[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.

[Medical rehabilitation of children with obstructive uropathy]. / Meditsinskaya reabilitatsiya detei s obstruktivnoi uropatiei.

Obstructive uropathy in children is predominantly urinary system malformation and one of the leading causes of chronic renal failure. Antenatal ultrasound can detect obstructive uropathy in infants. It is important to conduct diagnostics not only to identify the obstruction level in urinary system, but to assess renal function, renal blood flow and urination. Children are given conservative and surgical treatment methods to restore urodynamics, prevent infectious complications, improve renal blood flow. Currently, there are no principles, approaches and technologies for medical rehabilitation of patients with obstructive uropathy, therefore, the use of selective chromotherapy, which has an activating effect on regional circulation, and sound stimulation improving muscles tone of pelvis and ureters, is pathogenetically reasonable and promising. OBJECTIVE: To develop technologies of physiotherapy application (sound stimulation, selective chromotherapy) for inclusion in comprehensive medical rehabilitation of children with megaloureter. MATERIAL AND METHODS: Clinical observations and special examinations have been performed in 90 children with megaloureter aged from 1 to 10 years. The patients were divided into 2 groups: 30 children (study group) received sound stimulation combined with selective chromotherapy; 30 children (the 1st comparison group) - sound stimulation; 30 children (the 2nd comparison group) - selective chromotherapy (blue spectrum). General clinical methods, ultrasound of kidneys and bladder with Doppler monitoring of intrarenal blood flow, functional methods of bladder examination were used. RESULTS: The positive effects of separate and combined application of sound stimulation and selective chromotherapy on clinical and laboratory indicators, urodynamics of urinary tract and renal blood flow in children with megaloureter after surgery have been revealed. The efficacy of selective chromotherapy use in children with megaloureter and comorbid neurologic bladder dysfunction has been proven. CONCLUSION: Modern technologies for the application of physiotherapy, namely selective chromotherapy and sound stimulation, to include them in the comprehensive medical rehabilitation of children with megaloureter, have been developed for the first time and their high efficacy has been proven.

[Hyperbaric oxygenation in outpatient rehabilitation of COVID-19 convalescents]. / Primenenie giperbaricheskoi oksigenatsii v ambulatornoi reabilitatsii patsientov, perenesshikh COVID-19.

Searching for drug and non-drug modalities for the rehabilitation of patients with the post-COVID syndrome is an urgent public health challenge during the COVID-19 pandemic. Hyperbaric oxygenation is a promising method as a part of complex rehabilitation after COVID-19 due to its antihypoxic, anti-inflammatory, antioxidant and anticoagulant effects. OBJECTIVE: To study the effect of hyperbaric oxygenation as a part of comprehensive outpatient rehabilitation on clinical and functional parameters in COVID-19 convalescents. MATERIAL AND METHODS: The effect of hyperbaric oxygenation on clinical and functional parameters of 45 COVID-19 convalescents was studied: 22 males and 23 females aged 40-60 years. Patients were divided into three groups of 15 subjects each, depending on the CT stage of COVID-associated pneumonia (CT-0, CT-1, and CT-2-3). RESULTS: Patients in group 3 (CT-2-3) were on average in the older age group, had a higher body weight and a higher percentage of fat mass according to bioimpedance measurements, compared to the other groups. Most clinical-functional and laboratory parameters in this group were within normal or subnormal ranges. In addition, high cholesterol levels (total cholesterol 6.5±1.2 mmol/L) and subnormal levels of C-reactive protein (9.3 mg/L) were noted in group 3 patients. After comprehensive rehabilitation, an increase in the distance walked in the 6-minute walking test with a significant trend in the CT-0 (467.9±37.7→531.5±44.3 m; p<0.01) and CT-1 (533.9±74.3→570.1±57.8 m; p<0.05) groups was observed. A significant decrease in norepinephrine level in the group of COVID-19 convalescents with CT-2-3 (Δ 13%), and a decrease in glutathione peroxidase in all three groups (6465.0±1637.3→5101.0±1353.3, 6587.8±1919.3→5418.1±1289.7, 7699.5±1747.9→6620.1±1702.1 units/L in groups 1, 2 and 3, respectively; p<0.05) were recorded. CONCLUSION: The use of hyperbaric oxygenation in comprehensive outpatient rehabilitation of COVID-19 convalescents was associated with benefits, given the improvement of functional parameters, laboratory signs of limiting low-grade inflammation, sympathoadrenal activity, and oxidative stress.

