[Application of peripheral magnetic stimulation in physiotherapeutic practice. (A literature review)]. / Primenenie perifericheskoi magnitnoi stimulyatsii v fizioterapevticheskoi praktike. (Obzor literatury).

Search and development of new physiotherapeutic technologies of regenerative medicine for the treatment of patients with different diseases is an urgent task of modern medicine. OBJECTIVE: To analyze scientific data on the effectiveness of the peripheral magnetic stimulation (PMS) application in patients with different diseases. MATERIAL AND METHODS: An analysis of publications in databases of electronic resources (PEDro, PubMed, Embase, eLibrary, Cochrane Library) over the past 20 years was carried out, the results of PMS application in patients with different nosologies were presented. RESULTS: The majority of the presented articles confirm the clinical effectiveness of PMS application mainly in patients with diseases of the nervous system, spine and genitourinary system. CONCLUSION: Further research to confirm the effectiveness of the therapeutic impact of magnetic stimulation in patients with other nosologies is needed.

[Instrumental physiotherapy for treatment of patients with chronic prostatitis: analysis of evidential researches]. / Apparatnaya fizioterapiya v lechenii patsientov s khronicheskim prostatitom: analiz dokazatel'nykh issledovanii.

Currently important task of modern medicine is the development of personalized comprehensive physiotherapy technologies for the treatment of patients with chronic prostatitis (CP). OBJECTIVE: To analyze scientific data about efficacy of physiotherapy methods for the treatment of CP. MATERIAL AND METHODS: The number of publications equal 55 about evaluation of therapeutic effects of instrumental physiotherapy in patients with CP have been conducted. The search was done in electronic databases (PEDro, PubMed, EMBASE, eLIBRARY), systematic reviews databases (Cochrane library) for the last 20 years by keywords in Russian and English: «Ñ…ронический простатит¼ (chronic prostatitis), «ÑÐ»ÐµÐºÑ‚ротерапия¼ (electrotherapy), «Ð¼Ð°Ð³Ð½Ð¸Ñ‚отерапия¼ (magnetotherapy), «Ð»Ð°Ð·ÐµÑ€Ð½Ð°Ñ терапия¼ (laser therapy), «ÑƒÐ´Ð°Ñ€Ð½Ð¾-волновая терапия¼ (shock wave therapy), «ÑƒÐ»ÑŒÑ‚развук¼ (ultrasound). RESULTS: The clinical effects and suggested action mechanisms of instrumental physiotherapy methods in patients with CP were presented. CONCLUSION: Based on the results of the randomized placebo-controlled trials, presented in the review, it can be concluded, that certain physiotherapeutic interventions, such as transcutaneous electrical nerve stimulation, extracorporal shock wave therapy, ultrasound, impulsive magnetotherapy lead to decrease of prostatitis symptoms.

[Low level laser therapy: molecular mechanisms of anti-inflammatory and regenerative effects]. / Nizkointensivnaya lazernaya terapiya: molekulyarnye mekhanizmy protivovospalitel'nogo i regenerativnogo effektov.

Laser therapy as a physiotherapeutic method has been successfully used for a long time in the treatment of various pathologies, but the action mechanisms of low level laser therapy (LLLT) remain understudied. OBJECTIVE: To perform the analysis of published results of LLLT investigations, to describe the physical principles of photobiomodulation, its action mechanisms on various cells and tissues, therapeutic intervention and efficiency of the technique. MATERIAL AND METHODS: The search of articles was done for the period from 2014 to 2022. The preference was given to the articles for the last 5 years in the PubMed database depending on keywords: low level laser therapy, photobiomodulation, exosomes, monocytes, macrophages. RESULTS AND DISCUSSION: This article represents the current conceptions about the action mechanisms and reproduced effects of low level laser therapy, the photobiomodulation influence on the inflammation and reparative processes in human body by intervention on cells and their signal pathways. The discussion of research results and probable causes of conflicting data are performed, as well as the efficacy assessment of laser irradiation in different conditions and diseases is made. CONCLUSION: Laser therapy has certain variety of advantages, among which: non-invasiveness and availability, long-term service of equipment, stable intensity of light radiation and the ability to use in various wavelength ranges. The technique efficacy was proven for a large number of diseases. However, for the successful application of photobiomodulation in clinical practice in current evidence-based medicine, additional investigations are necessary to determine the best dosimetric radiation parameters, as well as further study of action mechanisms on various human cells and tissues.

