Use Of Non-drug Methods Research Articles

Osteoarthritis of “atypical” localization: Epidemiology, clinical manifestations, principles of therapy

The problem of osteoarthritis (OA), the most common chronic rheumatic disease, is usually considered in relation to three groups of joints – knee, hip and hands. However, OA can affect any joints of the human body, causing pathological changes characteristic of this nosological form: destruction of joint tissue associated with mechanical stress, chronic inflammation and degenerative processes (neoangiogenesis, fibrosis, heterotopic ossification). This review examines 5 “atypical” OA localizations – shoulder, acromioclavicular, elbow, ankle and foot. The defeat of these joints is observed quite often: shoulder – about 15%, ankle – 3–5%, foot joints – 17% of the inhabitants of the modern population. The main risk factors for this disease are injuries, repeated significant stress, instability and deformities of the joints. The clinic is typical for OA and is manifested by “mechanical” and “starting” pains, stiffness, increasing dysfunction, crunching and deformation. In some cases, persistent synovitis is noted, accompanied by pain at rest and at night. Generally recognized criteria for OA of “atypical” localization have not yet been developed, therefore, its diagnosis is based on the presence of characteristic complaints, typical radiological changes (narrowing of the articular gap, subchondral sclerosis, osteophytes) and the exclusion of other pathology that can cause joint damage. Treatment of this pathology should be complex and include the combined use of non-drug methods (orthosis, physical therapy, physiotherapy) and pharmacological agents, such as nonsteroidal anti-inflammatory drugs, slow-acting symptomatic agents and local injection therapy (intra-articular administration of glucocorticoids, hyaluronic acid, platelet-enriched plasma). When conservative therapy is ineffective, a wide range of surgical interventions is used, from arthroscopic chondroplasty to total endoprosthetics.

Non-Drug Methods in the Treatment of Inflammatory Bowel Diseases: a Review

INTRODUCTION. The relevance and importance of the problem of inflammatory bowel diseases is associated with a chronic, recurrent course and a steady increase in morbidity. With a complicated course of the disease, extensive operations on the intestine, this leads to disability, reduced working capacity and social adaptation. It is important to note that the maximum number of cases occurs at a young age and increasingly diseases are detected in childhood. OBSERVATIONS. Based on the analysis of the literature using Russian and foreign sources on the use of non-drug methods in the treatment of inflammatory bowel diseases, it is noted that, despite the constant improvement of drug treatment methods, including the active development of genetic engineering therapy, the search for effective methods and ways to optimize the treatment with the use of non-drug technologies continues. CONCLUSION. Long-term course of inflammatory bowel diseases is associated with a possible risk of side effects from drug therapy and a decrease in the quality of life of patients. Therefore, the use of non-drug methods in the treatment of IBD in adults and children is relevant at the moment. Data on the use of a number of methods, including non-invasive, in the treatment of this category of patients are presented. High potential, promising direction, a small number of side effects show the need for further research and observations.

Clinical diversity and main directions of medical rehabilitation of dorsopathies of cervical-thoracic localization

Introduction. The high prevalence and increase in cases of seeking medical help for pain in dorsopathies determines the relevance of this problem. Among all the conditions included in the study of health care costs, non-specific musculoskeletal back pain ranks first in the world. A special place belongs to cervicothoracic dorsopathy (CTD), which are most common in developed countries and are characterized by a variety of clinical forms. In our opinion, a comprehensive method of treating CTD with the mandatory use of non-drug methods of therapy is the most optimal.Aim. Determination of the relationship between the pathogenetic form of CTD (verification of pain triggers) and a personalized method of treating patients, containing a combination of drug therapy and a rehabilitation complex of physiotherapeutic, psychotherapeutic effects.Materials and methods. Patients with CTD were included in the study. Neurological status assessment and biomechanical tests were carried out for accurate clinical verification of pathogenetic forms of CTD. Depending on the choice of treatment, respondents were stratified into comparable groups. The main group included patients to whom the original technique was applied, which implied a combination of drug therapy, a complex of rehabilitation physiotherapy and psychotherapeutic effects (n = 155), the control group (n = 65) – respondents who received a standard course of therapy. The statistical analysis included a comparative assessment of the intensity of pain syndrome, static-dynamic and reflex disorders before and after therapy.Results. Both methods have shown their effectiveness. The original technique more effectively reduced the intensity of pain syndrome, reduced the frequency of reflex disorders (p < 0.05), significantly reduced static-dynamic disorders in all subgroups (p < 0.05), while the standard significantly reduced them only in the subgroup with uncomplicated forms of CTD, without achieving a therapeutic effect in complicated CTD.Conclusion. The original method of therapy of patients with HCG has confirmed its effectiveness.

