[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.

[The use of transdermal electroneurostimulation in the rehabilitation of patients after surgical decompression of the carpal tunnel]. / Primenenie transdermal'noi elektroneirostimulyatsii pri reabilitatsii patsientov posle khirurgicheskoi dekompressii karpal'nogo kanala.

Most of the clinical and neurophysiological disorders of the median nerve that persisted in patients after surgical decompression of the carpal tunnel (DCT) are associated not with acute compression of the nerve, but with myelinoaxonopathic disorders in the structure of the nerve that developed as a result of prolonged compression. OBJECTIVE: To study the effectiveness of transdermal electroneurostimulation (TENS) in the rehabilitation of patients with residual neurological deficit after surgical DCT. MATERIAL AND METHODS: We observed 45 patients after DCT (6-12 months), aged 30 to 50 years (mean age 42±3 years). All patients were diagnosed with primary carpal tunnel syndrome with a lesion of the dominant hand, of which 15 patients received pharmacotherapy; 15 patients - in addition to pharmacotherapy, received a course of low-frequency high-amplitude TENS (NTENS) and 15 patients - a course of high-frequency low-amplitude TENS (VTENS). RESULTS: The regression of positive sensory symptoms was more pronounced against the background of VTENS and NTENS than after the use of pharmacotherapy, on average 6.6 times (p<0.01). At the same time, VTENS turned out to be more effective than NTENS by 28.5% (p<0.05). In the long-term follow-up period (2 months), the severity of positive sensory symptoms decreased in patients who received VTENS and NTENS, by an average of 58.1% compared with the baseline values before treatment (p<0.05). The severity of Tinel's symptom in patients who received a course of VTENS decreased by 44%, after a course of NTENS - by 67%, and after pharmacotherapy - by 14%. It was found that NTENS compared with VTENS was 51% more effective in reducing Tinel's symptom (p<0.05) and by 64% - Falen's symptom (p<0.05). The decrease in the time to perform the Jebsen-Taylor test (JTT) after the use of pharmacotherapy was on average 9% (p>1.00), and after TENS - 23% (p<0.05). When comparing VTENS and NTENS among themselves, NTENS turned out to be more effective on average by 68% (p<0.05). An improvement in electro-kymographic parameters was revealed only after the use of VTENS. At the same time, the decrease in the residual latency was 21.3% and the increase in the amplitude of the M-response was 14.3%. CONCLUSION: Transdermal electroneurostimulation is a highly effective method used in the complex treatment of patients with residual neurological disorders after undergoing surgical decompression of the carpal tunnel. The maximum regression of positive sensory symptoms develops against the background of high-frequency low-amplitude transcutaneous electroneurostimulation, and the maximum anti-inflammatory effect, the greatest improvement in the function of small hand muscles and statistically significant neurophysiological restoration of the function of the median nerve are revealed after the application of a course of low-frequency high-amplitude transcutaneous electroneurostimulation. At the same time, positive dynamics after low-frequency high-amplitude transcutaneous electroneurostimulation and high-frequency low-amplitude transcutaneous electroneurostimulation persists in the long-term period.

[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.

[Myostimulating effect of comprehensive application of general magnetotherapy, fractional CO2 laser, electro-myostimulation and special complex of exercise in patients with rectoceleal after open-peconstructure]. / Miostimuliruyushchii effekt kompleksnogo primeneniya obshchei magnitoterapii, fraktsionnogo CO2-lazera, elektromiostimulyatsii i spetsial'nogo kompleksa LFK u patsientok s rektotsele posle rekonstruktivno-plasticheskikh operatsii.

The article presents data on the treatment of 200 women of childbearing, peri - and menopausal age with rectocele of II-III degree, which were divided into 4 groups comparable in clinical and functional characteristics: 1-50 patients who, after surgical treatment of rectocele, underwent a complex consisting of a course of General magnetic therapy, 2 intra-vascular procedures of fractional microablative CO2 laser therapy, electromyostimulation with the pelvic floor muscles and a special complex of therapeutic physical education; comparison 1, which included 50 patients who underwent the above-mentioned complex of rehabilitation measures without General magnetotherapy; comparison of 2-50 patients after surgical treatment of rectocele, who in the late postoperative period (one month after the operation) underwent a set of rehabilitation measures, including a course of electromyostimulation with the biological connection of the pelvic floor muscles, consisting of 10 daily procedures and a special complex of physical therapy and a control group - 50 patients after surgical treatment of rectocele, who in the late postoperative period were treated with symptomatic therapy, including painkillers and antispasmodics, which served as a background for all other groups. As a result of the research, it was found that the developed rehabilitation complexes have a pronounced myostimulating effect, and can be recommended for wide use in rehabilitation programs for postoperative management of patients with rectocele.