[Non-drug methods of treatment of post-thrombophlebitic syndrome]. / Nemedikamentoznye metody lecheniya posttromboflebiticheskogo sindroma.

Postthrombophlebitic syndrome (PTPS) develops in 20-50% of patients who have had deep vein thrombosis (DVT). Patients with chronic venous insufficiency (CVI) of class C4-C5 according to the CEAP clinical classification, which developed as a result of DVT of the lower extremities, including those who underwent endovascular treatment (iliac vein stenting), are subject to staged medical rehabilitation. In this regard, the development of personalized complex technologies for the sanatorium treatment of patients with PTPS is an important medical and social problem. PURPOSE OF THE STUDY: Study of clinical efficacy and identification of the mechanisms of action of a new complex of spa treatment of patients with PTPS of the lower extremities using supravenous laser radiation, low-frequency magnetotherapy, dry-air carbon dioxide baths and structured therapeutic exercises in the gym. MATERIAL AND METHODS: 60 patients with PTPS of the lower extremities (CVI C4-C5 according to CEAP) were under observation. All patients were randomly divided into 2 groups: first group (main group) included 30 patients who received a treatment, including procedures for supravascular laser blood irradiation, pulsed magnetotherapy and dry-air carbon dioxide baths, as well as structured therapeutic exercises in gym under the supervision of an exercise therapy instructor; second group (control group) included 30 patients who received standard elastic compression (compression class 2-3) while taking lymphovenotonics (a combination of diosmin and hesperidin) and therapeutic exercises in the gym. RESULTS: Against the background of the course of treatment in patients of the main group, to a greater extent than in the control group, a decrease in the clinical symptoms of the disease was noted: a more pronounced regression of edema, a decrease in heaviness in the legs, as evidenced by the data of anthropometric studies and questionnaires on the CIVIQ-2 scale. Positive dynamics in the microcirculation system (MC) was established, which was confirmed by the data of laser Doppler flowmetry. In patients with spastic-congestive type of MC, a decrease in the initially increased myogenic and neurogenic tone of arterioles was registered. There was a decreasing of stagnation in the venular link. In patients with hyperemic-congestive type of MC, the initially reduced tone of arterioles increased, which contributed to the improvement of blood flow in the capillaries. There was also a decrease in congestion in the venular link of the microvasculature. CONCLUSION: A new effective complex method for the rehabilitation of patients with PTPS has been developed, including laser exposure according to the general method, pulsed magnetotherapy and dry-air carbon dioxide baths, which have a multifocal effect on different links in the pathogenesis of PTPS.

[Laser therapy effect on endothelial dysfunction in patients after the surgery for orthognathic disorders]. / Vliyanie lazernoi terapii na endotelial'nuyu disfunktsiyu u bol'nykh, operirovannykh po povodu ortognaticheskoi patologii.