Features of rehabilitation of patients with chronic vertebrogen dorsalgia in combination with metabolic disorders

Lower back pain is an urgent global problem. Often it is combined with metabolic disorders, which leads to mutual aggravation of both pathological conditions. The aim of the study was a comparative assessment of the complex therapy of patients with exacerbation of chronic vertebrogenic dorsalgia using various methods. Materials and methods. We examined 60 patients with concomitant metabolic disorders in the form of obesity. Results. The effectiveness of the use of non-drug methods, namely therapeutic exercises with elements of yoga practice and reflexology in the complex therapy of patients with chronic pain in the lower back in combination with metabolic disorders, has been proven. Conclusion. The use of these methods allows to achieve a positive effect, which manifests itself in reducing the intensity of the pain syndrome and improving the functionality of patients, as well as correction of concomitant metabolic disorders.

Osteopathic status of maternity patients after spinal anesthesia and the possibility of its correction

Introduction. Spinal anesthesia (SA) is one of the most versatile and reliable methods used for pain relief in obstetric patient groups. However, like any other method of anesthesia, spinal anesthesia in some cases can be associated with the risk of complications and side effects. These effects may include developing functional disorders (somatic dysfunctions), timely diagnosis and correction of which can prevent the development of pathology. Evaluation of the impact of SA on the osteopathic status of patients, as well as the use of non-drug methods (including osteopathic correction) for treating side effects after using SA, taking in consideration the lack of the possibility of using drug correction methods in the postpartum period, has an interest to the practitioner. The aim of the study is to study the osteopathic status of maternity patients (puerperas) after spinal anesthesia and the possibility of its osteopathic correction.Materials and methods. The study involved 140 women aged 20 to 30 years with a pregnancy of 38–41 weeks. Three groups were formed by simple randomization: the main group (50 people, participants received spinal anesthesia during childbirth and osteopathic correction after childbirth), the control group (50 people, participants did not receive spinal anesthesia during childbirth, but received osteopathic correction after childbirth), and comparison group (40 people, participants received spinal anesthesia during childbirth, but did not receive osteopathic correction after childbirth). All participants were assessed for osteopathic status and the presence of soreness during palpation at typical painful points. The examination was carried out three times: before childbirth, after childbirth, and after the course of correction in the main and control groups (in the comparison group, this was, respectively, the second postpartum examination).Results. In the postpartum period, the participants of the main group and the comparison group (who received SA) were characterized by a statistically signifi cant (p<0,05) increase in the detection frequency of global rhythmogenic cranial disorders compared with the initial (prepartum) values. At the time of the fi nal examination, there were no signifi cant differences with the initial values. During all stages of the study, biomechanical disorders of the following regions were most characteristic for its participants: thoracic (structural component), lumbar (visceral and structural component), pelvis (visceral and structural component). In the control group, there was a statistically signifi cant (p<0,05) increase in the detection frequency of somatic dysfunctions (SD) in the lumbar region (visceral component) after childbirth, compared with baseline indicators. After osteopathic correction in this group, the detection frequency of these disorders did not signifi cantly differ from the initial values. In the main and control groups, a statistically signifi cant (p<0,05) decrease in the detection frequency of SD in the pelvic region (structural component) was found after the correction, compared with the initial values. After childbirth, an increase in the amount of SD in the dura mater region was observed in the main group and the comparison group. During this period, there was a statistically signifi cant (p<0,05) more frequent detection of dura mater SD in the main group compared with the control group. At the fi nal examination, dura mater SD was detected in all groups almost as rarely as before childbirth.Conclusion. The regional somatic dysfunctions of the thoracic, lumbar, and pelvic regions were the most characteristic for the examined puerperas. Postpartum women who received spinal anesthesia during childbirth are characterized by an increase in the detection frequency of global rhythmogenic cranial disorders and regional biomechanical disorders of the dura mater after childbirth. Postpartum women who did not receive spinal anesthesia during childbirth are characterized by an increase in the detection frequency of regional biomechanical disorders in the lumbar region (visceral component) after childbirth. After osteopathic correction, the frequency of detection of these disorders decreases almost to the baseline. Osteopathic correction is accompanied by a decrease in the detection frequency of disorders of the pelvic region (structural component) compared with the initial values, both in puerperas who received spinal anesthesia and in those who did not receive it.

