Therapeutic Physical Factors Research Articles

Correction of immune disorders under the influence of pharmacotherapy and extracorporeal magnetic stimulation with patients after surgical treatment of prostate adenoma

BACKGROUND: The course of benign prostatic hyperplasia is associated with immunological disorders at the systemic and local level. Despite the wide arsenal of pharmacological agents for the treatment of benign prostatic hyperplasia, some patients undergo surgical treatment. Postoperative management programmes should be aimed at reducing the risks of complications, including infectious-inflammatory complications. In this regard, the inclusion of immunomodulatory pharmacotherapy and therapeutic physical factors in the course of reconstructive treatment is reasonable and justified. AIM: To study the role of the complex effect of pharmacotherapy and extracorporeal magnetic stimulation in the correction of immune disorders with the patients after surgical treatment of benign prostatic hyperplasia. MATERIALS AND METHODS: There have been observed 88 patients after surgical treatment of benign prostatic hyperplasia, who underwent a medical rehabilitation at stages II and III. At stage II 43 patients in the comparison group underwent standardized drug therapy, individual exercise therapy; in the main group 45 patients additionally were prescribed immunomodulatory therapy with Tameritis. At stage III the patients of the comparison group continued pharmacotherapy, exercise therapy, and transrectal magnetic therapy; in the main group 45 patients were additionally prescribed extracorporeal magnetic stimulation. A method of enzyme-linked immunosorbent assay was used to study the content of interleukins (IL); IPSS-QOL (International Prostate Symptom Score – Quality-of-Life) and SF-36 (The Short Form-36) were used to assess the quality of life. Confidence level (р) 0.05. RESULTS: After the second inpatient stage of rehabilitation the patients of the main group after surgical treatment of benign prostatic hyperplasia had a decrease the level of pro-inflammatory IL by 47.5% on average (p 0.01) with an increase in the level of anti-inflammatory IL-10 by 36.2% (p 0.01). After the III outpatient rehabilitation stage, a positive dynamics significantly increased and amounted to 63.2% (p 0.01) and 51.9% (p 0.01), reaching the normative values in the population. It should be noted that the achieved results have been preserved in a long time. In the comparison group the positive dynamics was significantly lower (p 0.05; p 0.01) in all the cases after the II and III stages of rehabilitation. The patients of the main group were observed a decrease in the severity of urinary disorders (p 0.01), restoration of quality of life (p 0.05) according to IPSS-QOL and SF-36 questionnaires at significant inter-group values (p 0.05) with the same confidence. CONCLUSION: The integrated use of pharmacotherapy and extracorporeal magnetic stimulation with the patients after surgical treatment of benign prostatic hyperplasia provides significant correction of immune disorders, restoration of physical and mental health.

The effectiveness of using mesodiencephalic modulation in combination with ozone therapy in patients with peri-implantitis according to long-term results of the study

BACKGROUND: Evaluation of the clinical effectiveness of the use of various treatment regimens for peri-implantitis should take into account not only the immediate results achieved during treatment, but also the manifestations of the disease in the long-term period. AIM: Assessment of the effectiveness of the integrated use of mesodiencephalic modulation (MDM therapy) and ozone therapy in patients with dental peri-implantitis based on long-term results of the study. MATERIALS AND METHODS: The study was carried out with the participation of 116 patients with peri-implantitis of classes I and II according to S.A. Jovanovic. Using the fixed randomization method, all patients were divided into 4 groups based on the results of generating random numbers obtained using a computer program. Patients of the first group (control group, n=28) received standard dental therapy, including professional oral hygiene and local use of antiseptics. Patients of the second group (comparison group 1; n=29) received a course of ozone therapy in addition to standard dental therapy, for which the periimplant area was irrigated with ozonated saline solution with an ozone concentration of 2.5–5.5 μg/ml for 15 minutes. Patients of the third group (comparison group 2; n=30) received a course of MDM therapy in addition to standard dental therapy. In the fourth group (main group; n=29), patients, along with standard dental therapy, received a course of complex physiotherapy in the form of a combination of ozone and MDM therapy. Long-term results of complex therapy for peri-implantitis were assessed 6 and 12 months after the end of treatment. RESULTS: A comparative assessment of dental indices in the long-term period showed that the addition of SST with a course of physiotherapeutic effects, in general, is accompanied by the preservation of the effect achieved after the end of treatment. At the same time, the best results were noted in the main group with the combined use of ozone and MDM therapy. Changes in the osseointegration index also indicated the preservation of the values achieved after the end of therapy, and in the main group a significant increase in this parameter was observed, which indicated additional activation of osseointegration processes under the influence of the physiotherapeutic complex. CONCLUSION: The results of the performed follow-up study convincingly prove the advantages of the additional use of therapeutic physical factors (MDM therapy, ozone therapy and their combination).

