[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 importance of muscular disbalance in physical therapy of the patients presenting with pneumonia].

UNLABELLED: Thematic justification. Pneumonia holds a leading position among the pathological conditions responsible for temporary disability. AIM: The objective of the present study was to develop a rationale for the system of therapeutic physical exercises designed to treat the patients presenting with pneumonia taking into consideration the myofascial disorders and to elucidate its advantages, if any, over the conventional approaches. MATERIAL AND METHODS: A total of 134 patients the patients presenting were examined and treated after they were randomly divided into two groups. The study group was comprised of 73 patients at the mean age of 48.0 ± 4.0 years while the control group consisted of 61 patients (mean age 48.0 ± 4.0 years). The standard clinical and laboratory examination and the chest X-ray study of all the patients were supplemented by the evaluation of the external respiration function and the assessment of the state of myofascial structure with the use of the methods for testing the muscular function. RESULTS: The complete resolution of pneumonia documented by X-ray investigations in the patients of the study group was achieved 20.6% more frequently than in controls (p < 0.05). Chest excursion in the study and control groups increased by 36.63% (p < 0.01) and 7.46% (p < 0.05) respectively. The number of the patients with the unaltered vital lung capacity (VLC) (up to more than 90% of the normal value) increased in the study group by 35.6% (p < 0.01). Simultaneously, the number of the patients with moderate and severe disorders decreased in the study group by 21.9% (p < 0.01) and 12.3% (p < 0.05) respectively. The results of the testing of the muscular function suggest that it was most frequently altered in the erector muscle of the spine, gluteus maximus and gluteus medius muscles, musculus quadriceps femoris, iliopsoas muscle, rectus abdominis muscle and oblique abdominal muscle, deep cervical flexor muscles, pectoralis major and pectoralis minor muscles on the side of the affected lung. After the treatment, these changes in the patients of the study group were observed significantly less frequently than in those of the control one. CONCLUSION: The patients with pneumonia developed the signs of muscular disbalance as a result of pathological myofascial disorders in the muscles of the neck, thoracic cage, abdominal wall, paravertebral region, thigh, and the ilio-lumbar region. The program for the combined treatment of the patients presenting with pneumonia based at a hospital facility including the newly proposed method of physical rehabilitation promoted the accelerated resolution of the inflammatory process as is apparent from the results of the X-ray examination. The respiratory exercises prescribed with due regard for the localization of the inflammatory process and specific changes of spirographic measurements together with microcorrection procedures exerted a more pronounced positive influence on the external respiration function and the state of the locomotor system in the patients of the study group in comparison with the control subjects prescribed a complex of conventional therapeutic physical exercises.

[The principal approaches to the treatment of post-stroke shoulder pain syndrome].

Post-stroke pain syndrome is one of the serious complications of stroke preventing the restoration of motor activity, routine everyday and professional independence of the patients. This review is focused on pathogenesis of central and peripheral shoulder pain syndromes on the affected side of the body and the principal approaches to their treatment during the post-stroke recovery period. The paper describes the main manual and robotic methods for the treatment of shoulder pain depending on its pathogenesis and the typical therapeutic protocols. The special emphasis is laid on the necessity of the pathogenetic approach to the pain alleviation as well as clinical significance of the correction of biomechanical disorders in the upper body and the restoration of the functional ability of the upper limbs in the patients presenting with post-stroke hemiparesis associated with pain syndrome.

[Verticalization as a factor of early rehabilitation in the patients with a spinal cord injury].

The number of days from the spinal cord injury to rehabilitation of the victim has significantly decreased. It means that the rehabilitative treatment begins when the risk of secondary trophic lesions, cardiovascular and respiratory complications is especially high. Training with the use of a tilt-table equipped with the dynamic foot support is considered to be the highly effective method for the prevention or reduction of orthostatic hypotension, impaired ventilation, and pressure sores. This approach makes it possible to influence the patient's motivation for further recovery, decrease the duration of hospitalization in the intensive therapy ward, accelerate adaptation of the patients to the vertical posture, decrease hypotension and hypoxia, reduce to a minimum the occurrence of secondary neurologic disorders. Dynamic tilt-table training is considered to be a more effective modality for the adaptation of the patient to the vertical position than standing with the assistance of a simple table.

[The development of physical education as a basic instrument of rehabilitative treatment, remedial medicine, and goal-oriented health promotion for the benefit of man].

This paper presents a brief description of the development of physical therapy as a basic technology for medical rehabilitation and the current state of research activities in this field at the Federal Therapeutic and Rehabilitative Centre. The importance of targeted re-equipment of health centres, departments of medical rehabilitation and remedial medicine is emphasized for the wider application of novel health-promoting technologies and optimization of control over health improvement procedures through increasing and mobilizing the functional reserves of the human body.

[Physical education and training in the system of purpose-oriented health promotion at the stage of medical rehabilitation].

The present article concerns organization of the health promotion system and its practical implementation with a view to making healthier the population of Russia in general.

[The comparative effect of classic massage of different intensities on patients with chronic salpingo-oophoritis]. / Sravnitel'noe vliianie klassicheskogo massazha razlichnoi intensivnosti na bol'nykh khronicheskim sal'pingooforitom.

Massotherapy in different regimens has been used in 30 patients in remission of chronic salpingo-oophoritis (CSO). The massage produced positive changes in blood coagulation, immune status, regional hemodynamics of the small pelvis, bioelectric activity of the muscles of the anterior abdominal wall and lumbosacral region. A strong anesthetic and antiinflammatory effect of intensive massage in 78%, recovered reproductive function in 33% of the patients allow to recommend intensive massage as possible monotherapy of patients in remission of CSO.

[The effect of massage on the neuromuscular apparatus and blood coagulating system of patients with chronic salpingo-oophoritis]. / Vliianie massazha na nervno-myshechnyi apparat i svertyvaiushchuiu sistemu krovi bol'nykh khronicheskim sal'pingooforitom.

74 patients with chronic salpingo-oophoritis (CS) in remission were assessed as to effects of classic massage of the uterine and epoöphoronic reflexogenic zones on clinical pattern of the disease, bioelectric activity of the abdominal muscles, spine and pelvis, blood coagulation. The combined massage produced a more potent effect on electric activity of the above muscles and blood coagulation than massage on a single area. It is better to start massage from the abdomen and continue in the lumbosacral area.