Possibility of using osteopathic methods of correction in the treatment of myofascial pain syndrome

Recently, there has been a significant improvement in the methods of diagnosis and treatment of myofascial pain syndrome. The continuing high frequency of occurrence of this pathological condition against the background of numerous scientific studies in the field of its diagnosis, treatment and prevention testifies to the significant scientific and practical relevance of this problem at the present time, and the predominant use of pharmacotherapy, which often entails side effects, significant financial costs against the background of its comparatively low effectiveness, actualizes the use of non-drug methods of influence.

Application of Non-drug Methods in the Complex Rehabilitation of Children with Congenital Epidermolysis Bullosa

Congenital epidermolysis bullosa is known to be on the list of rare diseases for which there is no specific treatment. Determining thecontent and means of the rehabilitation program for patients with epidermolysis bullosa is not an easy task and involves a carefulselection of methods for each patient. Aim. The article analyzes the results of the use of non-drug methods in the complex rehabilitation of 90 children (from 6,5 to 18 years)with congenital epidermolysis bullosa. Material and methods. To assess the effectiveness of rehabilitation in the study before and after treatment we used methods ofclinical examination with skin state evaluation and standard psychological and pedagogical examination to determine the degree ofsocial adaptation of patients (analysis of medical and psychological and pedagogical documentation, structured conversation aboutsocial conditions of the child’s life, “Color diagnostic test of nervous and mental states and relations” (V.I. Timofeev and Y.I. Filimonenko),the method “Drawing of an unknown animal” (M.Z. Dukarevich, adaptation by A.L. Venger), “The T.V. Dembo-S.Y. Rubinstein Self-AssessmentResearch Method, the Self-Concept Scale” (E. Pierce, L. Harris, adapted by A. M. Prikhozhan), questionnaire “Assessment ofparental compliance” (D.E. Morisky, L.V. Green), questionnaire “Feeling, activity, mood” (V.A. Doskin, N.A. Lavrentieva, V.B. Sharay andM.P. Miroshnikov). The way in which diagnostics was organized varied taking into account the individual psychophysical capabilitiesof the child. Results. The effectiveness evaluation of the complex rehabilitation of children with epidermolysis bullosa showed an improvementin the clinical condition of the children (significant reduction/elimination of dryness and itching of the skin) and the indicators of wellbeing(mean value: before 30 points after 45, p ≤0.05), activity (mean value: before 25 after 34, p ≤0.05), mood (mean value: before 44,after 51, p ≤0.05) of patients (WAM questionnaire), an increase in the degree of parental commitment to treating children (Moriski-Green questionnaire) from medium to medium and high values. Conclusion. The inclusion of physical therapy and psychological and pedagogical methods of assistance in the process of rehabilitationtreatment increases its effectiveness, activates the compensatory potential of the child’s body, promotes harmonization of intrafamilyrelationships, and thus improves the quality of life of the child and his or her relatives.