OBJECTIVE: To optimize postoperative rehabilitation by applying low-intensity laser irradiation (LILI) with different wavelengths in the early postoperative period to prevent inflammatory complications. MATERIAL AND METHODS: After radiological examination and ultrasound diagnostics of the periodontal tissue vessels, surgical methods of orthognathic treatment were performed, after completion of which a course of LILI was carried out. The VEGF its receptors (sVEGF-R1; sVEGF-R2) content was measured by enzyme immunoassay using standard reagent kits. The laser therapy using 635 nm laser light was applied directly to the vestibular and oral surfaces of the gingival tissues and in the operation area, changeable by the scanning method, for 1.5 minutes (5 W power); the pulsed infrared laser therapy (PILT) with the 904 nm wavelength (light pulse duration 100 s, power 15 W, 1500 Hz) applied epicutaneously to the operation projective zones (four control points of the upper and lower jaw) through the skin of the cheek, in stable method (1.5 minutes) with a time range between red and infrared wavelength LILI not exceeding 100 s (1.5 minutes). RESULTS: Vascular and endothelial dysfunction after laser irradiation with different wavelengths is better controlled by increasing the microcapillary blood flow (66.7% gain; p<0.05) in arteriolar and 70.3% in venular sections of capillaries (p<0.01), which is associated by vasodilatation: diameter increased by 26.9% compared to that under the influence of red laser radiation (by 13.0%) and infrared laser radiation (by 7.2%); p<0.01). CONCLUSIONS: Early laser therapy using the low-intensity laser irradiation with different wavelengths improves vasoactive processes of hemoregulation in dental tissues associated with the elimination of vasospasm caused by operative stress, activation of arteriolodilatory effects, contributes to the prevention of development of inflammatory complications.

[Role of total cryotherapy in combination with transcranial magnet therapy in the change of microcirculation and psychological status in patients with menopausal syndrome]. / Rol' obshchei krioterapii v komplekse s transkranial'noi magnitoterapiei v izmenenii mikrotsirkulyatsii i psikhologicheskogo statusa u patsientok s klimaktericheskim sindromom.

One of the current health care problems is a menopausal syndrome (MS), a set of symptoms characterized by specific metabolic, neurological, autonomous, and psychosomatic changes. Many authors believe that one of the main methods of prevention and treatment of menopausal disorders is hormone replacement therapy, but there are many contraindications. Therefore, there is increasing interest in the development of non-medicinal therapy methods, in particular, physiotherapeutic treatment. OBJECTIVE: To study the effect of total cryotherapy alone and in combination with transcranial magnet therapy on the microcirculation state and psychological status in patients with MS. MATERIAL AND METHODS: The study included 62 female patients (mean age was 51±1.9 years). Thirty-five (56%) patients had mild menopausal syndrome and 27 (44%) moderate severity. All patients were divided into two clinically and functionally comparable groups by simple randomization: Group 1: 30 patients who received total cryotherapy (TCT); Group 2: 32 patients who received complex treatment including TCT and transcranial magnet therapy. The blood lipid spectrum was studied in all patients before and after the treatment course. The psychological examination was carried out using the well-being/activity/mood test (WAM). The microcirculation state was assessed by laser Doppler flowmetry (LDF). RESULTS: The majority of the patients had abnormalities in the lipid spectrum, decreased psychological adaptation, and worsened microcirculation indices (according to LDF data). After a treatment course, improvement in the lipid spectrum, LDF, and WAM test scores according to all scales was more pronounced in group 2 patients receiving complex therapy. CONCLUSION: The combined effect of total cryotherapy and transcranial magnet therapy had a more pronounced positive impact on the lipid spectrum, psychoemotional state, and microcirculatory processes in patients with menopausal syndrome compared with the total cryotherapy alone. It can be assumed that this complex will be effectively used in practical healthcare.

[Vacuum interference therapy in the complex treatment of patients with chronic bacterial prostatitis]. / Vakuum-interferentsterapiya v kompleksnom lechenii patsientov s khronicheskim bakterial'nym prostatitom.