The influence of a course of complex application of supravenous laser irradiation of blood and phototherapy on indicators of the neurohormonal status of patients with true eczema

BACKGROUND: In the pathogenesis of true eczema, an important place is occupied by stress, under the influence of which stimulation of the hypothalamus and brain stem occurs, as well as activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Stress-induced secretion of neurotransmitters impairs the barrier function of the epidermis, slows wound healing, increases itching and inflammation, and suppresses immunity by changing the immune response of T-helper cells. AIM: Assessment of the severity of the corrective effect of a course of application of supravenous laser irradiation of blood and broadband medium-wave phototherapy on the blood levels of adrenocorticotropin, cortisol and beta-endorphin in patients with true eczema with a moderate form of the course. MATERIALS AND METHODS: The study was carried out with the participation of 120 patients with a moderate form of true eczema. Using simple fixed randomization, all patients were divided into 4 groups. The first group (control, n=30) received only basic drug therapy, including the use of detoxification, hyposensitizing, antihistamines and topical glucocorticosteroids. Patients of the second group (comparison group 1, n=30) additionally underwent a course of supravenous laser irradiation of blood. In the third group (comparison group 2, n=30), broadband medium-wave phototherapy was performed against the background of basic therapy. Patients of the fourth group (main group, n=30) in addition to basic therapy received a course of combined exposure to supravenous laser blood irradiation and phototherapy. The concentrations of adrenocorticotropin, cortisol and beta-endorphin were determined in the blood of patients twice (before the start of treatment and 1 month after the start of therapy) using ELISA. The clinical condition of patients in the groups was assessed by changes in the EASI index. Additionally, we studied the dynamics of the level of reactive and personal anxiety using the Spielberger–Khanin questionnaire. RESULTS: Positive dynamics of adrenocorticotropin, cortisol and beta-endorphin were noted only in the comparison groups and the main group, which proves the high efficiency of correction of the neurohumoral status of patients through a course of complex use of supravenous laser blood irradiation and broadband mid-wave phototherapy. Quantitative changes in the assessed parameters during complex therapy with therapeutic physical factors indicate a supra-additive version of their interaction, realized through different modalities, points of application and mechanisms for realizing the biological potential of physiotherapeutic effects. CONCLUSION: The results obtained convincingly prove the effectiveness of an additional course of use of supravenous laser irradiation of blood in combination with broadband medium-wave phototherapy when correcting the neuroendocrine status in patients with true eczema. The close correlation between neurohumoral indicators and clinical and psychological patterns of the disease proves the pathogenetic significance of the studied neuroendocrine indicators, which allows us to consider their dynamics as informative criteria for the effectiveness of the treatment.

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

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.

Higher therapeutic potential following complex application of therapeutic physical factors in patients with chronic rhinosinusitis and nasal polyps

Higher therapeutic potential following complex application of therapeutic physical factors in patients with chronic rhinosinusitis and nasal polyps

A personalized application of therapeutic physical factors in patients with metabolic syndrome

A personalized application of therapeutic physical factors in patients with metabolic syndrome

Development of adaptive reactions when applying drinking mineral water and electromagnetic radiation against the background of a high-calorie diet on the model of experimental metabolic syndrome