The use of whole-body cryotherapy for increasing the stress resistance of female athletes in group types of gymnastics

Background. Representatives of complex coordination sports are most susceptible to psychoemotional stress, since they demonstrate high sports results already at a young age. The tightening of anti-doping control has significantly reduced the possibility of using pharmacological and biologically active drugs to speed up the recovery of athletes. Against this background, in sports medicine, more attention is paid to the use of non-drug methods to improve performance and recovery in athletes. Aim to study the efficiency of the introduction of whole-body cryotherapy in the training process of female athletes of complex coordination sports (for example, group gymnastics) to increase stress resistance and reduce violations of adaptation processes as a result of neuropsychiatric overstrain. Materials and methods. During the academic-training year, 22 gymnasts received six ten-day courses of whole-body cryotherapy in the ICEQUEEN cryosauna. 19 athletes were included in the control group. The studies were conducted 3 times: before the start of the procedures, after the first course of procedures, at the end of the training year. The diagnosis of nocturnal bruxism and the definition of the psychological component of health were carried out. Total and effective albumin concentrations were determined in the blood serum with the calculation of the albumin binding reserve, helper T-lymphocytes and killer T-lymphocytes with the calculation of the immunoregulatory index. Results. After one course, there was an increase in the functional activity of serum albumins, a decrease in the number of episodes of involuntary contractions of the masticatory muscles at night, and an increase in the psychological component of health according to SF-36. After six courses of cryotherapy, the functional activity of serum albumins and the initial values of the immunoregulatory index were preserved by the end of the season, and the psychological component of health according to SF-36 was increased, while these indicators decreased in the control group. There was also a decrease in the number of episodes of involuntary contractions of the masticatory muscles at night with an increase in their number in the control group of female athletes. Conclusions. Considering the obtained results, it is possible to recommend the use of whole-body cryotherapy in gymnasts during the preparatory and recovery periods of the annual training cycle in order to increase stress tolerance and prevent psychoemotional overstrain.

Nondrug Treatment Approaches Used in Alcohol and Substance Addictions and Related Factors

Objectives: Current treatment methods in alcohol and substance use disorders (ASUDs) cannot meet the demands of patients for many reasons. This situation may result in individuals with addiction seeking different approaches. This study aims to investigate nondrug methods used by individuals with ASUD to cope with their disorder and the factors that may be associated with it. Materials and Methods: The study was carried out on 103 volunteer patients who presented to a Training and Research Hospital alcohol substance treatment center. In the study, the God Attachment Inventory, the Addiction Profile Index-Practitioner Form, and the Non-Drug Treatment Questionnaire were used, and Structured Clinical Interview for DSM-IV (SCID-1) and Structured Clinical Interview for DSM-IV (SCID-2) psychiatric interviews were conducted. Result: In individuals with addiction, the rate of seeking any nondrug method was found to be 33%. To get rid of addiction, turning to religion was mostly preferred (24.3%). In terms of subheadings, self-help methods such as praying (17.4%) and engaging in sports (6.7%) were the most preferred. No relationship was found between the patients’ attachment style to God and personality disorder diagnoses and the frequency of seeking nondrug methods and the type of nondrug method. It has been found that there is a relationship between the severity of addiction and the use of nondrug methods. Conclusions: In addition to the medical approaches of patients with ASUD problems, it is observed that they attempt to cope using traditional and complementary methods and prefer the self-help methods among these methods. However, further studies are needed to investigate the contribution of these methods to current treatment methods.

Prospects for personalized rehabilitative medicine

A personalized approach, taking into account the genotype and individual characteristics of the patient, provides great opportunities for more effective prevention, treatment and rehabilitation. The review is focused on the main directions of personalized medicine. Prospects for the development of personalized rehabilitative medicine, including the use of non-drug methods, are described. Studies showing the influence of physical factors on the genome are discussed. It has been shown that the effects of physiotherapeutic factors are genetically determined. Advances in the field of physiogenetics indicate the need for developing and implementing personalized rehabilitative technologies.