[Drinking mineral waters: problematic issues and prospects of use in treatment and rehabilitation]. / Pit'evye mineral'nye vody: problemnye voprosy i perspektivy ispol'zovaniya v lechenii i reabilitatsii.

The article is devoted to the use of drinking mineral waters in the treatment and rehabilitation of patients with various pathologies. The results of numerous studies carried out in previous years have proven the ability of mineral waters to positively influence the functional state of the digestive system, eliminate various metabolic disorders, and affect the processes of hormonal and immune regulation. However, due to the current lack of educational programs for the training of doctors at medical universities, as well as further training in the basics of balneology, medical workers often encounter difficulties in determining the most suitable schemes for the use of mineral waters for a specific pathology. It is known that today there are quite a lot of bottled waters on the market that do not have a healing effect, but are quite suitable for use as table waters. The latter circumstance, combined with not always correct information about the real healing properties of waters, creates certain difficulties even for doctors. In addition, there is a need for a certain clarification of the methods of prescribing mineral waters, taking into account the magnitude of mineralization, the main cation-anionic composition, the nature of the disease and the phase of its course. Taking into account the fact that drinking mineral waters are actively used in the treatment of many diseases, including in children and the elderly, the task of fully and competently informing doctors of different specialties, and with their help, patients, about the features of specific mineral waters available in different regions of the Russian Federation, their unique capabilities, optimal methods of therapeutic use.

[Modern medical and meteorological assessment of Moscow weather and the effectiveness of non-drug methods of increased meteosensitivity correction in patients with joint diseases]. / Sovremennaya mediko-meteorologicheskaya otsenka pogody Moskvy i effektivnost' nemedikamentoznykh metodov korrektsii povyshennoi meteochuvstvitel'nosti u patsientov s zabolevaniyami sustavov.

Weather is one of the leading negatively acting on the human body factors. Abnormal regimes and extreme hydrometeorological and geophysical phenomena form the most biotropic external conditions that can have a negative effect and provoke weather-related exacerbations in people with chronic non-infectious diseases. Today, the problem of the climatic and weather factors influence acquires a new content and becomes relevant in connection with the global climate change and its regional manifestations. PURPOSE OF THE STUDY: To scientifically substantiate the need for medical and meteorological monitoring to determine the most biotropic weather conditions in the Moscow metropolis and to evaluate the meteorological effectiveness of non-drug rehabilitation methods. MATERIAL AND METHODS: 335 patients diagnosed with osteoarthritis of various locations, and after total hip and knee arthroplasty, were included in the study. Patients were divided into 4 groups: 67 patients of the 1st group received "dry" carbonic baths and exercise therapy; general radon baths and exercise therapy were prescribed to 60 patients of the 2nd group; 61 patients of the 3rd group received general sodium chloride baths and exercise therapy; 84 patients of the 4th group got local cryotherapy and exercise therapy procedures. The study of weather sensitivity was carried out by the questionnaire method. Psychological examination was carried out using the tests HAM (health, activity, mood), Mini-Mult (Abbreviated multifactor questionnaire for personality research) and HADS (Hospital Anxiety and Depression Scale). RESULTS: 272 (81.2%) patients had increased meteosensitivity, which was accompanied by mild manifestations in 24.3%, moderate severity in 48.2%, and severe ones in 27.5%. The effectiveness of the balneotherapy and cryotherapy methods was confirmed by positive dynamics and a clear regression of meteopathic reactions in 76.1% of patients after a general radon therapy and in 61.7% after «dry¼ carbon dioxide baths. Total sodium chloride baths did not have a significant meteorological effect. However, a positive trend in psychological testing indicators was noted, which indicates an improvement in psychological adaptation after a course of treatment. Local cryotherapy procedures helped to reduce only severe meteopathic reactions from 14.3 to 8.3% and improve the psychoemotional state, which may be the choice when it is impossible to use balneotherapy. CONCLUSION: The increase in the frequency of biotropic weather conditions (hypoxic and spastic) is observed in the climate of the Moscow metropolis. This contributes to the increase and aggravation of the meteopathology manifestations. The effectiveness of non-drug methods in the prevention of increased meteorological dependence in patients with joint diseases has been proved.