To identify features of development of adaptive protective reactions when applying drinking sulfate mineral water (MW) and low-intensity electromagnetic radiation of extremely high frequency (EMR EHF) against the background of a high-calorie diet and after its elimination at an early stage of development of experimental metabolic syndrome. Experiments were conducted on 40 non-linear male rats with 200-220 g. weight. The model of metabolic syndrome was reproduced for 60 days. All animals were divided into 5 groups: 2 study groups, 2 control groups and 1 intact one. Rats of the 1st study group were given sulfate MW in combination with EMR EHF against the background of a high-calorie diet, controlled by rats receiving only a high-energy diet. Rats of the 2nd study group also received sulfate MW in combination with EMR EHF but when the metabolic syndrome simulation was finished and the high-calorie diet was eliminated, control was done by rats that were given standard food after eliminating the high-energy diet. Liver, testes and blood were objects of the study. Light-optical, morphometric methods of examination and electron microscopy were used. The use of sulfate MW in combination with EMR EHF against the background of the high-calorie diet was the most cause of increased activity of the antioxidant system and the plastic processes were weaker; the activation of natural adaptive reactions was noted after the elimination of the diet that in combination with actions of MW and EMR EHF led to the further intensification of protein synthesis (RNA, DNA, total protein), intensification of cellular and intracellular regeneration processes. The identified adaptive shifts during the action of the studied factors were caused by their antioxidant, membrane stabilizing and detoxifying actions. The results of the study can be used to develop the problem of regulating adaptive reactions with the application of therapeutic physical factors and to create new highly effective methods of preventing and treating metabolic syndrome.

Evaluation of the effectiveness of complex medical rehabilitation of patients with polyposis rhinosinusitis associated with atopic dermatitis using ICF

BACKGROUND: In medical rehabilitation of patients with polyposis rhinosinusitis, aimed at solving the urgent strategic task of public health care to achieve and maintain an optimal level of functioning of persons suffering from partial disability through the development of effective methods of restoration of impaired functions and prevention of complications, there is a need to adequately assess the effectiveness of the measures taken. In this regard, it should be noted that the International Classification of Functioning, Disability and Health (ICF) serves as the gold standard for assessing the patient's quality of life and the effectiveness of rehabilitation measures. The category of human functioning acts as a system-forming basis and starting point of the patient's rehabilitation process in the ICF. In practice, the ICF is based on the biopsychosocial model of health (disease) assessment, which considers psychological and social factors of health (disease) and biological disorders in close interrelated unity. AIM: To evaluate the effectiveness of complex medical rehabilitation of patients with polyposis rhinosinusitis associated with atopic dermatitis using dynamic changes in the main domains of the ICF. MATERIALS AND METHODS: The study was performed with 89 patients with polyposis rhinosinusitis associated with atopic dermatitis. All patients were divided into 4 groups by simple fixed randomisation. The first group (control, n=22) received only basic therapy, including endonasal application of nasonex 2 doses 2 times a day, daily twice daily washing of the nasal mucosa, as well as the use of desensitising (antihistamines, topical glucocorticoids and moisturising and emollient agents) and detoxifying agents. Patients in the second group (comparison group 1, n=22) were additionally subcutaneously administered dupilumab at a dose of 300 mcg once a fortnight. In the third group (comparison group 2, n=23) against the background of dupilumab administration the combined effect of alternating magnetic field and low-intensity laser radiation of red spectrum was performed. Patients of the fourth group (the main group, n=22) received a course of phototherapy in addition to the scope of treatment of patients of the third group. The results of medical rehabilitation of patients with polyposis rhinosinusitis associated with atopic dermatitis were evaluated according to the dynamics of specialised categories of ICF, which most accurately characterise the patient's condition from the perspective of the biopsychosocial model of the disease. RESULTS: Changes in the estimated parameters of ICF at comparable initial values had different character and were determined by the scheme of medical rehabilitation. Minimal changes were recorded in the control group. The use of dupilumab was accompanied by positive dynamics of the parameters after 1 month with a significant increase in the shifts after 6 months, indicating the recovery of a number of mental and physical functions, as well as the ICF categories characterising the organism structures, activity and participation of the patient. Supplementation of biological therapy with course magnetolaser influence was accompanied by an increase in positive changes, which were confirmed in 6 months after rehabilitation. The maximum dynamics of the considered ICF categories was noted in the 4th group, where dupilumab administration was supplemented with complex use of therapeutic physical factors. CONCLUSION: The obtained results prove the high informativeness of the system approach realised with the help of ICF in assessing the effectiveness of medical rehabilitation measures. The comparative evaluation of rehabilitation results convincingly showed the advantages of the complex programme including dupilumab target therapy in combination with physiotherapeutic effects.