Tension-type headache in patients with concomitant musculoskeletal disorders

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.

Osteopathic support of sportsmen during the annual training process

Introduction.Modern sports places high demands on the functional systems of the body at all stages of the training and competitive processes. High loads create signifi cant background for the occurrence of musculoskeletal diseases, among which the myofascial syndrome (MFS) holds the leading position. MFS negatively affects the functional readiness of the sportsman′s body and is a risk factor for injuries of the musculoskeletal system. In this regard, timely treatment of MFS is important. It creates the conditions for the improvement of sports achievements, for health maintenance and sports longevity. Treatment of patients with MFS should include methods that normalize trophism and muscle tone. Given the problem of doping, the use of non-drug methods, including osteopathy, is preferable. The goal of research — to develop a system of monitoring and osteopathic correction of myofascial disorders (MFD) and to introduce it into the practice of medical and biological support for sportsmen of different categories and levels during the annual training process.Materials and methods.93 sportsmen (45 women and 48 men), mean age 22,1±1,1 years, representing diffe rent sports were examined. The essence of the proposed system is regular clinical and electroneurophysiological monitoring of the body condition and preventive correction of myofascial disorders in order to exclude their infl uence on the success of sports activities.Results.It was established that the proposed system of monitoring and osteopathic correction led to a signifi cant reduction in clinical and electroneurophysiological manifestations both in local and in extensive forms of myofascial disorders, which allowed to maintain the optimal functional readiness of sportsmen throughout the entire annual training cycle.Conclusion.The system of monitoring and correction of MFS with the use of osteopathic treatment can be one of the elements of medical and biological support for sportsmen during the annual training process.

Lifestyle Modification as a Method of Treatment of Vasovagal Syncope

Vasovagal syncope is the most common cause for loss of consciousness. The need for treatment of this condition is warranted by impaired quality of life and a risk of trauma due to the fall. At present, there are no medications with proven preventive effectiveness for vasovagal syncope as demonstrated by large randomized, placebo-controlled studies. At the same time, information about the pathogenesis of vasovagal reaction and provoking factors allows effective use of non-drug methods (such as patient education, physical exercise, maneuvers) in the management of patients with vasovagal syncope.

Pathogenetic treatment of non-specific back pain

Back pain is one of the most common reason for all physician visits, which makes the problem of rational therapy especially urgent. Non-specific dorsalgia is the most common in clinical practice, that is subdivided into acute, sub-acute or chronic. Modern guidelines for the treatment of acute and chronic non-specific back pain offer primarily the use of non-drug methods – cognitive-behavioural therapy and therapeutic gymnastics, and if they are ineffective – rational pharmacotherapy, taking into account the comorbid pathology in patients. Non-steroidal anti-inflammatory drugs, in particular Dexalgin, are the drugs of choice for the management of pain syndrome.

АНАЛІЗ КОРЕЛЯЦІЙНИХ ЗАЛЕЖНОСТЕЙ ДІАГНОСТИЧНИХ ПОКАЗНИКІВ У ХВОРИХ З ГЕМОРАГІЧНИМ ІНСУЛЬТОМ У ПІЗНЬОМУ РЕАБІЛІТАЦІЙНОМУ ПЕРІОДІ

