[Pre-rehabilitation of oncological patients before extensive abdominal and thoracic surgery: a literature review]. / Prereabilitatsiya onkologicheskikh patsientov pered obshirnym khirurgicheskim vmeshatel'stvom v bryushnoi i grudnoi polostyakh: obzor literatury.

Surgery is one of the leading treatment methods of patients with primary or recurrent malignant neoplasms in the thoracic or abdominal cavity. Extensive abdominal interventions are accompanied by such adverse outcomes as blood loss, hypoxia, inflammation, blood clotting abnormality, emotional and cognitive disorders, that increases the incidence of serious complications and worsens the treatment outcome and life quality in weakened oncological patients. Multimodal pre-rehabilitation before surgery can significantly decrease the incidence and severity of postoperative complications. The rehabilitation complex includes exercise therapy, nutritional and psychological support, smoking cessation and pharmacotherapy. Currently, there are a number of questions facing rehabilitation specialists and oncologists, that are related to the determination of pre-rehabilitation optimal timing and process duration, the choice of specific physical exercises, determining the load intensity. This review presents a current view on understanding of surgical stress in extensive abdominal interventions, its effect on the oncological process course, summarizes the experience of last years in choosing pre-rehabilitation program taking into account pathogenetic mechanisms of surgical stress and individual patient's characteristics. Special attention is paid to the comparison of physical exercises' various types, their action mechanisms at different stages of pathological process, the issues of load dosing during pre-rehabilitation activities.

[Modern view on upper limb physical rehabilitation after stroke. Literature review]. / Sovremennyi podkhod k fizicheskoi reabilitatsii funktsii verkhnei konechnosti posle insul'ta. Obzor literatury.

Stroke is the world's second leading cause of death and the first cause of disability among all diseases. The most common complication of a stroke is a violation of the motor function of the limbs, which significantly worsens the quality of life and the level of self-care and independence of patients. Restoring the function of the upper limb is one of the priority tasks of rehabilitation after a stroke. A large number of factors, such as the location and size of the primary brain lesion, the presence of complications in the form of spasticity, impaired skin and proprioceptive sensitivity, and comorbidities, determine the patient's rehabilitation potential and the prognosis of ongoing rehabilitation measures. Of particular note are the timing of the start of rehabilitation measures, the duration and regularity of the treatment methods. A number of authors propose scales for assessing the rehabilitation prognosis, as well as algorithms for compiling rehabilitation programs for restoring the function of the upper limb. A fairly large number of rehabilitation methods and their combinations have been proposed, including special methods of kinesitherapy, robotic mechanotherapy with biofeedback, the use of physiotherapeutic factors, manual and reflex effects, as well as ready-made programs that include sequential and combined use of various methods. Dozens of studies have been devoted to comparative analysis and evaluation of the effectiveness of these methods. The purpose of this work is to review current research on a given topic and draw up our own conclusion on the appropriateness of using and combining these methods at various stages of rehabilitation in stroke patients.

[The effectiveness of combined laser therapy in patients with trophic leg ulcer and chronic venous insufficiency]. / Effektivnost' kombinirovannoi lazernoi terapii patsientov s troficheskimi yazvami nizhnikh konechnostei na fone khronicheskoi venoznoi nedostatochnosti.

New prospects associated with the use of laser radiation of different wavelengths in the ultraviolet (365 nm) and the green emission spectrum (525 nm) have appeared in recent years. The high prevalence of the trophic leg ulcers necessitates the search for more effective methods of conservative treatment. PURPOSE OF THE STUDY: Development and scientific justification for the low-intensity laser radiation of different wavelengths combined use in patients with trophic leg ulcers and chronic venous insufficiency (CVI). MATERIAL AND METHODS: 102 patients with trophic leg ulcers and CVI were examined. They were divided into 3 equal groups using simple randomization. Patients in the control group received only traditional conservative therapy; comparison group - traditional conservative therapy and an intravenous laser blood irradiation (ILBI) (λ - 635 nm); the main group - traditional conservative therapy and different wavelengths laser therapy (LT) course. RESULTS AND CONCLUSION: A more significant improvement in the clinical condition occurred under the influence of the course application of combined different wavelengths laser therapy in patients with trophic venous leg ulcers. Compared to patients who received traditional conservative therapy and in combination with ILBI 635 nm, the speed of reparative regeneration of trophic ulcers increased, the time for cleansing trophic ulcers from devitalized tissues was reduced. Computer capillaroscopy data showed that the positive effect of laser exposure on all parts of the microcirculation underlies its therapeutic efficacy.

[The differential algorithm for the prescription of the stabilizing training to the patients following replacement arthroplasty of the lower extremities]. / Algoritm differentsirovannogo naznacheniia stabilotreninga dlia patsientov posle éndoprotezirovaniia sustavov nizhnikh konechnostei.