The influence of therapeutic physical factors on the dynamics of the clinical condition and quality of life of patients with peri-implantitis

BACKGROUND: The use of dental implants, being the gold standard in the dental rehabilitation of edentulous patients, is often accompanied by the development of inflammatory complications leading to loss of the implant. Common methods in dental practice for the prevention and treatment of peri-implantitis based on local antiseptic and antibacterial drugs and periodic measures of professional oral hygiene are limited and do not contribute to solving the existing problem.
 AIM: Assessment of the clinical effectiveness and dynamics of the quality of life of patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination.
 MATERIALS AND METHODS: the study was carried out with the participation of 116 patients with peri-implantitis of classes I and II according to S.A. Jovanovic. All patients were divided into 4 groups using simple fixed randomization. The first group (control; n=28) received standard dental therapy, including professional oral hygiene and local use of antiseptics. In the second group (comparison group 1; n=29), in addition to standard therapy, a course of ozone therapy was performed, for which the peri-implant area was irrigated with ozonated saline solution with an ozone concentration of 2.5–5.5 μg/ml for 15 minutes. In the third group (comparison group 2; n=30), standard treatment was supplemented with a course of MDM therapy. Patients of the fourth group (main group; n=29), along with standard treatment, received complex treatment, including a course of ozone therapy and MDM therapy. The results were assessed after the end of therapy based on the dynamics of dental indices, the osseointegration parameter of the implant and the level of quality of life of the patients.
 RESULTS: A course of use of various treatment regimens was accompanied by a significant improvement in the clinical and dental status of patients, but the severity of the effect was different in the groups. To a lesser extent, positive changes were identified in the control group. Additional course use of therapeutic physical factors (ozone and MDM therapy) was accompanied by a significant increase in regression of complaints and improvement in objective indicators of dental status. Achieving the maximum positive result was clearly evident in the main group with the complex use of the studied physiotherapeutic factors. The use of the correlation adaptometry method to assess the clinical effectiveness of various treatment regimens for peri-implantitis made it possible to establish that under the influence of the integrated use of ozone and MDM therapy, the most pronounced decrease in mutual correlations between the studied parameters is observed. This indicates an increase in functional reserves and adaptive capabilities of patients in the main group.
 CONCLUSION: the results obtained convincingly prove the high effectiveness of the complex use of therapeutic physical factors in the implementation of a therapeutic strategy aimed at eliminating inflammatory manifestations in the area of dental implants and improving the quality of life of patients.

Informativity of the method of correlation adaptometry for assessing the severity of the corrective effect of combined use therapeutic physical factors on the example of metabolic syndrome

BACKGROUND: Evaluation of the effectiveness of the use of therapeutic physical factors using the method of correlation adaptometry is based on the effect of increasing the number of severity of correlation dependencies between the parameters characterizing the functional state of the body under the action of a stressor.
 AIM: Evaluation of the effectiveness of the combined use of transcranial magnetotherapy and a pulsed low-frequency electrostatic field in patients with metabolic syndrome using the method of correlation adaptometry.
 MATERIALS AND METHODS: The study involved 100 patients with a diagnosis of metabolic syndrome established in accordance with clinical guidelines. All patients were divided into four groups of 25 by simple fixed randomization. Patients in the control group received a placebo effect (imitation of physiotherapeutic effects with the device turned off) for 10 days of observation, in comparison group 1 ― exposure to a low-frequency electrostatic field, in comparison group 2 ― transcranial magnetotherapy with a traveling magnetic field, in the main group ― exposure to a pulsed electrostatic field in combination with transcranial magnetotherapy. The objectification of the effects of physiotherapy (evaluation of functional, biochemical and hormonal parameters) was based on a two-stage examination (before and after a course of treatment).
 RESULTS: Correlation adaptometry was based on the results of correlation analysis using a correlation matrix of variables characterizing the condition of patients after course correction. For each of the four groups of patients, 28 correlation coefficients were determined. For each group, 378 correlation coefficients were calculated, presented as the weight of the correlation graph. Additionally, the indicator of the average adaptive correlation was calculated. It is shown that the use of therapeutic physical factors is accompanied by a decrease in the weight of the correlation graph, which indicates the severity of the clinical effect due to the sanogenetic action of physiofactors. The most pronounced decrease was noted in the group of combined physiotherapy. Correlation analysis between the parameters of the average adaptive correlation and the integral coefficient of therapy efficiency showed that there is a strong, negative significant relationship between the HOMA insulin resistance index and the Quetelet index, chosen as the most informative variables.
 CONCLUSION: It is concluded that the method of correlation adaptometry is highly informative in assessing the effectiveness of using a pulsed low-frequency electrostatic field, transcranial magnetotherapy and their combined effects in patients with metabolic syndrome. A decrease in the indicator of the average adaptive correlation indicates an increase in the functional reserves of the system, the patterns of which are changes in certain estimated parameters that are not related to each other.

