory system with high-intensity low-frequency sounds in the comprehensive medical rehabilitation of patients with coronavirus pneumonia. Methodology. A randomized controlled open parallel clinical trial of 28 patients was conducted to assess effectiveness of medical rehabilitation after coronavirus pneumonia. Results and Discussion. Changes in external respiration indicators, psychological status and severity of post-traumatic stress disorders statistically significantly differed in the intervention and control groups before and after the course of rehabilitation. Therefore, bioacoustic stimulation of the respiratory system as part of comprehensive medical rehabilitation program after coronavirus pneumonia significantly increases its effectiveness. Conclusion. Bioacoustic stimulation of the respiratory system with high-intensity low-frequency sounds can be recommended as an effective physical method for inclusion in the comprehensive medical rehabilitation program for patients recovered from coronavirus pneumonia.

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 < 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.

Effect of medical rehabilitation on improvement of quality of life in patients with breast cancer in the early postoperative period

Effect of medical rehabilitation on improvement of quality of life in patients with breast cancer in the early postoperative period

Possibilities of complex rehabilitation of young children with epilepsy and movement disorders

Development of an effective and safe complex for the rehabilitation of young children with epilepsy, accompanied by impaired movement function. The study included 123 young children (from 9 to 24 months) with epilepsy accompanied by impaired motor function. By the method of simple randomization, all patients were divided into 4 groups: 3 main groups and a comparison group. All children of the study groups, except for the comparison group, received medical rehabilitation: in the 1st group - classical massage with the exception of the cervical-collar zone; in the 2nd group - kinesitherapy according to the method of V. Voigt; in the 3rd group - a complex effect, including classical massage with the exclusion of the neck-collar zone and kinesitherapy according to the method of V. Voigt. Children of the comparison group received basic therapy. The effectiveness of medical rehabilitation was analyzed using the Gross motor function classification system (GMFCS) and the Griffiths intellectual development scale. Differences in GMFCS scores before and after medical rehabilitation were statistically significant in group 3. In patients with impaired movement function and suffering from epilepsy, the positive dynamics during complex rehabilitation was more pronounced than when using one isolated technique. Complexity in planning and prescribing a course of rehabilitation determines the greatest efficiency in reducing the deficit of physical activity. With an increase in the index of epileptiform activity according to electroencephalography data without any clinical manifestations, it is not required to cancel rehabilitation measures, it is necessary to strengthen control over the patient.

Modern physiotherapy technologies in medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction

This article discusses the issues of medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction. Objective of the study: scientific substantiation of the use of selective chromotherapy in medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction. Materials and research methods: clinical observations and special studies were carried out in dynamics in 40 children, aged 1 to 7, with megaureter after ureteral surgery. Of these, 20 children made up the main group (received selective chromotherapy, blue spectrum); 20 children — the control group (without physiotherapy). Based on the studies carried out, a beneficial effect of medical rehabilitation with the inclusion of selective chromotherapy in children with megaureter and concomitant neurogenic bladder dysfunction was revealed. The inclusion of selective chromotherapy in the program of medical rehabilitation of children with megaureter contributed to a decrease in the activity of inflammation in the renal parenchyma (decrease in proteinuria, leukocyturia). Selective chromotherapy had a positive effect on the urodynamics of the lower urinary tract (reduction in the number of urgent urges and episodes of urinary incontinence, decreased frequency of urination, improved uroflowmetry indicators). The effectiveness of medical rehabilitation with the inclusion of selective chromotherapy was 80.0 %, while in the control group — 40.0 %.

The effectiveness of the process of restoring the functional status of servicemen who were in the area of the Joint Forces operation