[The effect of complex use of nicotinic acid electrophoresis and air bubble baths on microcirculation in patients with diabetic polyneuropathy]. / Vliyanie kompleksnogo primeneniya elektroforeza nikotinovoi kisloty i vozdushno-puzyr'kovykh vann na mikrotsirkulyatsiyu u bol'nykh s diabeticheskoi polineiropatiei.

AIM OF STUDY: To study of the effect of the combined impact of nicotinic acid electrophoresis and air bubble baths on the state of microcirculation (MC) in patients with diabetic polyneuropathy (DPN). MATERIALS AND METHODS: 60 patients with DPN and type 2 diabetes mellitus with a disease duration of 6 to 25 years were examined and treated. All patients were divided into 2 groups: 30 patients of the 1st group received the combined impact of nicotinic acid electrophoresis and air-bubble baths; 30 patients of the 2nd group - only electrophoresis of nicotinic acid according to Vermel. The dynamics of the MC state was evaluated according to laser Doppler flowmetry (LDF). RESULTS: Before treatment, in most patients with DPN (98%), according to LDF, a spastic type of MC was established. After a course of treatment, it was found that the combined use of nicotinic acid electrophoresis and air bubble baths in patients with DPN has a more pronounced corrective effect on the condition of the MC than the use of Vermel's electrophoresis of nicotinic acid only. CONCLUSION: Complex therapy, including electrophoresis of nicotinic acid and air bubble baths, has a pronounced effect on the condition of the MC in patients with DPN and is pathogenetically justified for the treatment of this category of patients.

[The role and significance of the physical factors in the treatment and prevention of erosive-ulcerative lesions of the stomach and duodenum]. / Rol' i znachenie fizicheskikh faktorov v lechenii i profilaktike érozivno-iazvennykh porazhenii zheludka i dvenadtsatiperstnoi kishki.

This article covers the issues related to the use of the natural and the preformed physical factors for the treatment and prevention of erosive-ulcerative lesions of the gastro-duodenal area. The existing schemes of their therapeutic treatment provide for the influence only on the separate components of the pathological process which does not allow to achieve the proper correction of the local organic and functional disturbances or the associated systemic disorders. In this context, the purpose of the present article is to demonstrate the importance of the inclusion of various physical factors into the therapeutic programs designed for the treatment of the inflammatory and erosive-ulcerative lesions of the upper digestive tract including the stomach and the duodenum. The present review is focused on the modern data available from the current publications in the scientific literature concerning the possibility and the effectiveness of the application of drinking mineral waters, balneotherapy, and pelotherapy in the combination with secondary prophylaxis and a variety of the rehabilitation modalities for the treatment of the patients presenting with the inflammatory and erosive-ulcerative lesions of the upper part of a digestive tube. It is concluded that these measures, taken together, can efficiently eliminate the said pathological conditions and correct the accompanying systemic disorders. The currently available methods of physical therapy can be not only supplementary to the generally accepted therapeutic modalities but also constitute their basis their basis.

[The fundamental principles behind the evaluation of the bioclimatic potential of the Alma-Ata health resort (Kazakhstan) for the medical purposes]. / Osnovnye printsipy otsenki bioklimaticheskogo potentsiala kurorta Alma-Ata (Kazakhstan) dlya meditsinskikh tselei.

This article reports the results of the analysis of long-term observations carried out at the Almaty health resort (Kazakhstan) with the purpose of evaluating of balneotherapeutic potential of this facility with special reference to the elucidation of its seasonal dynamics and characteristic of the comfort conditions for the inclusion into the program of spa and health resort-based treatment and climatic therapy programs.