Comparative assessment of clinical efficacy of different methods of medical rehabilitation in patients with rhinosinusitis polyposa

The article presents the results of a comparative assessment of the effectiveness of the course application of therapeutic physical factors (alternating magnetic field and low-intensity laser radiation) in complex medical rehabilitation of patients with moderate and severe rhinosinusitis polyposa with uncontrolled course. It was shown that the use of genetically engineered biological therapy (GEBT) with dupilumab contributed to the positive dynamics of the clinical parameters of sinonasal polyposis. Complementing GEBT with the course application of an alternating magnetic field was accompanied by an increase in the regression of the main clinical manifestations of rhinosinusitis polyposa. The maximum corrective activity was noted in the group with the complex use of therapeutic physical factors — an alternating magnetic field and low-intensity laser radiation against the background of GEBT. The growth is based on the ability of the complex use of physiotherapeutic factors to cause the development of synergistic phenomena through the use of corrective effects of different modality, having different mechanisms of action. The physical factors under consideration are able to improve hemo- and microcirculation in the area of chronic inflammation, exhibit anti-inflammatory, analgesic, and trophic-stimulating effects, which, together with the inactivation of the main pro-inflammatory interleukins of type 2 inflammation, enhances the sanogenetic potential that determines the duration of remission. Taking into account the chronic relapsing nature of the rhinosinusitis polyposa course, it is planned to conduct prolonged studies covering a follow-up period of 1.5–2 years.

Predictors of effectiveness in the implementation of personalized use of therapeutic physical factors in patients with metabolic syndrome

BACKGROUND: A personalized approach to the use of therapeutic physical factors should take into account individual predictor biomarkers, which are predictive information regarding the effectiveness of the treatment, taking into account the initial state of the patient's reserve capabilities. The metabolic syndrome was defined as a model of a pathological condition characterized by reduced functional reserves. Previous studies have shown that transcranial magnetotherapy (TMT) and pulsed low-frequency exposure to an electrostatic field (INESP) have potential effectiveness in relation to the pathogenetic manifestations of the metabolic syndrome.
 AIM: The purpose of the study is to determine the predictors of effectiveness in the implementation of personalized combined use of TMT and INESP in patients with metabolic syndrome.
 MATERIALS AND METHODS: The study involved 100 patients with a diagnosis of metabolic syndrome established in accordance with clinical guidelines. All patients were divided into four groups of 25 by simple fixed randomization. The first group (control) received a placebo effect (imitation of physiotherapeutic effects with the device turned off) for 10 days of observation. Patients of the second group (comparison group 1) were exposed to a low frequency electrostatic field (INESP). The third group (comparison group 2) received transcranial magnetic therapy with a traveling magnetic field (TMT). Patients of the fourth group (main) were subjected to a combined effect of INESP and TMT. All patients before and after a course of physiotherapy underwent a comprehensive examination using functional, biochemical and hormonal methods. Statistical processing of the obtained results was carried out using the Statistica 12.6 software package using the algorithms of correlation and regression analyses.
 RESULTS: The analysis performed using the multiple regression algorithm made it possible to identify a cluster of independent variables in the form of an autonomic balance index, microcirculation index, body mass index and catalase activity, determined in the initial value of patients. The high efficiency of the combined use of TMT and INESP is achieved with a probability of at least 95% in patients with metabolic syndrome, the initial state of which is characterized by a level of the autonomic balance index below 1.7 conventional units. units, tissue perfusion parameter more than 14 perf. units, BMI value below 29 c.u. units and catalase activity above 90 units. аct. The results of the verification of the constructed information model convincingly prove its adequacy and objectively confirm compliance with the stated forecast requirements.
 CONCLUSION: It is concluded that the identified constellation of phenotypic patterns, which characterizes the state of the pathological process, reflects the main pathogenetic mechanisms that determine the severity of clinical and functional manifestations of metabolic syndrome. Evaluation of the initial values of the autonomic balance index, microcirculation index, body mass index and catalase activity in patients with metabolic syndrome makes it possible to predict the expected effectiveness of the course combined use of TMT and INESP.

