[Application of exoskeleton with functional electrostimulation for rebalancing of patients in acute and early recovery periods of ischemic stroke]. / Primenenie ekzoskeleta s funktsional'noi elektrostimulyatsiei v vosstanovlenii ravnovesiya u patsientov v ostrom i rannem vosstanovitel'nom periodakh ishemicheskogo insul'ta.

Static motor disorders are the main cause of falls and decrease of daily activity in patients after previous ischemic stroke. OBJECTIVE: To study impact of robotic mechanotherapy with functional electrostimulation (FES) on rebalancing in patients in acute and early recovery periods of ischemic stroke. MATERIAL AND METHODS: The number of patients equal 60, divided into 2 groups, were examined. Study group included 30 patients, who were treated in an exoskeleton with FES; control group consisted of 30 patients, whose walking and balance recovering was carried out with exercise therapy. RESULTS: The study group showed a more pronounced improvement of balance indicators by Tinetti scale compared to the control group (11 [8; 13] against 8 [6; 12]; p=0.0281) at the end of treatment. Patients of study group demonstrated significantly better results both by Tinetti scale and stabilometrical parameters in acute period of stroke compared to the control group. CONCLUSION: Application of exoskeleton with FES in patients in acute and early periods of ischemic stroke contributes (to a better balance recovery), which may be achieved by long-lasting verticalization and large repetition of the correct walking pattern during rehabilitative trainings.

[Capacity of vibroacoustic therapy for correction of respiratory manifestations of post COVID-19 syndrome]. / Vozmozhnosti vibroakusticheskoi terapii v korrektsii respiratornykh proyavlenii postkovidnogo sindroma.

The search for therapeutic strategies for the correction of post COVID-19 syndrome is an urgent task of medicine. One of the frequent manifestations of post COVID-19 syndrome is the prolonged persistence of respiratory syndromes - dyspnea and cough. Vibroacoustic therapy is promising methods in the complex effect on broncho-pulmonary symptoms of COVID-19. OBJECTIVE: To study the effect of vibroacoustic pulmonary therapy implemented through the BARK VibroLUNG apparatus on the clinical and instrumental parameters of patients undergoing COVID-19 with residual respiratory symptoms. MATHERIAL AND METHODS: The effect of vibroacoustic therapy (5-day course of 2 sessions) on dyspnea and cough and respiratory function in 60 patients aged 18 to 75 years who underwent COVID-19 of varying severity for more than 12 weeks before the start of the study, with the presence of distant respiratory symptoms, was investigated. Patients were divided into two equal and age-matched groups - without (1st) and with (2nd) chronic bronchopulmonary pathology. RESULTS: Analysis of comorbidity of patients with respiratory phenotype of post COVID-19 syndrome showed frequent presence of concomitant cardiovascular pathology (76.7%). The predominant patient complaint was dyspnea (93.3% in both groups): 29 patients (96.7%) in the non-lung group, and 27 patients (90%) in the chronic lung group. The mean mMRC dyspnea score for all patients was 1.1±0.49 points (1.2±0.5 points in the first group and 1.0±0.45 points in the second group). Cough was observed less often - in 18 patients of both groups (30%), mainly in the second group. During the course of vibroacoustic therapy in the 1st group, the number of patients with dyspnea decreased from 96.7 to 30%, in the 2nd group - from 90 to 10%, the total mean mMRC dyspnea score decreased to 0.2±0.4 (Δ 82%), and a complete regression of cough syndrome was achieved in both groups. Also, an increase in forced expiratory volume in 1st second and peak expiratory flow indicators was revealed both in the general group of patients and in the group of patients without chronic lung pathology. CONCLUSION: The results obtained during the study of the use of vibroacoustic therapy in patients with respiratory manifestations of post-COVID syndrome, including the presence of chronic bronchopulmonary pathology, allow us to conclude on the effective correction of dyspnea and cough during treatment. Vibroacoustic therapy is a promising non-drug method of exposure to bronchopulmonary manifestations of post-COVID syndrome in patients during rehabilitation.

[Virtual reality technology in medical rehabilitation of patients with ischemic stroke]. / Tekhnologiya virtual'noi real'nosti v meditsinskoi reabilitatsii bol'nykh s ishemicheskim insul'tom.