[Restoration of the complicated locomotor functions of the upper extremities in the patients surviving ischemic stroke].

During the late and residual periods of stroke, it is necessary to pay attention to the training of complex spatial movements along with the traditional restoration of the balance and strength of para-articular muscles and the mobility of the paretic limb joints. The objective of the present study was to evaluate the effectiveness of robotic therapy for the recovery of the functions of the upper extremities in the late and residual periods of stroke. The study involved 52 patients who had survived ischemic stroke in the middle cerebral artery. The patients were divided randomly into 2 groups. All of them performed therapeutic physical exercises based on the standard technique during 5 days a week for 3 weeks. In addition, the treatment included massage, laser and pulsed current therapy. The patients of the main group (n=36) were additionally trained to perform complex spatial movements with special emphasis on their speed, fluidity, precision, and agility with the use of the Multi Joint System (MJS) robotic electromechanical device (40 min, 5 days/wk x 3wk). The analysis of the results of the study has demonstrated the statistically significant difference in the degree of improvement of the range of motion (ROM) in the elbow and shoulder joints, the speed and the accuracy of these movements between the patients of the main and control groups. It is concluded that the instrumental restoration of complex spatial movements of the upper extremities during the late and residual periods of stroke contributes not only to the improvement of the functional capabilities but also to the enhancement of independence and personal adjustment of the stroke patients.

[The influence of procaine electrophoresis and mesotherapy on the indices of body components and biochemical characteristics in the subjects above 30 years of age].

This study has demonstrated the effectiveness of a 2% procaine solution given with a view to improving metabolic parameters of aging, such as the body weight and composition along with the lipid profile in the patients varying in age from 30 years to 75 years. The study involved 95 patients treated with a 2% procaine solution that was administered by different methods (electrophoresis and mesotherapy) into several points of the collar region and upper back. The control group was comprised of the patients who received placebo by means of galvanization and mesotherapy. The results of the study indicate that the introduction of a 2% procaine solution in the treatment of metabolic disorders effectively improves selected metabolic characteristics of ageing and thereby helps to reduce the biological age in comparison with the control patients treated with placebo.

[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 influence of physiobalneotherapy on the hormonal status of men suffering from obesity].

The objective of the present work was to study the efficacy of the combined treatment of the patients suffering from obesity and erectile dysfunction with the use of contrast baths, electrical stimulation, and cryomassage. Dynamics of the following anthropometric characteristics was evaluated: bodyweight and height, body mass index, waist and hip circumference, waist-to-hip ratio. In addition, general clinical studies were carried out including total blood count, urinalysis, estimation of lipid and carbohydrate metabolism, blood rheologic properties, general hormonal status, and psychological testing. The most pronounced statistically significant dynamics of the above characteristics was documented in the patients treated with the use of general contrast baths, remedial gymnastics, electrical stimulation and cryomassage of the anterior abdominal wall.

[The influence of different massage techniques on the characteristics of biological age in the subjects above the age of 30 years].

This paper is designed to demonstrate the efficacy of different massage modalities used to decrease the biological age in relatively healthy subjects between 30 and 69 years of life. The study involved 78 subjects (67 women and 11 men). Each of them underwent a course of 10 sessions of massage of the collar and upper back regions for the prevention of premature ageing and the reduction of the biological age. Cryomassage was performed with the use of cryocare packs and vacuum massage on the Cerri apparatus (Italy). The control group was comprised of the subjects given no treatment. The main characteristics measured before and after therapy included biomarkers of ageing and biological age. The results of the study indicate that both cryogenic and vacuum massage effectively improves certain biomarkers of ageing; namely, such treatment reduces systolic, diastolic, and pulse pressure, increase pulmonary vital capacity and breath holding time in expiration, improves the sense of equilibrium, self-assessment of health condition, and concentration of attention. Taken together, these effects contribute to the reduction of the biological age of the subjects and prevent their premature ageing to a greater extent than in the untreated persons.

[The influence of procaine electrophoresis and mesotherapy on the characteristics of biological age].