Therapeutic physical factors in treatment programs for patients with chronic pancreatitis

The purpose of the study is to study the effectiveness and safety of using therapeutic physical factors in rehabilitation treatment of patients with chronic pancreatitis in hospitals. Material and methods. There has been carried out an open randomized controlled trial which included 95 patients with chronic biliary pancreatitis of stage II-III, moderate severity, in the stage of exacerbation, not requiring surgical treatment. Two groups were formed by simple randomization. The patients of the control group (n = 46) had stationary treatment in accordance with Russian clinical guidelines; in the main group (n = 49) the patients were prescribed low-mineralized mineral water in the form of ingestion and electrophoretics according to the mitigated methods in addition to the treatment complex. Results. The inclusion of low-mineralized sulphate-hydrocarbonate calcium-sodium mineral waters in the treatment complex of patients with chronic pancreatitis in hospitals, their ability to enhance pharmacological potential of the used drugs at the stationary stage provided a significant reduction of clinical and ultrasound indicators with 76.56% of the patients at reduction of pain syndrome in 3.56 (p < 0.01) times, diarrhea - 1.94 (p < 0.01), decrease in enzymatic activity - 3.16 (p < 0.01), acute-phase blood values - in 3.14 (p < 0.01), improvement of metabolic status - in 2.29 (p < 0.01) times. This helped to reduce the length of stay in a 24-hour hospital by 2.7 days, reliably significant in comparison with the data in the control group based on the treatment in accordance with Russian clinical recommendations. In addition, a comparable number of adverse drug reactions were detected in both groups (8.13% verses 10.63%), which indicates equal safety of the used medical technologies. Conclusion. Inclusion of therapeutic physical factors in the complex of treatment of patients with chronic pancreatitis in hospitals provides reliably significant increase of therapeutic measures effectiveness.

Therapeutic physical factors in chronic inflammatory diseases of the pelvic organs. (A wounded home-controlled study)

In case of chronic inflammatory diseases of the pelvic organs (CID) in women, it is advisable to use therapeutic physical factors that have a sanogenetic effect in rehabilitation treatment programs. To study the effectiveness of complex restorative treatment of patients with chronic salpingoophoritis with the consistent use of therapeutic physical factors. The study included 96 patients with chronic salpingoophoritis at the age of 18 to 49 years. Two groups were formed by a simple sampling method: in the main group (MG/n=44), against the background of standardized treatment in inpatient conditions, patients received intravaginal ultrasound therapy, in non-hospital settings - interference therapy; in the control group (CG/n=41) - women received only standardized therapy. The criteria for the effectiveness of treatment were: determination of markers of pain and inflammation; ultrasound examination of the ovarian arteries with their Doppler measurements; assessment of quality of life criteria. Comprehensive restorative treatment of patients with chronic salpingoophoritis with sequential use of curative physical factors (CPF), according to direct and long-term observations, provides a significant reduction in pain intensity (p<0.01), inflammation (p<0.01), peripheral blood flow (p<0.01), physical and mental health (p<0.01). The implementation of a new developed method of restorative treatment of patients with chronic salpingoophoritis with sequential use of CPF provided a significant increase of 10-12% in the effectiveness of therapeutic measures in comparison with standardized therapy (p<0.05-<0.01).

Modern Approaches to the Application of Therapeutic Physical Factors in Physiotherapy and Balneology

Modern Approaches to the Application of Therapeutic Physical Factors in Physiotherapy and Balneology

Drinking Mineral Water and Low-Intensity Electromagnetic Radiation Combinational Effect on Rat Testes in Metabolic Syndrome: а Randomized Controlled Study