Taking into account the complex etiology and pathogenesis of chronic prostatitis, a large number of complications including the reproductive function impairment, the developing new effective methods of treating this pathology remains highly relevant. OBJECTIVE: Scientific substantiation of combined electric vacuum exposure in patients with chronic bacterial prostatitis (CBP). MATERIAL AND METHODS: The 90 patients with CBP aged 27-55 years were examined and were divided into 3 equal groups by the method of simple randomization. Patients of the main group received vacuum interference therapy procedures, the comparison group received interference therapy without vacuum exposure, and the control group received only standard drug therapy that was also prescribed in the first two groups. The effectiveness of therapy was assessed before, immediately after and 6 months after using the NIH-CPS, IPSS, QOL scales, trans-rectal ultrasound examination of the prostate gland, bacteriological examination and microscopy of a native preparation of prostate secretion and uroflowmetry. RESULTS: An improvement in the clinical symptoms of CBP was found largely in the groups receiving physiotherapy. In the main group there was a more significant volume decrease in the inflammatory-altered prostate gland (by 31.5%), in the comparison group the volume of the prostate gland decreased by 14%, and in the control group - by 9.6% that indicates the most pronounced anti-inflammatory effect of electro-vacuum actions. In the main group, there was also a more pronounced positive dynamics of dysuric disorders' indicators and maximum urination rate compared to the comparison and control groups. CONCLUSION: A higher clinical efficacy of vacuum interference therapy in patients with CBP (93.3%) has been proven compared with interference therapy (80.0%) and standard therapy (66.6%). The data obtained confirm the advantages and usage prospects of the combined physiotherapeutic effects.

[Nutraceutical correction in the complex non-drug treatment of metabolic syndrome]. / Nutritsevticheskaya korrektsiya v kompleksnom nemedikamentoznom lechenii metabolicheskogo sindroma.

The use of complex non-drug technologies at the stage of rehabilitation of metabolic syndrome (MS) includes multifactorial correction of its main manifestations: abdominal obesity, insulin resistance, arterial hypertension and dyslipidemia. A prospective randomized study on the use of low-calorie diet (LCD) and nutraceutical correction of the nutritional status of patients with MS was carried out. OBJECTIVE: To study the effect of a non-drug complex including LCD, physical exercises, as well as correction of the gut microbiome and hepatic protection in relation to reduction of visceral fat volume in abdominal obesity and the dynamics of lipid and carbohydrate metabolism hormones in metabolic syndrome. MATERIAL AND METHODS: 120 patients with MS were randomized into 2 groups: Group 1 received LCD, physical exercises in the gym, and physical activity like daily walking up to 3-5 km/day. Group 2 received LCD, physical exercises in the gym, physical activity like daily walking up to 3-5 km/day, as well as nutraceutical correction of increased appetite, gut probiotic composition, hepatic protection. The treatment duration was 4 weeks. Anthropometric methods in order to control the body weight, waist and hip circumferences and bioimpedansometry were used. RESULTS: As a treatment result, patients in group 1 represented a reduction in body weight, lean and active cell mass, a decrease in musculoskeletal mass and a decrease in total fluid due to extracellular fluid. A decrease in total cholesterol and blood triglyceride fraction was noted. Leptin decreased by 13.96%. Patients of the 2nd group represented a decrease in body weight, fat mass, lean mass, total fluid and extracellular fluid. There was a statistically significant increase in active cell mass, skeletal muscle mass. There was a decrease in total cholesterol, triglycerides and transaminases. Due to weight loss and fat mass reduction a decrease in leptin expression by 29.85% and decrease in blood insulin levels by 11.2% were noted. CONCLUSION: Thus, LCD accompanied by nutraceutical correction of the gut microbiota and hepatic protection can be effectively used in combination with physical training in order to reduce the fat mass without pre-sarcopenia development that was confirmed by positive dynamics of volume indices, bioimpedance measurements and reduction in leptin and insulin expression.

[Pathophysiological mechanisms of the therapeutic action of alternating electromagnetic fields in the treatment of osteoarticular pathology]. / Patofiziologicheskie mekhanizmy terapevticheskogo deistviya peremennykh elektromagnitnykh polei v lechenii kostno-sustavnoi patologii.