The assessment of the biological age is needed to estimate the level of health and the efficacy of measures being undertaken to slow down the ageing processes and prolong the active life of the patients. Earlier studies have demonstrated the improvement of both physical health and psychic status of the elderly patients following intravenous administration of procaine. The objective of the present work was to evaluate effect of various methods of administration of a 2% procaine solution on the biological age. A total of 95 subjects at the age between 30 and 75 years were enrolled in the study. The procaine solutions were applied to the collar region. The patients of group 1 were treated with 2% procaine electrophoresis, those in group 2 with procaine galvanization with the same parameters. Mesotherapy using the 2% procaine solution was given to the patients of group 3. It was substituted by placebo (0.9% physiological solution) in the patients of group 4 (controls). The study revealed the most significant decrease of the biological age (calculated as described by L. M. Belozerova) in the patients treated with procaine electrophoresis (91% improvement). The mesotherapeutic administration of procaine also produced the beneficial effect (59% improvement). Neither procaine galvanization nor placebo mesotherapy caused any significant change of the variables characterizing the biological age.

[The application of a pulsed low-frequency electrostatic field for the prevention of premature ageing].

This paper demonstrates the effectiveness of the application of a pulsed low-frequency electrostatic field (PLFESF) in order to prevent premature ageing. The study involved 50 subjects. PLFESF therapy was conducted using the DEEP OSCILLATION-200 apparatus with the applicator moved 9.5 cm along the massage lines in the dorsal collar region during 15 minutes. The therapeutic course included 10 sessions of massage at regular intervals every other day. The control subjects did not receive PLFESF therapy. The analysis of the results obtained revealed the influence of effective PLFESF therapy on various biomarkers of ageing which gives reason to recommend this technique for the application for the normalization of hemodynamic parameters, the correction of asthenic-neurotic disorders, the improvement of the patients' well-being and, as a result, the reduction of the biological age and the prevention of premature ageing.

[Combined application of electric myo-stimulation and meso-therapy for the correction of age-related changes of the facial skin].

The objective of the present study was to evaluate effects of mesotherapy (MT) and electrostimulation (EMS) on age-related changes of the facial skin. The secondary objective was to identify factors influencing the therapeutic efficiency of these methods. The study included 60 women aged from 30 to 59 years. All the patients were examined prior to the onset and in the end (after one month) of the corrective treatment. Facial skin conditions were assessed using a Skin XP Pro system and skin microcirculation by laser Doppler flowmetry (LDF). The psychological status of the patients was evaluated with the help of the Well-being-Activity-Mood test. After the primary examination, the participants of the study were randomly divided into two groups. Group 1 (n=30) included women treated by MT and EMS, the control group 2 (n=30) was comprised of the patients who did not receive the above treatment. The results of the study indicate that combine MT + EMS therapy significantly improves the state of facial skin, decreases its pigmentation, reduces the number and depth of wrinkles, enhances skin moisture, improves its elasticity and decreases porosity. Dynamics of these parameters and overall effect of correction were shown to correlate with the severity of skin changes before the treatment. Age-related changes in the facial skin were especially well-apparent in women with the lowered activity level and impaired mood. Characteristics of mood in the course of therapeutic correction correlated with dynamics of skin smoothness and elasticity.

[Efficacy of different methods of ozone therapy in vascular complications of diabetes mellitus]. / Effektivnost' razlichnykh metodik ozonoterapii pri sosudistykh oslozhneniiakh sakharnogo diabeta.

21 patients with diabetes mellitus (DM) type 1 and 97 patients with DM type 2 (a total of 118 diabetics) complicated by angiopathy of the lower limbs and diabetic retinopathy (n = 96) received sugar reducing drugs and ozone-oxygen therapy (OOT). Three techniques of OOT were used: external ("ozone boot" method), systemic (intravenous introduction of ozone-inriched physiological solution or rectal insufflations of ozone-oxygen mixture), combined (external + systemic). The external and combined methods proved superior in trophic disorders in the region of distal parts of the lower limbs while the systemic and combined methods produced better effect on the other signs of diabetic angiopathy and retinopathy, functional and biochemical parameters.