INTRODUCTION. To correct disorders in the male reproductive system organs in the metabolic syndrome, it seems reasonable to use a combined effect of natural and artificial therapeutic physical factors – drinking mineral water and low-intensity electromagnetic interference of ultrahigh frequency – on an experimental model of this disease. These factors have antioxidant, cytoprotective and regenerative effects and can have a wide range of effects on various adaptation and protective regulatory mechanisms. AIM. To reveal the development of metabolic and structural adaptation-protective reactions in rat testes under the combined effect of drinking sulphate mineral water and low-intensity electromagnetic radiation microwave in experimental simulation of metabolic syndrome. MATERIAL AND METHODS. The experiments were performed on 26 nonlinear male rats weighing 180-200g. The metabolic syndrome model was reproduced for 60 days using a high-caloric diet. The rats were divided into 3 groups: 1st (experimental)-rats received drinking sulfate mineral water in combination with microwave electromagnetic radiation against the background of a high-calorie diet; 2nd (control) – rats received only a high-calorie diet; 3rd (intact) – rats without any influences. Research methods: biochemical, lightoptical, morphometric, electron microscopy. Significance of differences was assessed by Student's t-test. RESULTS AND DISCUSSION. It was found that the combinational effect of drinking sulfate mineral water and low-intensity electromagnetic radiation microwave contributed to the enhancement of a number of adaptive and protective reactions in the testes of rats against the background of a high-caloric diet. They were mainly manifested in the activation of antioxidant protection and protein synthesis, improvement of spermatogenic cells differentiation processes and increase in their number, enhancement of cellular and intracellular regeneration. CONCLUSION. The data obtained can be used in the development of new approaches to the methods of adaptation-protective and compensatory-restorative processes enhancement in the organs of the male reproductive system in metabolic syndrome.

Dynamic electric neurostimulation in the cognitive rehabilitation of patients in the early recovery period of ischemic stroke

BACKGROUND: Post-stroke cognitive impairments negatively affect the results of rehabilitation, worsening the outcomes of motor functions recovery, daily activity, and also increase the likelihood of recurrent stroke and premature death. Therapeutic physical factors contribute to the activation of the body's reserve capabilities and aim at correcting metabolic and vascular disorders, improving the functional status of the nervous system, which allows them to be used in a complex of rehabilitation measures.&#x0D; AIM: to substantiate the use of dynamic electric neurostimulation in the correction of cognitive impairment in patients in the early recovery period of ischemic stroke.&#x0D; MATERIALS AND METHODS: A prospective cohort study of 60 patients in the early recovery period of ischemic stroke, with mild and moderate cognitive impairment, at an average age of 62.44.5 years, divided by random sampling into 3 groups: group 1 (n=25), in addition to the basic rehabilitation complex, which included medication, sessions with a neuropsychologist, massage and physical exercise therapy, received a 15-day course of dynamic electric neurostimulation from the "Neurodance-PCM" device; group 2 (n=20) received the basic rehabilitation complex and procedures from the placebo device similar to procedures on "Neurodance-PCM"; group 3 (n=15) received only the basic rehabilitation treatment. All patients underwent an assessment of cognitive status using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB) and the study of psychophysiological status on the psycho-physiological tester "NS-Psychotest", using the following tests: tapping test, the SchultePlatonov tables with red-black cells, test of simple visual-motor reaction, reaction to a moving object test.&#x0D; RESULTS: Over the two-week rehabilitation, it was found that the inclusion of dynamic electrical stimulation, in addition to the standard therapy of cognitive impairment in patients in the early recovery period of ischemic stroke, improves attention, memory, speech fluency, generalization functions, complicated choice reaction, increases the functions of visual attention and the speed of sensorimotor response, which was not noted in the comparison groups.&#x0D; CONCLUSIONS: The inclusion of dynamic electric neurostimulation in the rehabilitation complex of patients in the early recovery period of ischemic stroke with mild and moderate cognitive impairment may affect cognitive functions by stimulating the third block of the brain according to A.R. Luria and improving the neurodynamic support of higher mental functions.