Мета. Дана стаття присвячена дослідженню ефективності реабілітаційних заходів з метою удосконалення реабілітаційного лікування хворих працездатного віку які перенесли геморагічний інсульт. Методика. Призначали комплексну поетапну реабілітацію, із додатковим використанням немедикаментозних методів (голкорефлексо-, апі-, гірудо- та мануальна терапія). Обстежено 116 пацієнтів з паренхіматозним півкульовим геморагічним інсультом у пізньому реабілітаційному періоді. Використовувалися бальні шкали та визначення кількості нуклеїнових кислот і активності кислих і лужних нуклеаз сироватки крові та проводився кореляційних аналіз отриманих результатів. Результати. Отримали ряд залежностей клінічних показників, які при високих значеннях коефіцієнтів кореляції дадуть можливість отримання попередніх матеріалів за однією із них за результатами інших. Так, маючи дані неврологічного статусу за шкалою NIHSS, можемо розрахувати рівень функціональної неспроможності за шкалою Ренкіна, відносний рівень психо-емоційних розладів за шкалами Монтгомері Асберг та Бека, рівень когнітивних розладів за шкалою MMSE.Наукова новизна. Вперше показано ефективність комплексної поетапної методики реабілітації та встановлена низка позитивних змін за шкалами NIHSS, Ренкіна, Бартеля, Ашфорта, MMSE, MADRS, Бека. Вперше проаналізовано кореляційні взаємовідносини між результатами тестових шкал при геморагічному інсульті в пізньому реабілітаційному та резидуальному періодах.Практична значимість. Результати роботи використовуються для планування та оптимізації діагностично-лікувальної тактики пацієнтів із паренхіматозним півкульовим геморагічним інсультом у пізньому реабілітаційному та резидуальному періодах.

Improving the quality of life of patients with stable angina pectoris using combined therapy

Treatment of chronic ischemic heart disease includes the use of non-drug methods (anti-hypodynamia, smoking cessation, etc.), as well as drug therapy, the main tasks of which are to reduce the risk of complications such as stroke, myocardial infarction, sudden cardiac death, and to gain an increase in life expectancy. An important aspect of treatment is also a decrease in the frequency and intensity of angina attacks, the need for short-acting nitrates, to gain an increase in physical activity, that is, an overall, improvement in the quality of life of patients. The article presents the results of studying the quality of life indicators of patients with stable angina pectoris with the use of omega-3 polyunsaturated fatty acids and magnetotherapy. 85 patients with stable angina pectoris were examined, divided into three groups according to the method of therapy. 28 patients of the I (control) group received a drug complex corresponding to the national protocol for the treatment of patients with angina pectoris: nitrates, beta-blockers, ACE inhibitors, antiplatelet drugs, statins (atorvastatin at a daily dose of 20 mg). 29 patients of the II group, together with protocol therapy, received the drug omega-3 polyunsaturated fatty acids in a daily dosage of 2000 mg, divided into 2 doses. In connection with the known hypolipidemic action of omega-3 PUFA, the daily dose of atorvastatin in this and the next group was reduced to 10 mg. Group III consisted of 28 patients who were prescribed omega-3 polyunsaturated fatty acids and a course of magnetotherapy according to a special method against the background of the protocol medication complex. It was revealed that, initially in patients with angina, the quality of life indicators according to the Seattle questionnaire and the visual analogue scale were reduced. It was shown that with the use of the protocol medication complex, all the parameters of the quality of life improved reliably, with a significant reduction in the angina pain scales and less significant improvement on the scales of physical activity, assessments of health and the perception of the disease . Upon adherence to the therapy of omega-3 polyunsaturated fatty acids, there was a positive but very weak tendency to improve the quality of life indicators, which did not differ significantly from the control. The use of combined therapy with simultaneous inclusion of omega-3 polyunsaturated fatty acids and magnetotherapy led to significant and reliable improvement in the quality of life indicators, not only on the scales reflecting the pain component, but also on the indicators that characterize the psychological contribution to the quality of life (treatment satisfaction and quality of life (disease perception)). The significant improvement in the quality of life in patients receiving magnetotherapy in contrast to the absence of such influence in patients receiving omega-3 polyunsaturated fatty acids without magnetotherapy was due to the strong antianginal effect of MT, its sedative and emotionally relaxing action, and the ability to enhance the effects of medications.

