[Comprehensive rehabilitation of patients with osteoporosis after hip arthroplasty]. / Kompleksnaya reabilitatsiya patsientov posle endoprotezirovaniya tazobedrennogo sustava na fone osteoporoza.

Most people who have undergone hip arthroplasty belong to the older age groups, so they often have signs of osteoporosis. A decrease in bone mineral density in combination with a decrease in local blood circulation caused by additional trauma to bone structures and surrounding soft tissues during surgery contributes to osteolysis, early instability of the endoprosthesis and increases the risk of periprosthetic fractures. OBJECTIVE: To study the effectiveness of the developed rehabilitation complex, including the combined effect of a physiotherapeutic factor (increased gravity) and antiresorptive therapy, in patients with osteoporosis who underwent hip arthroplasty. MATERIAL AND METHODS: The study included 40 patients aged 60-75 years with signs of osteoporosis, who underwent total hip arthroplasty, no more than 3 weeks ago. The patients were randomized into two groups: the main group - 16 (40%) people, comparisons - 24 (60%) people. To assess the effectiveness of rehabilitation complexes, orthopedic examination, functional diagnostics of motor pathology of the lower extremities on an automatic hardware-software complex, X-ray densitometry, and indicators of the visual analogue pain scale and Harris scale were evaluated. Patients of both groups were prescribed a rehabilitation complex, including therapeutic exercises, mechanotherapy for training the thigh muscles and electrical stimulation of the thigh muscles, a course of 10 procedures. Patients of the main group were additionally prescribed a course of gravitational and antiresorptive therapy according to our methodology. RESULTS: The intensity of pain before treatment in patients of both groups corresponded to moderate pain syndrome. After 3 months after the course of rehabilitation, the pain intensity in the patients of the main group decreased statistically significantly by 3.1 times, in the patients of the comparison group - by 2.6 times. When assessing the biomechanical data of walking at the beginning of the rehabilitation course, the asymmetry of pressure indices was revealed in patients of both groups, corresponding to the average degree of lameness. After 3 months, the asymmetry coefficient in the patients of the comparison group reached a mild degree, while in the patients of the main group it approached the norm. According to X-ray densitometry, after 12 months, the bone mineral density index only in patients of the main group increased to the level of osteopenia. The indicator of the combined assessments of the Harris scale was statistically significantly different between the groups at 3 and 6 months after the course of rehabilitation. CONCLUSION: The combined use of gravitational therapy and antiresorptive drugs in the treatment and rehabilitation complex in patients with osteoporosis who have undergone total hip arthroplasty helps to reduce pain, reduce signs of osteoporosis, improve the functional parameters of patients' activity, and increase household and social adaptation.

[Influence of complex rehabilitation programs on the uterine blood flow in patients of different age after plastic surgery for rectocele]. / Vliyanie reabilitatsionnykh kompleksnykh programm na pokazateli matochnogo krovotoka po dannym 3D-ekhodopplerografii u patsientok raznykh vozrastnykh grupp posle plasticheskoi operatsii po povodu rektotsele.

OBJECTIVE: To develop the optimized complex programs, including general magnetotherapy, fractional microablative therapy with a CO2 laser, electromyostimulation with biofeedback of the pelvic floor muscles, and a special exercise therapy complex in late rehabilitation programs for women of different age after reconstructive plastic surgery for rectocele. MATERIAL AND METHODS: There were 200 women of childbearing, peri- and menopausal age with rectocele grade II-III and 20 healthy women of comparable age. All patients were divided into 4 groups by 50 womes: main group, two comparison groups and control group. Surgical treatment of rectocele was followed by long-term postoperative rehabilitation including symptomatic therapy, general magnetotherapy, and electromyostimulation with biofeedback of the pelvic floor muscles, intra-vaginal fractional microablative therapy with a CO2 laser and special complex of therapeutic physical education. RESULTS: General magnetotherapy in early (1 day) postoperative period and complex rehabilitation in long-term postoperative period (within a month after surgery) including 2 procedures of intra-vaginal microablative fractional therapy with carbon dioxide laser, electromyostimulation with biological connection of the pelvic floor muscles and special complex of therapeutic physical education ensured more significant improvement of uterine blood flow regardless age and baseline disorders in the uterine arteries in patients with rectocele. In our opinion, this is primarily due to vasoactive effects of general magnetotherapy, recovery of circulation via relief of spasm in the arteries and arterioles, improved vein contractility and venous outflow. These processes combined with electrical stimulation and therapeutic exercises of pelvic floor muscle followed by their reinforcement, as well as fractional microablative therapy ensured significant vascular effect.

[Influence of various rehabilitation complexes on sexual function in fertile females and women of perimenopausal and menopausal age after surgery for rectocele]. / Otsenka vliyaniya razlichnykh reabilitatsionnykh kompleksov na seksual'nuyu funktsiyu u patsientok detorodnogo i perimenopauzal'nogo i menopauzal'nogo vozrasta posle operatsii po povodu rektotsele.

OBJECTIVE: To study the effect of general magnetotherapy, muscle stimulation with biofeedback of pelvic floor muscles, and a special complex of physiotherapy exercises with and without fractional microablative CO2-laser therapy on sexual status in females after plastic surgery for rectocele. MATERIAL AND METHODS: There were 200 fertile females and women of perimenopausal and menopausal age with rectocele grade II-III. Various rehabilitation programs were used in delayed postoperative period in order to improve sexual function. Rehabilitation included various combinations general magnetotherapy, electrical muscle stimulation with biofeedback of pelvic floor muscles, intravaginal fractional microablative CO2-laser therapy and a special complex of exercise therapy. RESULTS AND CONCLUSION: Postoperative rehabilitation including general magnetotherapy, fractional microablative CO2-laser therapy, muscle stimulation with biofeedback of pelvic floor muscles and a special exercise therapy significantly improves sexual function in patients with rectocele. This is true for fertile females and women of perimenopausal and menopausal age. Significant data on PISQ-12 questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire) and Female Sexual Function Index of (FSFI) confirmed these results.

[Contemporary potential of nonmedical treatment in ophthalmology].

The article covers treatment results of 90 patients with primary glaucoma simplex of stage 1 and 2 (137 eyes). The authors proved that using a specified magnetotherapy method, when compared to regular medical therapy, causes more fast and marked regression in clinical symptoms and improvement of vision in patients with primary glaucoma simplex of stages 1 and 2.

[Combined treatment of palmoplantar syndrome in patients under antitumor therapy].

Observation covered 12 patients under various antitumor medications. Group 1 was formed of patients with developed palmoplantar syndrome varying in severity, who received complex treatment including IR-therapy and local antioxidant medication. Group 2 included patients without palmoplantar syndrome, who received preventive treatment with IR-therapy. All patients of group 1 demonstrated lower severity of palmoplantar syndrome manifestations. In group 2, 80% of the patients avoided palmoplantar syndrome development, and 20% of the patients had light course of the syndrome manifestations. Patients at high risk of palmoplantar syndrome under antitumor therapy are recommended to undergo IR-therapy and local antioxidant medication.