Rehabilitation of patients after an ischemic stroke is a complex and time consuming process that requires coordinated interaction between specialists of different specialisations. Functional outcomes in patients can vary from asymptomatic lesions to complete incapacity and depend on the location of the stroke, premorbid background, the time of initiation of therapy, its duration, and other factors. Goals of medical rehabilitation include not only motor rehabilitation, but also the restoration of cognitive, affective, visual, speech and many other disorders. The development of rehabilitation methods that have a minimum number of contraindications or no contraindications remains relevant. One of the promising methods that complement traditional rehabilitation is virtual reality technology. The article describes modern technologies of virtual reality and methods of their application in medical rehabilitation.

[Implementation of robotic mechanotherapy for movement recovery in patients after stroke]. / Primenenie robotizirovannoi mekhanoterapii dlya vosstanovleniya dvizheniya u patsientov posle insul'ta.

Lower extremity dysfunction after a stroke can vary from mild to extremely severe and significantly reduce the functional independence of patients. The restoration of walking is one of the key components of rehabilitation, it requires a balanced approach and the participation of a multidisciplinary team. In the last decade, new rehabilitation methods have appeared that meet high safety standards and have a minimum set of contraindications. One of the promising methods is robotic mechanotherapy. The article presents an overview of modern technologies of robotic mechanotherapy, its types and recommendations for use in medical rehabilitation.

[Effectiveness evaluation of the psychological support inclusion in the correction of pain syndrome in patients with movement disorders at the stage of medical rehabilitation using the virtual reality technology]. / Otsenka effektivnosti vklyucheniya psikhologicheskogo soprovozhdeniya s ispol'zovaniem tekhnologii virtual'noi real'nosti v korrektsiyu bolevogo sindroma u patsientov s narusheniyami dvigatel'nykh funktsii na etape meditsinskoi reabilitatsii.

OBJECTIVE: Evaluation of the comparative effectiveness of various methods of psychological support in the correction of pain syndrome in patients with degenerative-dystrophic diseases of big joints and spine in the process of medical rehabilitation. MATERIAL AND METHODS: In conditions of hospital, the 70 patients with degenerative-dystrophic diseases of the big joints and spine who received drug and non-drug treatment were examined. The dynamics of the psycho-emotional state, subjective assessment of well-being and pain was studied in three groups: the main group (24 patients) where the psycho-correction plan included classes with a medical psychologist using a high-tech VR tool - «Vive Focus Plus EEA virtual reality helmet¼. A comparison group (24 patients) who received a standard format of psychological support within the patient-centered approach. The control group (22 patients) where only psycho-diagnostic measures were carried out. The «Tamp Kinesiophobia Scale¼, «Visual Analogue Scale of Well-Being Evaluation¼, «McGill Pain Questionnaire¼ were used as diagnostic tools. When comparing the effects of the interventions the nociceptive or mixed nature of pain was taken into account. RESULTS AND CONCLUSION: It has been shown that psychological support improves the effectiveness of pain therapy while the inclusion of a high-tech VR tool in psycho-correctional programs is expedient for overcoming the fear of movement and pain of neuropathic and mixed genesis but ineffective for relieving nociceptive pain, i.e. pain where there is no psychological component.

[Modern possibilities of cryotherapy for chronic functional constipation in children]. / Sovremennye vozmozhnosti krioterapii pri khronicheskikh funktsional'nykh zaporakh u detei.

INTRODUCTION: Among the urgent problems of pediatrics, chronic constipation occupies one of the leading positions due to its high prevalence (20-40%) and the possibility of complications. Conductive cryotherapy, used separately and in combination with percutaneous electroneurostimulation, is a promising technology for the treatment of chronic constipation in children. AIM OF STUDY: Scientific evidence of the use of conductive cryotherapy and its combined effect with percutaneous electroneurostimulation in children with chronic constipation. MATERIALS AND METHODS: We examined 80 children aged 3-15 years (average age 8±2 years) suffering from chronic constipation: 35 (43.8%) boys, 45 (56.2%) girls. In 47 (58.8%) children, chronic constipation of the hypotonic type (HT) was detected, in 33 (41.2%) - chronic constipation of the spastic type (ST). Children were divided into 4 groups, comparable in number, age, gender and clinical manifestations. Patients of all groups received basic treatment: laxative diet, probiotics, choleretic drugs, enzymes. Patients of the main group used the combined effect of conduction cryotherapy and percutaneous electroneurostimulation - cryoelectroneurostimulation. Conduction cryotherapy was prescribed for children of the 1st comparison group, percutaneous electroneurostimulation was assigned to the 2nd comparison group. Patients in the control group received only basic therapy. In order to assess the effectiveness of impact of physical factors, clinical and functional examinations of children were carried out before treatment, immediately after the course of treatment, and also 3, 6 and 12 months later after treatment. RESULTS AND DISCUSSION: The highest treatment efficacy was found in children of the main group with HT and ST (91.6 and 87.5%, respectively) after cryoelectronic neurostimulation. Conduction cryotherapy was most effective for the treatment of ST (77.7%). The results of the study made it possible to develop an algorithm for the prescription of percutaneous electroneurostimulation and conduction cryotherapy, depending on the type of dyskinetic disorders of the colon in children. All children, regardless of the type of chronic constipation, are prescribed to use the combined effects of physical factors (cryoelectroneurostimulation), percutaneous electroneurostimulation is recommended for HT, conductive cryotherapy - for ST. CONCLUSION: The higher therapeutic effectiveness of the combined use of conduction cryotherapy and percutaneous electroneurostimulation in various types of dyskinetic disorders in children has been proved according to immediate and long-term results of treatment. An algorithm is proposed for differential use of conduction cryotherapy and percutaneous electroneurostimulation taking into account the type of dyskinetic disorders of the colon.