Treatment of osteoarticular pathology with an alternating electromagnetic field (AEMF) is used today as a promising, non-invasive and safe strategy of physiotherapy. It has been shown that the action of alternating electromagnetic fields on the musculoskeletal system triggers signaling cascades that effectively contribute to the restoration of bone and articular tissue. The pathophysiological mechanisms underlying the cellular and subcellular effects of stimulation by an alternating electromagnetic field during the restoration of bone and articular tissue are considered. It was pointed out the several key signaling pathways involved in the restoration of bone and articular tissue under the influence of electromagnetic fields with an analysis of the potential for therapeutic application of electromagnetic fields alone or in combination with other available therapies.

[Rehabilitation methods for cancer patients with peripheral polyneuropathy induced by cytostatics]. / Metody reabilitatsii onkologicheskikh bol'nykh s perifericheskoi polineiropatiei, indutsirovannoi tsitostatikami.

An analytical review of the methods of cancer patients' rehabilitation with peripheral polyneuropathy induced by cytostatics (PNPIC) was carried out. Studies from electronic databases were investigated: Scopus, Web of Science, MedLine, World Health Organization, The Cochrane Central Register of Controlled Trials, ScienceDirect, US National Library of Medicine National Institutes of Health, PubMed Cancer, eLIBRARY, CyberLeninka. Despite the improvement of anticancer therapy and an increase in patients' life expectancy, the emerging peripheral polyneuropathy remains an urgent problem, since it significantly affects both the patients' life quality and the selection of adequate therapy. The frequency of detection of PNPIC is 90%, after discontinuation of treatment; symptoms of damaged peripheral nerve fibers remain in 30% of patients. The clinical symptoms of PNPIC are varied and most often include numbness in the extremities and / or increased sensitivity to thermal or mechanical stimuli, neuropathic pain. Currently, to prevent PNPIC, treatment is being modified with a reduction in the duration of courses and doses of cytostatics, and interruption of treatment. Official guidelines do not recommend any prophylaxis other than the possible use of duloxetine or a topical gel containing baclofen, amitriptyline, and ketamine. Over the past few years, there has been no significant progress in the prevention and treatment of PNPIC. The most common drug treatment method in clinical practice is the prescription of vitamins B. Among the non-drug treatment methods of PNPIC, the authors used acupuncture, electro-acupuncture, manual therapy, massage, gymnastics, yoga, sensorimotor training, general vibration therapy, percutaneous electro-neuro-stimulation, electro-analgesia, local cryotherapy, hydrotherapy, low-intensity alternating magnetic radiation. The studies included in the review are heterogeneous in design and protocol, number of patients, and time points for assessing outcomes. In connection with the existing differences, it is not possible to carry out a comparative analysis of the results of these rehabilitation types and to give an unambiguous answer about their effectiveness. As the analysis has shown, peripheral PNPIC is well known all over the world, however, the search for methods of its treatment is far from complete.

[The effectiveness of combined laser therapy in patients with trophic leg ulcer and chronic venous insufficiency]. / Effektivnost' kombinirovannoi lazernoi terapii patsientov s troficheskimi yazvami nizhnikh konechnostei na fone khronicheskoi venoznoi nedostatochnosti.

New prospects associated with the use of laser radiation of different wavelengths in the ultraviolet (365 nm) and the green emission spectrum (525 nm) have appeared in recent years. The high prevalence of the trophic leg ulcers necessitates the search for more effective methods of conservative treatment. PURPOSE OF THE STUDY: Development and scientific justification for the low-intensity laser radiation of different wavelengths combined use in patients with trophic leg ulcers and chronic venous insufficiency (CVI). MATERIAL AND METHODS: 102 patients with trophic leg ulcers and CVI were examined. They were divided into 3 equal groups using simple randomization. Patients in the control group received only traditional conservative therapy; comparison group - traditional conservative therapy and an intravenous laser blood irradiation (ILBI) (λ - 635 nm); the main group - traditional conservative therapy and different wavelengths laser therapy (LT) course. RESULTS AND CONCLUSION: A more significant improvement in the clinical condition occurred under the influence of the course application of combined different wavelengths laser therapy in patients with trophic venous leg ulcers. Compared to patients who received traditional conservative therapy and in combination with ILBI 635 nm, the speed of reparative regeneration of trophic ulcers increased, the time for cleansing trophic ulcers from devitalized tissues was reduced. Computer capillaroscopy data showed that the positive effect of laser exposure on all parts of the microcirculation underlies its therapeutic efficacy.