Psychological rehabilitation of combatants is especially relevant today, when the hybrid war in the east of our country has been going on for eight years. The scale of this phenomenon in Ukrainian society requires an active study of the psychological problems of servicemen that have emerged during this time. The aim of the work is to determine the effectiveness of medical rehabilitation of servicemen after being in the combat zone according to the indicators of emotional burnout. A specially designed questionnaire was used to assess the impressions of combat and domestic problems that arise in the military in the area of the Joint Forces Operation (JFO) in relation to the effects of internal and external factors of combatants. To determine the development of chronic fatigue, the method "Diagnosis of emotional burnout" by Boyko V. V. was used. Statistical analysis of the obtained results was carried out with the involvement of methods of parametric and nonparametric statistics, cluster, stepwise multiple correlation and stepwise discriminant analysis using the software package STATISTICA 13.3. Analysis of the obtained data showed that six psychophysiological qualities (Rsl=0.67) were the most related to the parameter of stress load "before" treatment. The list of informative characteristics indicates the high activity of the body of servicemen, the dependence of endurance of their nervous system, the level of concentration and reliability of activity from the received stress. After treatment, the number of informative psychophysiological indicators decreases significantly, and the strength of the connection with stress increases slightly (Rsl=0.78), which indicates the gradual restoration of relevant body functions. It was found that the characteristics of emotions are associated with stress (Rsl=0.52). Before treating these relationships, there are three feelings: "self-dissatisfaction", "caged", "emotional and moral disorientation". After treatment, this connection is slightly reduced along with the elimination of the emotion of "self-dissatisfaction", which characterizes the gradual ordering, systematization of the feelings of the combatant, starting with the relationship to himself. It was found that the average efficiency of 10-day treatment is 16.7 %, which indicates the benefit of restorative procedures. Information technology has been developed that allows to quantify the outcome of treatment, the use of which will allow a meaningful approach to the treatment process, to carry out dynamic control of its results and improve rehabilitation techniques.

Qualification in the field of osteoporosis treatment in doctors working in the field of physical and rehabilitation medicine

Introduction. The special rehabilitation programs are often required for patients with osteoporosis (OP). So physicians working in the field of physical and rehabilitation medicine should be well-versed in this problem.Aims. To study the awareness of doctors of rehabilitation medicine in the field of diagnosis and treatment of osteoporosis and their activity in providing medical care to patients with OP.Materials and methods. A questionnaire survey of 157 doctors (M-34, F-123) of 8 medical specialties working in 27 specialized medical institutions on the profile of “medical rehabilitation” was carried out. The questionnaire for doctors consisted of 21 items of special questions.Results and discussion. In the sample of rehabilitation doctors, 90.45% of the interviewed doctors believed that the problem of OP is relevant for their clinical activities, 100% of the respondents indicated that the presence of OP significantly affects the rehabilitation prognosis and 95.54% - on the degree of effectiveness of medical rehabilitation. According to the respondents, patients with OP make up on average 30.0% [20.0; 50.0] (0-90) of the total flow of patients. Endocrinologists (all surveyed doctors - 100%), obstetricians - gynecologists (66.67%) and therapists (60%) are mainly involved in the treatment of OP. Most often, specialists from rehabilitation institutions recommend zoledronic acid (23.57% of doctors indicated in this aspect), preparations of vitamin D (23.57%) and calcium (14.65%), various methods of physical therapy (14.65%) and parenteral form of ibandronic acid (12.74%).Conclusions. The presence of OP significantly affects the rehabilitation prognosis and the effectiveness of medical rehabilitation. 23.57% of specialists in the field of rehabilitation medicine prescribe treatment for OP to patients, giving preference to parenteral bisphosphonates, vitamin D, calcium and physical exercises.

Clinical analysis of video recordings of the basic motor patterns (CLAVIR) for the assessment of movement disorders in children and adolescents with acute lymphoblastic leukemia

Movement disorders arising in pediatric patients with acute lymphoblastic leukemia (ALL) during treatment require a more differentiated approach to diagnosis and the choice of rehabilitation methods. The aim of this study was to investigate the conceptional structure of supine-to-stand (STS) transition patterns and to develop a method for the diagnosis of movement disorders and the assessment of the effectiveness of medical rehabilitation in children and adolescents with ALL. We carried out a prospective comparative non-randomized study. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation. The study included 184 children who were assigned to three groups. Group 1 (study group) included patients with ALL treated at the Center (n = 48, the median age was 14.0 years). Group 2 (control group) included patients with various serious diseases (acute myeloid leukemia, primary immunodeficiency, CNS malignancies, bone tumors, etc.) who also underwent treatment at the Center (n = 69, the median age was 14.5 years). Group 3 (control group) included healthy children and adolescents (n = 67, the median age was 14.2 years). We analyzed the characteristics of video recordings of the supine-to-stand process in apparently healthy children (Group 3) and in the patients treated at the Center (Groups 1 and 2) and then performed comparative analysis. We managed to detect, document, and divide into phases the video-based criteria of invariant characteristics of the acyclic locomotor pattern of the STS movement (from a supine to standing position with both feet on the floor). We identified the STS movement phases and clinically significant variants of STS transition patterns which were easily detectable on the video recordings. The objectivity of the analysis of the video-based criteria of invariant characteristics of the STS movement was achieved by the registration of timing characteristics of the locomotion pattern phases on video recordings. By calculating the coefficients of variation for observations from different angles and inter-researcher variability, we detected the most representative phases of the STS movement pattern on video recordings. A quantitative analysis of the STS test performance revealed significant differences between healthy controls and children with oncological diseases. The clinical analysis of video recordings of the basic motor patterns (CLAVIR) contributes a substantial amount of objective data to the clinical assessment of the diagnostic supine-to-stand test results in children and adolescents treated for ALL.