[Rehabilitation of the patients presenting with the operated spine syndrome during the complicated postoperative period after discectomy].

This article presents an analytical review of the literature concerning the problem of rehabilitation of the patients following the surgical treatment of hernias of intervertebral disks. The relevance of this problem and the importance of the related research activities in the context of neurorehabilitation are beyond any doubt. Despite the obvious progress in the modernization of the methods and technologies for medical rehabilitation, the number of re-operations in connection with the recurrences of herniated discs remains too high and the overall success thus far achieved in this field falls short of expectations. The authors discuss in detail the need for and the contemporary approaches to the rehabilitative treatment of the patients undergoing vertebral microdiscectomy including medication therapy, physiotherapy an therapeutic physical exercises. The variants of the application of magnetic stimulation during the early period of the rehabilitative treatment of the patients following the minimally invasive interventions for discogenic radiculopathy are considered.

[The feasibility of the application of cryotherapy and radonotherapy for the treatment of the patients presenting with osteoarthritis].

Osteoarthritis (OA) is currently considered to be one of the most widespread diseases. Its main clinical symptoms include pain and dysfunction of joints. In the present review of the foreign and domestic literature, the questions of pathogenesis and risk factors underlying the development of osteoarthritis are discussed. The understanding of OA pathogenesis have altered essentially in the recent years which made necessary the search for the novel approaches to the treatment of this pathology. According to the modern views of OA origin and progression, its therapy should be based on the application of the combination of medicamentous and non-medicamentous modalities including, in particular, collective and individual activities focused on the implementation of the programs of therapeutic physical training as an obligatory component of ОА prophylaxis and treatment. The present review gives evidence of the feasibility of the application of the methods of cryotherapy and radonotherapy for the management of the patients suffering from osteoarthritis. It is emphasized that many recent publications report extensive investigations of the clinical and pathogenetic aspects of the application of these methods for the combined regenerative treatment of the patients presenting with gonarthrosis. The influence of cryotherapy and radonotherapy on the neuroendocrine and immune systems is discussed with special reference to the possibility of regulation of the metabolic processes and retardation of inflammation. It is concluded that the introduction of the above methods into the compulsory individual program for the regenerative treatment of patients presenting with osteoarthritis is pathologically substantiated since it greatly contributes to the reduction of pain and retardation of the progress of the disease. The main pharmaceutical preparations for the OA treatment remain to be slow-acting symptomatic medicines possessed of the chondro-protective effect.

[Rehabilitation of the patients following the endoprosthetic replacement of the joints of the lower extremities].

The present article is the analytical review of the literature pertaining to the problem of rehabilitation of the patients following the endoprosthetic replacement of joints of the lower extremities. The relevance of the problem of interest for medical rehabilitation is beyond any doubt. The traditional methods for the rehabilitation of the patients do not always lead to the desired results. The authors discuss in detail the need for and the contemporary approaches to the rehabilitation of the patients who had undergone reconstructive surgery and arthroplasty of the joints of the lower extremities. The pathogenetically-based three-stage algorithm for medical rehabilitation is proposed.

[The application of the modern phototherapeutic technologies for the medical rehabilitation of the children].