BACKGROUND: The biological feedback-based stability (balance) training is used for the rehabilitation of the patients following replacement arthroplasty of the lower extremities with the purpose of restoration of their postural balance. AIM: The objective of the present study was to develop a differential algorithm for the prescription of the stability training to the patients after they had undergone the endoprosthetic replacement of the joints of the lower extremities. MATERIAL AND METHODS: The study included 48 patients presenting with the following nosological forms: hip arthrosis with total replacement arthroplasty and gonarthrosis with total replacement arthroplasty. All the patients underwent the biofeedback-based stability training with the use of the dynamic balance Pro-Kin system ('Technobody', Italy) using the 'Skiing' No. 10 computer game during 20 minutes every day. The clinical and instrumental methods were employed for the purpose. RESULTS: The rehabilitation subgroups of the patients who had undergone the were distinguished for the first time based on the identification of the main risk factors. It was shown that the main factors having the most pronounced influence on the recovery of postural balance under the conditions of stability training with biological feedback include the age, the time after surgery, the results of evaluation using the Spielberger-Hanin anxiety scale and the Bek depression scale, the level of co-morbidity, the risk of falling estimated from the Morse-Fall scale, and the results of the digit-symbol test based on the Wegsler intelligence scale. CONCLUSION: The distinguishing between rehabilitation subgroups allowed to develop the differentiated algorithm for the prescription of the stability training with biological feedback for the purpose of restoration of the patients' postural balance following total replacement arthroplasty of the lower extremities.

[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.

[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.

[Approaches to the clinical classification of the functional status in patients with stroke].

The article presents the results of original investigation that included a detailed clinical analysis of 203 patients with stroke undergoing rehabilitation. The significance of pathogenic type of stroke and localization of the lesion in the brain are demonstrated. <> are distinguished among the patients with ischemic stroke of hemispheric and stem localization, and hemorrhagic hemispheric stroke. For each ((rehabilitation subgroup) a detailed description of the key indicators of the neurological status, results of cognitive and psychological tests based on general and local rehabilitation scales are presented. The prognostic value of the (rehabilitation activities profile) scale for stroke patients is estimated.

[The neurophysiological basis of the effectiveness of transcranial methods for the treatment of neuropathic pain].

The present article reports the data concerning the prevalence of chronic pain syndromes in clinical practice. The importance of addressing the problem of finding effective treatment modalities for the patients presenting with these conditions is emphasized. The mechanisms of neuropathic pain are analyzed. The possible pathogenetically sound substantiations for the pharmacological and non-pharmacological treatment of chronic pain are discussed. The article highlights the results of recent meta-analyses of the comparative effectiveness of transcranial methods. The mail lines of further investigations in the field of monotherapy and combined treatment of neuropathic pain are outlined.

[The modern approaches to the prediction of the state of the higher mental functions during post-stroke rehabilitation of the patients].

UNLABELLED: Based on the results of our original study, we came to the conclusion that such readily available and objective method as electroencephalography for the examination of the patients with ischemic stroke may be useful for the analysis of the parameters of the alpha rhythm with a view to predicting the development of cognitive disorders (CD) which is important for the timely prescription of medicamental therapy and correction of the approaches to the rehabilitative treatment of these patients. MATERIAL AND METHODS: the present study involved 26 patients with ischemic stroke receiving there habilitative treatment and 35 healthy volunteers comprising the control group. All participant of the study underwent the neurological examination and neuropsychological testing; the stroke patients were additionally examined with the use of electroencephalography. RESULTS: It was shown that the increase of the alpha rhythm amplitude in the anterocentral brain regions to more than 60 mV and its reduction to below 20 mV reflected the disturbed hierarchical regulation of the functioning of cerebral structures in the form of the dominant synchronized state of the brain. Its most pronounced clinical manifestations were cognitive disorders. The disturbances to the physiological gradient and the alteration of the alpha rhythm amplitude (to below 20 mV and above 60 mV) in the anterocentral brain regions accounted for the higher than 70% probability of detecting moderate CD in the patients with ischemic stroke. The amplitude of alpha rhythm in the anterocentral brain regions may serve as an indicator of the effectiveness of the consolidation of information in the process of memorization and of the speed of information retrieval; moreover, it is an objective characteristic of the patients' emotional state. It is concluded that the estimation of the amplitude of alpha rhythm in the anterocentral brain regions is needed to predict the course of CD in the patients presenting with ischemic stroke including those receiving the rehabilitative treatment. CONCLUSION: The detailed analysis of the electroencephalograms of the patients makes possible the well-timed correction of the individual rehabilitation program and the enhancement of the effectiveness of recovery of both cognitive and motor functions.