The Comparison of the Effect of Two Complementary Medicine Methods (Music Therapy and Massage Therapy) On Postoperative Acute Pain After Abdominal Surgery: A Randomized Clinical Trial Study

Background: Despite advances in postoperative pain control, it is still a big challenge with high-prevalence for practitioners. Inadequate control of postoperative acute pain is common which can lead to serious complications for patient. Objectives: This study aimed to compare massage therapy and music therapy in the control of postoperative pain and amount of received opioid drug after abdominal surgery. Methods: In this randomized 3-group trial, 102 patients in the surgical wards of 3 military hospitals, Ahvaz, Iran, were randomly allocated to music group, massage group, and usual-care group. Participants in the massage and music groups received 10-minutes sessions of slow-stroke back massage and without lyrics music, respectively, 1, 6, and 12 hours after surgery. The pain intensity was measured by numeric rating scale 10 minutes after each intervention session. Also, the mean of received opioid drug during 12 hours was measured in each group. Results: The results indicated a decreasing trend of pain intensity in all the groups. However, the trend of pain intensity had a significantly more decrease in the massage group compared to the both music group (P = 0.001) and usual-care group (P = 0.001). Pain intensity at the baseline had no significant difference between the massage group and the music group (Mean ± SD: 7.13 ± 1.2 vs. 6.97 ± 1.3, P = 0.6); whereas, pain intensity 12 hours after surgery had a significant difference between the massage group and the music group (Mean ± SD: 2.26 ± 1.03 vs. 3.30 ± 1.5, P = 0.002). Also, the mean of received opioid drug was significantly lower in the massage group than both the music and the usual-care groups (P = 0.013 and P = 0.001, respectively). Also, the mean of received opioid drug was significantly lower in the music group than the usual-care group (P = 0.047). Conclusions: Massage therapy was more effective than music therapy in controlling postoperative acute pain after abdominal surgery. Hence, the use of non-drug methods (especially massage therapy) as safe, inexpensive, effective, and available methods are very helpful for controlling postoperative acute pain.

Methods of Prevention of Sudden Death in Chronic Heart Failure

Chronic heart failure (CHF) is a natural finale of all cardiovascular diseases. Its prevalence in Russian Federation (as assessed using traditional Framingham criteria) is 4.5% what corresponds to 5 million patients. Prognosis of decompensation of cardiac action remains unfavorable even at the background of optimal drug therapy and use of nondrug methods of treatment. Main causes of death of patients with CHF are cardiac decompensation and sudden cardiac death (SCD). In this review, we present analysis of Russian and foreign studies which have investigated immediate causes of SCD as well as methods of its primary and secondary prevention.

The effectiveness of an integrated pain management program for older persons and staff in nursing homes

This study examined the effects of an 8-week integrated pain management program (IPMP) on enhancing the knowledge and attitude toward pain management among staff; and improving the pain, quality of life, physical and psychosocial functions, and use of non-drug therapies for the elderly in nursing homes. Nursing home staff (N=147) and residents (N=535) were recruited from ten nursing homes. Nursing homes were randomly assigned into an experimental group (N=296) with IPMP or control group (N=239) without IPMP. The IPMP consisted of pain education for staff and physical exercise and multisensory stimulation art and craft therapy for residents. Data were collected before and after the IPMP. The staff demonstrated a significant improvement in knowledge and attitude to pain management, with the survey score increasing from 8.46±3.74 to 19.43±4.07 (p<0.001). Among the residents, 74% had experienced pain within the previous 6 months, with pain intensity of 4.10±2.20. Those in the experimental group showed a significantly better reduction in pain scores than the control group, from 4.19±2.25 to 2.67±2.08 (p<0.001). Group differences were also found in psychological well-being, including happiness, loneliness, life satisfaction and depression (p<0.05), and the use of non-drug methods (p<0.05). These results suggested that IPMP is beneficial for staff, and is effective in reducing geriatric pain and negative impacts. Management support and staff involvement in the program are important for its long-term continuation.