[Comparative characterization of walking biomechanical parameters in hip prosthesis users with mechanical and electronic knee modules]. / Sravnitel'naya kharakteristika biomekhanicheskikh parametrov khod'by u pol'zovatelei protezov bedra s mekhanicheskim i elektronnym kolennymi modulyami.

According to many studies, prostheses with electronic knee modules have some important technical advantages over mechanical knee modules, allowing the user to have a more active lifestyle and significantly improving the overall quality of life. However, we have found no published Russian studies of the biomechanics of walking on such prostheses for more than 20 years of their use in Russia. OBJECTIVE: To compare spatial and temporal parameters of walking in patients after hip replacement using prostheses with electronic and mechanical knee modules. MATERIALS AND METHODS: The study included 94 patients aged between 18 and 50 with hip prostheses. The patients were divided into two groups: Group 1 included 48 patients with a hip prosthesis with a mechanical knee module; Group 2 included 46 patients with a hip prosthesis with an electronic knee module. The groups were comparable in size, gender and age distribution, and mobility grade (grade 3 according to the MOBIS classification system). All patients had no comorbidities or injuries that could limit mobility. Spatial and temporal parameters of walking on hip prostheses with different knee modules were assessed using a video analysis system (SMART DX5000, Italy). RESULTS: Group 2 patients (prostheses with electronic knee modules) had the following spatial and temporal biomechanical walking indices: arbitrary walking speed 1.10-1.08 m/s, walking pace 105.82 steps/minute, step cycle 1.13-1.15 s, double step length 1.27 m, rhythm index 0.89. Group 1 patients (prostheses with mechanical knee modules) had worse outcomes according to the same indices: walking speed 0.81-0.87 m/s, walking pace 90.84 steps/minute, step cycle 1.33 s, double step length 1.07 m, rhythm index 0.74. Preferred walking speed and walking pace indices in patients with electronic knee modules in hip prostheses were at the lower limits of reference values in healthy individuals; the step length was insignificantly reduced; the rhythm index was close to that of healthy individuals (0.94-0.97). CONCLUSION: The results of the study show that the use of prostheses with electronic knee modules in patients with amputation at the hip level enables patients to learn better symmetrical walking and significantly increases their mobility compared to mechanical modules.

[Kinematic parameters of gait in patients with supra- or subtentorial focus location during the early rehabilitation period after ischemic stroke]. / Kinematicheskie parametry pokhodki pri supra- i subtentorial'noi lokalizatsii ochaga v rannem vosstanovitel'nom periode ishemicheskogo insul'ta.

OBJECTIVE: To study kinematic gait parameters during early rehabilitation period in patients with supra- or subtentorial ischemic stroke (IS). MATERIAL AND METHODS: We examined 24 patients (11 women, 13 men, age 61.3±8.2) 4-6 weeks after stroke onset. 15 patients had supratentorial IS (middle cerebral artery location), 9 patients had subtentorial IS (brainstem and cerebellum). NIHSS score was 6.4±0.6/6.1±0.8, modified Ashwort scale score - 0.5±0.6/0.4±0.7, hand paresis - 3.4±0.9/3.7±0.7, leg paresis - 4.1±0.7/4.0±0.8 points. Kinematic gait parameters were recorded on video analysis system Physiomed Smart (Physiomed, Germany, Davis protocol). RESULTS: Gait kinematic parameters in paretic and in unaffected leg were changed in both groups. Patients with supratentorial lesion had on paretic side exaggerated pelvic obliquity, an excessive internal rotation and amplitude of movements in the paretic hip joint, and an insufficient plantar extension on both sides. Patients with subtentorial stroke had exaggerated pelvic tilt forward, excessive flexion and insufficient extension of the hip joint, insufficient extension of the knee joint, excessive plantar flexion, and insufficient plantar extension on both sides. CONCLUSION: Patients with supra- or subtentorial IS with muscle weakness less than 3-4 points and slightly changed or normal muscle tone differed in kinematic parameters in pelvic motions and in joints of paretic and unaffected lower extremity. These results highlight the importance of differentiating rehabilitation techniques according to supra- or subtentorial focus location and cerebellar involvement.

[Analysis of the publication activity of medical massage specialists in the Russian segment of the Internet]. / Analiz publikatsionnoi aktivnosti spetsialistov v oblasti meditsinskogo massazha v rossiiskom segmente Interneta.

AIM: To assess the qualitative and quantitative composition of publications on medical massage, to determine the share of researches among them, and to compare the publication activity of Russian and foreign specialists in this area. MATERIAL AND METHODS: The authors analyzed an original sample of 4532 works published in 1900 to 2019, which met the primary retrieval request 'massage'. The scientific electronic library eLibrary.ru was used as a database. A detailed analysis was carried out among 1522 works, the main content of which was devoted to massage. Publication activity during this period was also assessed. RESULTS AND CONCLUSION: Publication activity has considerably increased since 2001. There have been 4117 publications, i.e. 90.8% of the entire sample. The share of researches in the Russian Internet segment was 17.47% (266 works) from the analyzed sample, which suggests that there is a lack of attention to the topic of medical massage in Russian professional publications and a need for additional investigations in this area.