[The modern approaches to the prognostication of rehabilitation of the patients after stroke on an individual basis: a review of the literature and the results of original investigations].

This article was designed to analyze the results of the investigations with the purpose of elucidation of the prognostic factors relevant to the rehabilitation of the patients who survived after stroke. Special attention is given to the role of demographic (age and sex) factors and the data of the clinical, neurological, psychological, cognitive, and instrumental examination of the patients. The results of the original studies based on the treatment of 203 stroke patients are discussed in the context of modern concepts of the significance of the factors contributing to the recovery of the patients in the course of the post-stroke rehabilitation. The prognostic value of the selected factors, such as leukoareosis (for the patients presenting with hemorrhagic stroke), has been demonstrated for the first time. The new data on the duration of the rehabilitation period are presented with reference to its dependence on the type of stroke and localization of the lesions. Specifically, it is estimated to be 2 years for the patients who suffered from ischemic stroke in the brain stem, 31 months for those with ischemic stroke of the hemispherical localization, and 38 months for the patients presenting with hemorrhagic stroke (hemispherical hematoma). In addition, the data on the magnitude of the post-ischemic atrophic changes of prognostic values are presented.

[Analysis of the cerebral mechanisms underlying rehabilitation of the patients after stroke].

The authors present the results of the comprehensive analysis of the principal cerebral mechanisms involved in the processes of rehabilitation of the patients after stroke based on the review of the literature concerning this issue. The data obtained in the course of original investigations including 203 patients who had undergone stroke confirm and refine the currently available information pertinent to the problem in question. First and foremost, they demonstrate the influence of the demographic, neurophysiological, and clinical factors as well as neuroimaging and ultrasound studies on the parameters of the evoked potentials in the brain of the stroke-affected patients. In addition, they provide a deeper insight into the role of short-term memory in the realization of the motor response. The probable macro- and microstructural, functional, neurochemical, and pathophysiological mechanisms contributing to the rehabilitation of the patients who had undergone stroke are considered with reference to their relationships. Special emphasis is laid on the methods for regulation of these mechanisms.

[The factors influencing the recovery of the patients suffering from stroke during the rehabilitation period].

In this article, the results of the authors' research, including analysis of the clinical and instrumental data concerning 203 patients with stroke, are presented. The factors significantly affecting the recovery of patients in the rehabilitation are determine, viz. the age, the presence of the chronic pain, the level of education, the nature of the pathological process in the brain (the stroke type), the localization of the lesion (hemispheric, stem), right/left-sided localization of the lesion, the width of the lesion, the volume of the lesion (the atrophic post-ischemic changes, the volume of hematoma), the presence of cerebral atrophy (the width of the third ventricle), the presence of leukoareosis, the presence and the severity of stenosis in the internal carotid artery, the operations on the main arteries in the medical history, the presence of focal lesions on the electroencephalogram, the presence of the perifocal brain edema, accompanied by a shift of midline structures in the acute phase of stroke, the incidence of the stroke. We distinguished the "rehabilitation subgroups" according to the representation of the basic and additional risk factors. The influence of leukoareosis on the recovery of patients after hemorrhagic stroke in shown for the first time. The values of each risk factor for the patients presenting with ischemic stroke of hemisphere and stem localization, as well as for the patients with intracerebral hematomas were calculated. The prognostically significant percentage of the clinical improvement of the patients' conditions in the course of rehabilitation for each of the subgroups is estimated.

[The peculiarities of the application of transcranial magnetic therapy and electrical stimulation for the treatment of the patients presenting with various types of stroke].

In this article, the results of the authors' research, including analysis of the clinical and instrumental data concerning 203 patients with, stroke are presented. It is shown that the clinical effectiveness of the transcranial methods incorporated in the combined rehabilitation programs depends on the type of stroke and localization of the lesions. Specifically, the patients presenting with ischemic stroke of hemispheric localization experienced a neurophysiologically confirmed significant clinical improvement that became apparent after the consistent application of transcranial magnetic therapy and micropolarization. In the patients with ischemic stroke of stem localization, the positive influence on psychomotor recovery was achieved with the application of transcranial magnetic therapy, but transcranial micropolarization did not have an appreciable effect on the recovery of such patients. The patients presenting with hemorrhagic stroke did not experience any significant improvement of psychomotor parameters from transcranial magnetic therapy and transcranial micropolarization. The likely mechanism underlying the recovery of psychomotor processes under effect of transcranial magnetic therapy in the patients with ischemic stroke is the normalization of the frequency of interaction between brain structures. In addition, in the patients with ischemic stroke of hemispheric localization and in the patients with hemorrhagic stroke electrical myostimulation has a marked impact on the psychomotor recovery only in case of functional treatment. In the patients suffering from ischemic stroke of stem localization non-functional electromyostimulation significantly improves motor functions and cognitive motor control.