The relevance of the diagnosis, treatment and prevention of osteoporosis for the clinical practice of doctors working in the field of rehabilitation and spa medicine

To study the relevance of the OP problem for physicians working in the field of physical and rehabilitation medicine, their awareness of the main methods of diagnosis, treatment and prevention of OP, as well as the frequency of using these methods in daily clinical practice. A cross-type study was carried out using a questionnaire survey. The study included 157 doctors (male 34, female 123) of 8 medical specialties working in 27 specialized medical institutions on the profile of «medical rehabilitation» or «spa treatment». The questionnaire for doctors consisted of 21 items of special questions. 90.45% of doctors considered the problem of OP is relevant for their clinical activities, 100% of respondents indicated that the presence of OP significantly affects the rehabilitation prognosis, 95.54% - the effectiveness of medical rehabilitation. According to the respondents the patients with OP cover 30.0% of total patients flow on average. 145 (92.36%) doctors noted that they know the OP risk factors, 155 (98.73%) - methods for OP diagnosing, 108 (68.79%) - methods for OP treatment, 126 (80, 25%) - methods for OP prevention, 74 (47.13%) - FRAX. 55 (35.01%) respondents identified their level of awareness on the OP problem as sufficient for managing patients with this pathology. Diagnostic procedures for OP were recommended by all interviewed endocrinologists (100%), most of traumatologists-orthopedists (72.73%), obstetricians-gynecologists (66.67%) and cardiologists (64.28%), as well as on average 1/2 (50%) neurologists and therapists. OP treatment was mainly performed by endocrinologists (100%), obstetricians-gynecologists (66.67%) and therapists (60%). 32.48% of physicians in the study sample have ever referred their patients to a densitometry and the diagnosis of OP was established in 80.25% of cases on the basis of bone densitometry data. The problem of OP is relevant for the clinical practice of doctors working in the field of rehabilitation and balneology medicine; the presence of OP significantly affects the prognosis and effectiveness of medical rehabilitation. The results of the study demonstrated the need to expand the availability of OP diagnostics methods in rehabilitation and balneology organizations, as well as the need to raise awareness of the OP problem among specialists working in this area.

The role of functional research of the respiratory system in assessing the effectiveness of rehabilitation of patients after COVID-19

SummaryCOVID-19 is a disease with manifestations ranging from asymptomatic to interstitial pneumonia associated with severe acute respiratory syndrome. The aim of the study isto assess the dynamics of the parameters of the pulmo-nary functional tests (PFTs), dyspnea, quality of life in the process of medical rehabilitation (MR) in the early recov-ery period after COVID-19. Materials and methods. An observational descriptive study was performed. 30 pa-tients were examined, median age 46 years, males (90%). The median of computed tomography (CT) abnormalities in the acute period was 52.5%. Before MR most patients had post-inflammatorychanges in the lungs. The medians of primary PFTs including spirometry, body plethysmog-raphy, diffusion test 15 days after discharge from hospital. The severity of dyspnea (mMRC) and qua lity of life (QoL, EQ-VAS) were also evaluated. Individual MR programs were designed taking into accountcase history, clinical picture, PFTs data. Results. Before MR, on average, all PFTs parameters were within the normal range, except for impaired lung diffusion capacity (83% of cases). 12 (40%) had restrictive, 3 (10%) — obstructive, and 1 — mixed type of ventilation disorders. The severity of dyspnea was 1–2, QoL was reduced. After MR, a statistically significant increase in SVC, FVC, FEV1, FEV1/SVC, МMEF25–75%, transfer factor CO (DLCO) and alveolar volume (VA) was revealed. The average increase in SVC, FVC, FEV1, DLCO and VA was 4.5% (150 ml), 6,4% (270 ml), 7% (323 ml), 5.5% (1.7 ml/min/mmHg) and 5.8% (380 ml), respectively. There was also a statistically significant reduction in dyspnea, and an improvement in QoL. Conclusion. Improvement in lung function, reduction of dyspnea, improvement in QoL indi-cates the effectiveness of MR after COVID-19