[A relationship between the movement pattern and lesion location in the early rehabilitation period after ischemic stroke]. / Sviaz' dvigatel'nogo stereotipa i lokalizatsii ochaga v rannem vosstanovitel'nom periode legkogo ishemicheskogo insul'ta.

To study the changes in movement pattern during the early rehabilitation period in patients after carotid/vertebro-basilar ischemic stroke. MATERIAL AND METHODS: The authors studied 11 patients (6 women, 5 men, mean age 57.2±5.2) 4-6 weeks after stroke onset. NIHSS on admission was 6.2±0.8, arm/hand weakness 3.9±0.7/3.7±0.8, leg/foot weakness 4.3±0.6/4.0±0.5. The lesion was located in the carotid artery (7 patients) and in the vertebro-basilar system (4 patients). All patients were examined on admission and at discharge (interval 13±4 days). The changes were assessed using FIM scale, Ashwort scale, TUG test, nine-hole peg test (NHPT), Berg balance scale, 20-point vestibular disorder score scale, MMSE, Beck depression inventory, and Spielberger anxiety questionnaire. Also kinematic and kinetic profiles of the step cycle and gait were analyzed by video analysis system Physiomed Smart (Physiomed, Germany, Davis protocol). RESULTS: All patients demonstrated improvement in FIM scale, Ashwort scale, TUG test, NHP test, Berg balance scale and 20-point vestibular disorder score scale. Patients with vertebro-basilar stroke had balance disturbance, which was assessed with 20-point vestibular disorder score scale. All patients had changes in spatiotemporal gait performance, kinematic and kinetic profiles of the walking cycle: shortening of the step length and widening of the step width, prolongation of step cycle, and decreased step speed. These changes were more obvious in patients with vertebro-basilar stroke. Also patients with vertebro-basilar stroke had pelvic tilt forward, while patients with carotid lesion had pelvic obliquity. CONCLUSION: Lesion location in patients with mild stroke may influence the spatiotemporal gait characteristics and kinematic and kinetic profiles. These features should be taken into account while planning rehabilitation strategy.

[The rehabilitative treatment of the patients presenting with chronic obstructive pulmonary disease including the application of the manual handling methods]. / Vosstanovitel'noe lechenie patsientov s khronicheskoi obstruktivnoi bolezn'iu legkikh s vkliucheniem metodov manipuliatsionnogo vozdeistviia.

AIM: The objective of the present study was to identify the peculiar features and advantages of different methods for the mechanical impact on the thoracic tissues of the patients presenting with chronic obstructive pulmonary disease (COPD) and to develop specific indications for their clinical applications. MATERIAL AND METHODS: This randomized prospective comparative study included 137 patients with COPD. In accordance with the currently accepted classification (GOLD, 2013), all the patients had COPD of medium severity. The smoldering inflammatory process was diagnosed in 75 (54.7%) patients, grade I and II respiratory insufficiency in 80 (58.4%) and 57 (41.6%) patients, respectively. The external respiration function was evaluated by means of pneumotachometry techniques during the forced expiratory maneuver and by spirometry. The pulmonary hemodynamics and myocardial contractility of the right ventricle were studied with the use of rheopulmonography and central hemodynamics by tetrapolar thoracic rheography. The routine inflammatory and immune tests were employed. RESULTS: Investigations of the systemic circulation have demonstrated the prevalence of its hyperkinetic type (54,0%) over the hypokinetic and eukinetic ones (23,3% and 22,7% respectively). All the patients were divided into three group identical in terms of clinical and functional characteristics. The patients comprising group 1 (n=46) were prescribed the rehabilitative treatment in the form of classical chest massage, those of group 2 (n=47) were treated by means of intense massage of asymmetric chest zones, and the patients included in group 3 (n=44) underwent manual therapy. It was shown that intense massage produced the most pronounced beneficial effect. Classical massage also resulted in the reduction of the inflammatory manifestations but its effectiveness was significantly lower than that of the intense treatment (р<0,05-0,02). Manual therapy failed to cause any appreciable changes in the character and severity of the inflammatory process (р>0,5). CONCLUSION: The intense massage of asymmetric chest zones proved to provide the most efficient tool for the anti-inflammatory treatment of the patients presenting with chronic obstructive pulmonary disease in comparison with other known methods for the mechanical impact on the thoracic tissues. However, the application of this technique is limited in the patients with the hypokinetic type of systemic circulation and pulmonary hypertension. The most important advantage of chest massage by the conventional method is the possibility of its application for the treatment of the patients suffering from severe forms of COPD associated with pulmonary and systemic cardiohemodynamic disturbances with alveolar hypoxia. Manual therapy can be recommended in the first place to the patients with COPD in remission and the accompanying functional blockade of the vertebral segments.