[Effectiveness of using a hardware complex with biofeedback in the rehabilitation of children with dysfunction of the upper limbs]. / Effektivnost' primeneniya apparatnogo kompleksa s biologicheskoi obratnoi svyaz'yu v reabilitatsii detei s narusheniem funktsii verkhnikh konechnostei.

The upper limb is of exceptional importance for human life as an organ of cognitive and practical activity. Fine motor skills of hands are a set of small, highly coordinated, precise and coordinated movements of varying degrees. Diseases and injuries of the musculoskeletal and nervous systems lead to violations of fine motor skills. Effective programs for medical rehabilitation of hand and fingers include using biofeedback devices (BFB). PURPOSE OF THE STUDY: Efficiency evaluation of the hardware-software complex with BFB in restoring the impaired function of the upper limb in children. MATERIAL AND METHODS: The clinical study included 79 patients aged 4 to 18 years with dysfunction of the upper limb not higher than level III according to MACS (The Manual Ability Classification System), who were divided by simple randomization into the main group (49 patients) who received 21 days of a comprehensive rehabilitation program (physiotherapy exercises, paretic muscle massage, mechanotherapy, hydrokinesiotherapy, methods of apparatus physiotherapy) using a hardware-software complex, and a comparison group (30 patients), in which the complex rehabilitation program did not include biofeedback procedures. RESULTS: This performed prospective open randomized comparative study revealed the effectiveness of the standard rehabilitation program in combination with training on the BFB complex (main group) to be higher than using only the standard program. After treatment, patients of the main group showed a noticeable decrease in the degree of muscle spasticity in the affected limb, strengthening of muscle strength, improvement of fine and gross motor skills of the hands, and improvement of manual skills. CONCLUSION: The use of a hardware-software complex with biofeedback in children with dysfunction of upper limbs increases effectiveness of the rehabilitation program.

[Treatment of patients with chronic cerebral ischemia: experience of using the combined neuroprotective drug Picamilon Ginkgo]. / Lechenie bol'nykh s khronicheskoi ishemiei golovnogo mozga: opyt primeneniya kombinirovannogo neiroprotektivnogo preparata Pikamilon Ginkgo.

OBJECTIVE: To compare the clinical efficacy and safety of Picamilon Ginkgo and ginkgo biloba in patients with cognitive impairment in vascular diseases of the brain (chronic cerebral ischemia). MATERIAL AND METHODS: An open multicenter randomized comparative study involved 278 patients over 45 years of age with a diagnosis of chronic cerebral ischemia and cognitive impairment. 139 of them received Picamilon Ginkgo and 139 received monotherapy with ginkgo biloba extract for 90 days. Dynamics were compared on the MoCA, MMSE, Hamilton scale for assessing depression and the quality of life of EQ-5D, and the subjective effectiveness of therapy by patients and doctors was evaluated. RESULTS: Combination therapy resulted in significantly greater regression of cognitive impairment compared to monotherapy. At the end of the study, the differences between the groups were significant both on the MMSE scale (p=0.007) and on the MoCA scale (p=00003). At the same time, significant differences between the groups in the magnitude of cognitive improvement on the MoCA scale were noted already from the 30th day of treatment. Combination therapy also contributed to a more significant improvement in the patient's quality of life: dynamics on the EQ-5D scale significantly (p<0.05) differed in the groups, also starting from the 30th day of therapy. There were no significant differences in the dynamics of the Hamilton scale for assessing depression between the compared groups. Both Picamilon Ginkgo and monotherapy with ginkgo biloba extract were safe and were not accompanied by significant adverse events. CONCLUSION: The combination of standardized ginkgo biloba extract with Picamilon has an advantage over monotherapy with ginkgo biloba extract in patients with chronic cerebral ischemia, as it contributes to a more significant regression of cognitive impairment and improvement of quality of life.

[General hydro galvanic baths in the treatment of patients with lumbosacral radiculopathy]. / Obshchie gidrogal'vanicheskie vanny v lechenii patsientov s poyasnichno-kresttsovoi radikulopatiei.

INTRODUCTION: Hydrogalvanic baths are a hydrotherapy method based on the combined effect of electric current and fresh water on the body. AIM OF STUDY: Scientific evidence and evaluation of the effectiveness of use of general hydrogalvanic baths in the treatment of patients with lumbosacral radiculopathy with the background of degenerative spinal disorder. MATERIALS AND METHODS: A randomized comparative clinical trial included 84 patients. The 1st (active) group included 43 patients, the 2nd (control) had 41 patients. Patients of the 1st group received general hydrogalvanic baths. Patients in the control group - drug treatment, including NSAIDs, muscle relaxants, anticonvulsants. The assessment was carried out before treatment, at the end of the course (on the 14th day) and 3 months after the end of treatment according to the results of neurological examination, VAS questionnaires, Pain DETECT, Beck scale, Oswestry scale, SF-36 scales, electroneuromyography (nerve conduction study). RESULTS: In patients receiving general hydrogalvanic baths, in comparison with the control group, there was an improvement in sensitivity (the incidence of hypesthesia decreased from 77 to 11%, p=0.008) and conductivity in peripheral sensory fibers. A decrease in pain was observed in both groups, however, a decrease in neuropathic pain was recorded only in patients receiving drug treatment. In the 1st group during therapy, an improvement in the emotional state in patients and a decrease in the level of depression were revealed. An analysis of long-term results showed that the delayed effect of non-drug treatment significantly increased in patients of the 1st group in comparison with the control group (p<0.05). CONCLUSIONS: Exposure to general hydrogalvanic baths is an effective way to treat lumbosacral radiculopathy, the main registered effects are: improvement of sensitivity, reduction of pain and stabilization of the emotional background. However, the studied method does not affect neuropathic pain.

[The modern methods of the electrical stimulation for the management of neurogenic disturbances of urination].

The results of the present study provide materials for the characteristic and the comparative analysis of the methods for electrical stimulation applied for the treatment of neurogenic disorders of urination and illustrate the up-to-date requirements to this therapy taking into consideration the neuroanatomical and neurophysiological features of micturition. One of the most advanced non-pharmacological methods is electrical stimulation and neuromodulation of the urinary bladder function and pelvic floor muscles. The objective of this three-step research was to elucidate the mechanisms of action of electrical stimulation and to compare the effects of tibial and pudendal neuromodulation in 22 patients presenting with ischemic lesions in the brain. The first step included the comprehensive clinical and neuroimaging investigations designed to determine the role of functional asymmetry of cortical and subcortical micturition regulatory centers during the recovery process following the ischemic lesions. At the second stage, afferent and central regulation of micturition was investigated by the method of tibial and pudendal somatosensory evoked potentials in the patients presenting with overactive bladder and acute or chronic cerebral ischemia. At the final step, the optimal parameters of neuromodulation were chosen depending on the form of the urination disorder. It is concluded that the study gave evidence of the high therapeutic effectiveness of tibial and pudendal neuromodulation for the treatment of overactive bladder associated with neurological disorders (including ischemic lesions in the brain).