EFFECT OF PHYSICAL EXERCISES WITH RESPIRATORY SIMULATORS ON CLINICAL AND FUNCTIONAL INDICATORS IN PATIENTS WITH BRONCHOPULMONARY AND CEREBROVASCULAR PATHOLOGY

Aim. The paper aims to evaluate the effectiveness of respiratory training as part of a comprehensive spa and medical rehabilitation. Materials and methods. Studies were performed in 90 patients with bronchial asthma and 60 patients with chronic cerebral ischemia. During physical training, New Breath breathing simulators were used. The effectiveness of medical rehabilitation was evaluated according to the severity of impaired body functions related to the corresponding domains of the International Classification of Functioning, Disability and Health. Results. Under rehabilitation, the condition of patients in both groups improved significantly, systemic rehabilitation effects in the form of improved indicators of the blood system and its oxygen transport functions, as well as increased reserves for handling stress and other psychological demands were notified. Conclusion. The study suggests the inclusion of physical exercises with the New Breath simulator in the comprehensive rehabilitation of patients with chronic cerebral ischemia and obstructive diseases of the respiratory system.

Complex medical rehabilitation of adolescents with dentoalveolar pathology in orthodontic treatment

The purpose of the study is to increase the effectiveness of medical rehabilitation of adolescents with dentoalveolar pathology in orthodontic treatment based on the inclusion of florentine waters, therapeutic physical exercise according to the craniovertebral method, and osteopathic craniosacral therapy in rehabilitation regimens. Material and methods. There have been observed 106 adolescents with dentoalveolar pathology on orthodontic treatment. They were distributed into 3 groups by simple randomization: in the main group 2, the patients received gum irrigation with fir extract florentine water, physical therapy exercises (PTE) according to the craniovertebral method and osteopathic craniosacral therapy in combination with the standard therapy; in the main group 1, the patients were prescribed gum irrigation with fir extract florentine water and PTE according to the craniovertebral method in combination with standard therapy; in the group of comparison, the patients had only irrigation of the gums with fir extract florentine water in combination with standard therapy. Results. In the main group 2, 83,1 % of cases noted levelling of clinical manifestations 6 months later, and 97.9 % — 18–20 months later, while the patients who received irrigation with fir extract florentine water (FW) in combination with standard therapy and PTE according to the craniovertebral method had an improvement in 63,5 % and 85.0 % of cases; when using only irrigations with fir extract FW against the background of standard therapy there was an improvement in 49.4 % and 78.1 % of cases; the reduction of the total number of functional disorders and stabilization of the statokinetic system within 6 months were improved by 1,81 (p < 0.01), and after 18–20 months — 2,61 (p < 0,01) times, while using irrigations with fir extract FW against the background of standard therapy and PTE according to the craniovertebral method, the improvement was by 1,38 (p < 0,01) and 1,69 (p < 0,01) times; when using only irrigations with fir extract FW against the background of standard therapy — by 1,27 (p < 0,05) and 1,73 (p < 0,01) times, respectively, which, with a high degree of reliability, has correlated with the improved dental, physical, and mental health. Conclusion. The developed technology of medical rehabilitation of adolescents using florentine waters, therapeutic physical exercises according to the craniovertebral technique and osteopathic craniosacral therapy is viable and pathogenetically justified.