This literature review is focused on the application of polychromatic and monochromatic polarized light for the treatment of various diseases of the childhood including those in the newborns and the premature babies. The analysis of the data of scientific research gives evidence of the beneficial effect of polychromatic polarized light on the clinical course of various skin diseases in the newborn children. Moreover, the improved immunological and reparative processes were revealed after the surgical interventions for congenital heart defects in the newborns. The light-induced changes in the skin contribute to the realization of therapeutic effects of polarized polychromatic light in such children's diseases as atopic dermatitis, bronchitis, bronchial asthma, neurogenic urinary bladder dysfunction, and the traumatic injuries of the limbs. The biologically positive physiological effects of monochromatic polarized light are known to contribute to the improvement of the clinical and functional status in the children presenting with bronchial asthma and in the patients frequently suffering from acute respiratory diseases. The versatility of the biological effects of polarized light taken together with the possibility of its application from the first days of the child's life, the short duration of the procedure, the absence of unpleasant sensations and contact between the damaged surface and the device as well as the simplicity of using the equipment determine the promising prospects for the use of the proposed method in the clinical pediatric practice.

[The health promotion programs for the children based at health promotion institutions]. / Programmy ozdorovleniya detei v uchrezhdeniyakh ozdorovitel'nogo tipa.

The research carried out in the framework of the health promotion programs for the children made it possible to obtain characteristics of the patients admitted to health promotion facilities, identify the risk factors for the development of acute respiratory diseases, and substantiate the principles of the differentiated approach to the rehabilitation of such patients based at the institutions of this type taking into consideration the health group to which a concrete patient is referred and the risk factors of acute respiratory diseases. The feasibility and effectiveness of the addition of aromatherapy and treatment with the use of polarized light into the health promotion programs for the children presenting with acute respiratory diseases that they develop during the period of adaptation based at health promotion institutions are discussed.

[The influence of the climatic and weather conditions on the mechanisms underlying the formation of enhanced meteosensitivity (a literature review)]. / Vliianie klimata i pogody na mekhanizmy formirovaniia povyshennoi meteochuvstvitel'nosti (obzor).

The present review concerns the problem of the influence of the climatic conditions on the human body, the creation of the medical weather forecast service, the development of non-pharmacological methods for the correction of meteopathic disorders, and the reduction of the risk of the complications provoked by the unfavourable weather conditions. The literature data are used to analyse the influence of climatic and weather factors on the formation of enhanced meteosensitivity and the development of exacerbations of chronic non-communicable diseases under the influence of weather conditions. It is concluded that marked changes of the weather may lead to an increased frequency of exacerbations of the chronic non-communicable diseases. The influence of weather and climate on human health is becoming an increasingly important factor under the current conditions bearing in mind the modern tendency toward variations of the global climatic conditions and their specific regional manifestations. The authors emphasize the necessity of the identification and evaluation of the predictors of the development of high meteosensitivity for the prognostication of the risks of the meteopathic reactions and the complications associated with the changes in weather conditions as well as the importance of the improvement of the existing and the development of new methods for the non-pharmacological prevention and correction of enhanced meteosensitivity with the application of the natural and preformed physical factors.

[Muscular disorders associated with ankylosing spondylitis and their correction with the help of whole body cryotherapy].

AIM: The objective of the present study was to evaluate the possibilities for the correction of muscular disorders associated with ankylosing spondylitis and their correction with the help of whole body cryotherapy. MATERIAL AND METHODS: The study included 55 patients randomly allocated to two groups. Group 1 was comprised of the patients treated with the use of the common mineral baths, physiotherapy, therapeutic physical exercises, spinal massage, and whole body air-cryotherapy. Group 2 contained the patients who were treated in a similar way with the exception of whole body cryotherapy; they served as controls. Muscular disorders were diagnosed by means of functional muscular testing. RESULTS: The study has demonstrated the high prevalence of muscular disorders in the patients suffering from ankylosing spondylitis. Moreover, it revealed the profile of such disorders associated with ankylosing spondylitis and showed significant correlation between the results of functional muscular testing, BASMI and BASFI indices as well as characteristics of chest excursions (p<0.01). The analysis of the results of the treatment gave evidence of the higher effectiveness of the combined treatment including whole body cryotherapy in comparison with the alternative therapeutic modalities employed in the present study. This therapeutic modality ensured the statistically more pronounced improvement of functional muscular testing parameters (p<0.05), muscle strength and extensibility, as well as certain other clinical and functional characteristics. The groups of muscles most susceptible to cryogenic therapy have been identified. CONCLUSION: The data obtained in the present study shed light on some specific features of the action of whole body cryotherapy accounting for its corrective influence on the muscular disorders in the patients presenting with ankylosing spondylitis. It is concluded that the proposed approach can be recommended for the introduction in the combined therapeutic and rehabilitative treatment of muscular disorders associated with ankylosing spondylitis.