The Effectiveness of Sanatorium Rehabilitation of Patients with Coronary Heart Disease after Myocardial Revascularization Against the Background of Post-Corneal Syndrome

Background: According to the literature, the use of natural and preformed therapeutic physical factors with proven anti-inflammatory effect and improvement of endothelial function is promising as a personalized treatment and rehabilitation of patients with heart and cardiovascular system damage after COVID-19. Aims: of the study is to develop new rehabilitation programs for patients with coronary heart disease with mutual burden syndrome after suffering COVID-19, allowing to improve the quality and effectiveness of specialized medical care in a sanatorium. Materials and methods: In representative groups of patients with coronary heart disease who underwent myocardial revascularization on the background of postcovid syndrome, the features of the clinical-functional, metabolic and hemostatic state were studied. Results: Three new programs have been developed and scientifically substantiated for operated patients with coronary heart disease with mutual burden syndrome at the sanatorium-resort stage, complementing the standard treatment with the complex use of normobaric hypoxytherapy, hyperbaric oxygenation, halotherapy and ozone therapy. The effectiveness of the applied new medical rehabilitation programs has been evaluated, taking into account the severity of the mutual burden syndrome according to clinical, functional, laboratory and sociological indicators. Conclusions: The highest effectiveness of rehabilitation programs has been proven, including a combination of these therapeutic factors in patients with severe functional classes according to NYHA and the degree of severity of the mutual burden syndrome on the CIRS-G scale.

Comprehensive medical rehabilitation using therapeutic physical factors including hydrokinesiotherapy in a pool with mineral water and its effect on circadian rhythms of arterial pressure and autonomic regulation in patients with arterial hypertension and with chronic psychoemotional stress

To study the effect of the course-based comprehensive rehabilitation using the therapeutic physical factors of the Belokurikha resort, including hydrokinesiotherapy in a pool with mineral water on the circadian rhythms of arterial pressure and its autonomous regulation in patients with arterial hypertension (AH) associated with chronic psychoemotional stress (CPES). The study involved 83 patients with stage I-II grade 1-2 of AH, whose professional activities were associated with CPES. Each participant had 24-hours Holter blood pressure monitored, and cardiointervalography (CIG) was performed before and after the medical rehabilitation course. The rehabilitation complex of the main group (II) included medication therapy for AH, diet, morning hygienic gymnastics, manual massage, total magnet therapy, and hydrokinesiotherapy in a pool with mineral water. Patients in the comparison group (I) were exposed to similar therapeutic physical factors with identical parameters of the procedures, except hydrokinesiotherapy, which was replaced by full baths with mineral water. Medical rehabilitation using the therapeutic physical factors of the Belokurikha resort with hydrokinesiotherapy in a pool promotes a decrease in the activity of a sympathetic nervous system and increase of vagal effects contribute to the regulation of vital functions of the AH patients, associated with CPES, thus minimizing the frequency of abnormal daily profiles night-peaker and over-dipper to 12.5% and 1.78% of cases, respectively, and increasing the percentage of subjects with its normal type (dipper) to 57.1% (p=0.039). The study results show the benefits of hydrokinesiotherapy in a pool with mineral water as a part of the course-based comprehensive rehabilitation in patients with hypertension and chronic psychoemotional stress in terms of normalizing circadian rhythms of arterial pressure and optimizing the activity of higher autonomous centers, which largely determine the cardiovascular system performance in this setting.

Natural therapeutic factors in medical rehabilitation of patients with post-COVID syndrome

To develop a new medical technology for the 3rd outpatient stage of medical rehabilitation of the patients with post-COVID syndrome using natural therapeutic factors of Nalchik resort. There has been carried out a controlled study in compliance with the principles of randomization to develop an outpatient medical rehabilitation program including 168 patients with post-COVID syndrome. All the patients were divided into four groups: the control group (n=40) was prescribed pharmacotherapy and physical therapy in the hall in accordance with federal clinical recommendations; comparison group 1 (n=43) had drinking mineral water in addition; comparison group 2 (n=43) received physical therapy on the route of Nalchik resort terrainkur in addition to the treatment in comparison group 1; the main group (n=42) included a group psychotherapy on the Terrainkur route in addition to the treatment in comparison group 2. The results of the comparative analysis showed the feasibility of the developed outpatient medical rehabilitation program for the patients suffering from post-COVID syndrome: the overall effectiveness of rehabilitation measures increased compared to other follow-up groups by 10-15% due to the improvement of external breathing function (p<0.05), cognitive status (p<0.01), increased exercise tolerance (p<0.01), physical recovery (p<0.01) and mental health (p<0.01). The summation and integration of sanogenetic effects of physical factors, psychocorrective techniques, and pharmacotherapy provide a significant improvement in the physical and mental status of the patients with post-COVID syndrome.