Complex Application of Laser Radiation and Interference Currents in Medical Rehabilitation of Children with Neurogenic Dysfunction of the Bladder

The article is devoted to the medical rehabilitation of children with neurogenic bladder dysfunction. Medical rehabilitation of children with neurogenic bladder dysfunction includes behavioral therapy, medication, biofeedback, and physical therapy. The popularity of physiotherapy methods is explained by the influence on the main links of pathogenesis, the absence of side effects and the possibility of use in young children. The aim of the study was to study the effectiveness of complex application of laser radiation and interference currents in the medical rehabilitation of children with PDMP. Materials and methods. Clinical observations and special studies were conducted in 40 children with hyperactive bladder aged 3 to 10 years. The main group consisted of 20 children who received laser therapy and interference currents, 20-a comparison group (without physical therapy). Results. Positive dynamics was observed by the middle of the course of medical rehabilitation, a third of patients showed a decrease in urgency and urgent urinary incontinence, there was a tendency to normalize the number of urinations per day, by the end of the course of medical rehabilitation, the dynamics of clinical symptoms was more pronounced and reliable. The favorable influence of interference currents and laser radiation on the clinical course of neurogenic bladder dysfunction, the state of urodynamics and speed characteristics of the act of urination was revealed. The feasibility of including interference currents and laser radiation in the medical rehabilitation of children with neurogenic bladder dysfunction is scientifically proved. Conclusion. Medical rehabilitation of children with neurogenic bladder dysfunction with the inclusion of laser radiation and interference currents has a favorable effect on the symptoms of hyperactivity of the bladder, indicators of uroflowmetry, cystometry and helps restore the normal rhythm of urination. As a result of the research, the effectiveness of medical rehabilitation with the inclusion of laser radiation and interference currents was 85.0 %, in the comparison group only 60.0 % (p < 0.05).

ВЛИЯНИЕ СЕЗОНОВ НА ЭФФЕКТИВНОСТЬ САНАТОРНО-КУРОРТНОЙ МЕДИЦИНСКОЙ РЕАБИЛИТАЦИИ ПАЦИЕНТОВ С ЦЕРЕБРАЛЬНЫМ АТЕРОСКЛЕРОЗОМ

The purpose of the work is to identify the dependence of the effectiveness of medical rehabilitation (MR) of patients with cerebral atherosclerosis (CA) on the seasons at the Southern coast of Crimea (SCC). Materials and methods. A prospective, single-center clinical trial in 216 patients with CA. Assessment of the effectiveness of MR was carried out in accordance with the "International Classification of Functioning, Disability and Health" (ICF). Results. As a result of MR, the level of violations of all controlled functions (on average for all ICF domains) was reduced by 28-35% in different seasons of the year, which indicates the high efficiency of the year-round integrated health resort MR at the SCC. Findings. The effectiveness of MR in patients with CA is quite high in all seasons of the year, which testifies to the validity of indications for referring patients to the SCC health resorts throughout the year.

Medical rehabilitation in the combination treatment of rheumatic diseases: a review

Medical rehabilitation is a set of non-drug methods aimed at reducing pain and functional disorders, restoring working ability, social activity, and mental stability in patients. This is a necessary part of treatment in patients with rheumatic diseases, which is as important as pharmacotherapy in many cases (for example, osteoarthritis, chronic nonspecific back pain, and spondyloarthritis). Unfortunately, many Russian physicians underestimate the possibilities of nondrug approaches, referring to the fact that the effectiveness of medical rehabilitation and physiotherapy methods have not been evaluated during clinical trials and their therapeutic significance has passed no serious test in the context of evidence-based medicine. This is not entirely true. This review presents data from a large number of clinical trials and related meta-analyses of studies evaluating the efficiency of the most commonly used medical rehabilitation techniques: cryotherapy, laser therapy, magnetotherapy, ultrasound therapy, percutaneous electroneuromyostimulation, acupuncture, manual therapy, massage, and therapeutic exercises.

THE PROSPECTS FOR THE FURTHER DEVELOPMENT OF THE ROBOTIC MANIPULATION MECHANOTHERAPEUTIC COMPLEXES

The ongoing active development of robotics in the framework of the new economic paradigm known as «the 4th technological revolution» opens up new possibilities for the progress in various disciplines including medicine. The further improvement and clinical application of robotic manipulation mechanotherapeutic complexes are among the major priorities for the Russian public healthcare system. The article represents the characteristics of the Russian robotic manipulator prototype designed to enhance the effectiveness of medical rehabilitation, develop various options of the robotic situational behavior, and specify the topical issues as regards the improvement of the manipulation robotic systems that require the effective solutions and actions. The prospects for the formation of the basic principles of new specialty «massage programmer» are outlined based on the above considerations.

Determining factors of the effectiveness of medical rehabilitation of patients with autoimmune thyroiditis

Determining factors of the effectiveness of medical rehabilitation of patients with autoimmune thyroiditis