[The application of cardiorespiratory training in the framework of the comprehensive programs for the medical rehabilitation of the patients presenting with chronic obstructive pulmonary disease].

This article is concerned with the modern concepts of chronic obstructive pulmonary disease. Also, it presents the international definition of "pulmonary rehabilitation". Especially much attention is given to the physical rehabilitation as one of the main and fundamental components of medical rehabilitation of the patients presenting with chronic obstructive pulmonary disease. The up-to-date approaches to the application of fitness gymnastics for the purpose of scientific research and clinical practice are considered with special reference to the combination of cyclic, static, and dynamic loads with the use of relevant modern equipment. The data on the effectiveness and safety of these rehabilitative technologies are discussed in the context of their application for further research in the field of rehabilitative medicine. Recommendations are proposed on the implementation of these methods in the current practical work.

[The results of the application of the pre-formed physical factors and neuroprotective therapy for the rehabilitative treatment of the patients with diabetic retinopathy].

To evaluate the effectiveness of the neuroprotective agent used to treat the patients presenting with non-proliferative diabetic retinopathy. The study included 114 patients (228 eyes) at the age varying from 42 to 70 who presented with diabetes mellitus and non-proliferative diabetic retinopathy. Three groups were formed depending on the mode of treatment. The patients in main group underwent endonasal electrophoresis of 0.1% semax preparation. Patients of the comparison group were treated with intranasal instillations of semax and those of the control group received only standard hypoglycemic therapy and treatment with Doxy-Hem. The patients of the first two groups showed positive dynamics of the studied functional characteristics (visual, perimetric, and electrophysiological ones). The most pronounced and long-standing (up to 12 months) positive effect on the visual function was documented in the main group. The results of the present study give reason to recommend the inclusion of endonasal electrophoresis in the combined rehabilitation treatment of the patients presenting with diabetes mellitus and non-proliferative diabetic retinopathy.

[The effectiveness of endonasal electrophoresis of neuroprotective agents used in the rehabilitative treatment of the patients presenting with primary open angle glaucoma].

The objective of the present study was to estimate the effectiveness of the peptide drug cortexin used to treat primary open angle glaucoma. It was shown that endonasal electrophoresis of cortexin resulted in more pronounced positive changes in the dynamics of clinical, functional, perimetric, and electrophysiological characteristics compared with intramuscular administration of the same drug to the patients of the control group. This difference was apparent both immediately after the termination of the treatment and during the long-term follow-up.

[The rationale for the combined application of cryomassage and silvinite speleotherapy for the rehabilitative treatment of the patients with bronchial asthma].

The present study is devoted to the estimation of therapeutic and prophylactic effects of cryomassage and silvinite speleotherapy in the patients with partially controlled asthma. Advantages of the combined application of rehabilitative technologies are illustrated by their well-expressed anti-inflammatory and immunocorrecive actions, reduced obstruction and hyper-reactivity of the bronchi, improved pulmonary cardiohemodynamics, enhanced physical tolerance and better psychological adaptation.

[The efficacy of health improvement measures for sickly children in a children's health promotion facility].

The results of the present study confirm the efficacy of combined health improvement measures applied in the children's health promotion facility for the treatment of frequently ill children. These measures included climatic therapy, rational day regimen, full-rate balanced diet, therapeutic physical exercises, and aromatherapy with the use of natural essential oils, e.g. clary sage oil. Children presenting with the symptoms of an acute respiratory infection were additionally treated with polarized light having the anti-inflammatory, immunocorrective, and antioxidative properties and thereby improved adaptive capacity of the organism.

[Complex treatment of tobacco dependence by means of psychotherapeutic correction in combination with mesodiencephalic modulation in patients with chronic diseases of digestive organs].

This paper deals with the problem of tobacco dependence and its medical treatment. Various methods available for this purpose are considered with special reference to their clinical efficiency. A scheme for combined treatment of the given pathology is proposed.

[Effect of naphthalan and therapeutic mud applications on clinical and roentgenological characteristics in patients with protracted pneumonia].

The influence of application of naftalan and therapeutic muds on clinical and roentgenological parameters, external respiration function, biochemical and immunological characteristics of the inflammatory process was studied in 82 patients presenting with protracted pneumonia and compared with the outcome of therapy using no physical factors. The application of naftalan and therapeutic muds was shown to reduce activity of inflammatory processes, improve airway patency and the state ofbronchial mucosa. Naftalan produced better therapeutic effect than muds.