[Forensic medical examination of clinical and biomechanical changes in mechanical injuries of the cervical spine ligaments].

Posttraumatic alterations in the cervical spine ligaments were studied clinically and psychologically in the victims with mechanical injuries of the musculoligamentous system of the cervical spine. A clinical course of the traumatic process and biomechanical musculoligamentous alterations, development and severity of mental disorders were established. These characteristics should be taken into consideration in forensic medical evaluation of health deterioration.

[Capacity and resistance parameters of the athlete's cardiovascular system and their dynamics in regular training]. / Emkostnye i rezistivnye parametry serdechno-sosudistoi sistemy sportsmenov i ikh dinamika pri reguliarno trenirovke.

Viscosity and elasticity of the cardiovascular system are assessed by a new method based on evaluation of correlations between deposit properties of the left ventricular chamber, aortic wall and vascular resistance in different parts of the arterial tree. This method examines individual hemodynamic characteristics of healthy untrained persons and hemodynamic changes due to regular training.

[Evaluation of the effect of exercise therapy on the elasticity and viscosity of the myocardium and blood vessels]. / Otsenka vliianiia lechebnoi fizkul'tury na uprugoviazkie svoistva miokarda i sosudov.

The article compares elastoviscous properties of the myocardium and large vessels in patients with ischemic heart disease and arterial hypertension in chemotherapy and its combination with therapeutic exercise and physiotherapy.

[The rehabilitative therapy of patients with osteochondrosis of the cervical spine and manifestations of hypermobility bv means of therapeutic physical exercise]. / Vosstanovitel'naia terapiia bol'nykh osteokhondrozom sheinogo otdela pozvonochnika s iavleniiami gipermobil'nosti sredstvami lechebnoi fizicheskoi kul'tury.

The problems of cervical spine osteochondrosis with hypermobility are of great medical and social significance. Physical rehabilitation methods can improve effectiveness of basic drug therapy. These include isometric exercises, postisometric muscle relaxation, proprioceptive neuromuscular facilitation, postural exercises and special massage.

[The correction of the cardiovascular system changes in patients with the spastic form of infantile cerebral palsy in the chronic residual stage by means of mesodiencephalic modulation]. / Korrektsiia izmenenii serdechno-sosudistoi sistemy u bol'nykh detskim tserebral'nym paralichom v khronicheskoi rezidual'noi stadii so spasticheskoi formoi metodom mezodiéntsefal'noi moduliatsii.

Transcranial electrotherapy--mesodiencephalic modulation on the basis of activation of the central regulatory structures induced by weak impulse current--proved effective in relief of clinical symptoms and mitral prolapse, correction of conduction, automatism, contractility, vegetative unbalance due to normalization of the sympathetic and parasympathetic components of the autonomic nervous system.

[Therapeutic physical exercise for patients after the amputation of the lower extremities at the sanatorium stage of rehabilitation]. / Lechebnaia fizicheskaia kul'tura u bol'nykh posle amputatsii nizhnikh konechnostei na sanatornom étape reabilitatsii.

The authors propose a set of therapeutic exercises developed to prevent degenerative-dystrophic processes and to improve locomotor function in patients undergoing sanatorium treatment after lower limb amputation. Swimming and loading exercises have improved strength and performance of spinal muscles, amputated and supporting limb, reduced osteoporosis of the stump bone fragment. The efficacy of the above approach was evaluated by dynamometry on the test-dynamometer Biodex and by ultrasound osteometry.

[The rehabilitative therapy of patients with persistent paralysis of the mimetic muscles]. / Vosstanovitel'naia terapiia bol'nykh so stoikim paralichom mimicheskikh myshts.

Based on the well-known rearrangement of the intracentral relationships when forming a new movement, the authors have developed a technique of functional rearrangement of the sternocleidomastoid muscle displaced on the angle of the mouth. The technique allowed the authors to improve the patients' appearance, to facilitate articulation and taking food.