[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.

[Transcerebral magnetic and shock wave therapy in correction of erectile dysfunction]. / Transtserebral'naya magnito- i udarno-volnovaya terapiya v korrektsii erektil'noi disfunktsii.

Given the complex pathogenesis of erectile dysfunction (ED), the inclusion of not only effective local physiotherapeutic effects, but also general physiotherapy methods into the treatment complexes of patients with ED is most justified. Transcerebral exposure to magnetic fields occupies a special place among them. AIM OF STUDY: Development and scientific justification of a new complex physiotherapeutic method, including shock wave therapy (SVT) and transcerebral magnetotherapy, for the treatment of patients with ED. MATERIALS AND METHODS: A prospective randomized study was carried out, which included 40 patients with a vasculogenic form of ED who underwent outpatient treatment at the Federal State Budget Scientific Institution «Research Center of the Republic of Kazakhstan¼ of the Ministry of Health of Russia. The 1st group (comparison) included 20 patients who received only 7 SVT procedures. The 2nd group (main) included 20 patients who received a comprehensive physiotherapeutic effect: topically - SVT (No. 7), transcerebral - running impulse magnetic field (No. 7). RESULTS: As a result of course of SVT in combination with transcerebral magnetotherapy, the total score according to the IIEF-5 questionnaire in patients increased by 34.1% (p <0.05), comparing with patients receiving only SVT (20.7%). In patients of main group, an increase in the quality of hardness of erection according to the Goldstein scale was noted to increase by 30.9%, in patients of comparison group - by 20.5%. It was found that the high clinical results of use of SVT in combination with transcerebral magnetotherapy are based on the compensation of local blood circulation, which manifests itself in eliminating the deficiency of blood supply by improving the tone of arterial vessels and eliminating venous stasis according to laser Doppler flowmetry (LDF). The inclusion of transcerebral magnetotherapy in the treatment complex helps to increase the level of total testosterone. CONCLUSION: Higher therapeutic efficacy of the complex treatment of patients with ED using SVT and transcerebral magnetotherapy was revealed.

[Impact of external counterpulsation on microcirculation in patients with coronary heart disease complicated by chronic heart failure after surgical and endovascular myocardial revascularization]. / Vliianie naruzhnoi kontrpul'satsii na sostoianie mikrotsirkuliatsii u patsientov s ishemicheskoi bolezn'iu serdtsa, oslozhnennoi razvitiem khronicheskoi serdechnoi nedostatochnosti, posle khirurgicheskoi i éndovaskuliarnoi revaskuliarizatsii miokarda.

AIM: To study the impact of external counterpulsation (ECP) on endothelial function and microcirculation in patients after myocardial revascularization (stenting and coronary artery bypass grafting) for functional class (FC) II-III chronic heart failure (CHF). SUBJECTS AND METHODS: Sixty patients aged 50 to 75 years after myocardial revascularization for FC II-III CHF were examined. All the patients received one-hour ECP sessions 5 times per week. The treatment cycle consisted of 35 sessions. To evaluate the microcirculatory bed, capillary blood flow was studied by laser Doppler flowmetry. RESULTS: The cycle of ECP in patients with FC II-III CHF after myocardial revascularization had a corrective effect on the microhemodynamic system. Microcirculatory changes were due to the normalized myogenic and neurogenic tone of arterioles and to increased oscillations in the endothelial range. The pronounced beneficial effect of ECP on the cardiovascular system in the examined patients was confirmed by a significant increase in exercise tolerance and by a statistically significant improvement in the results of 6-minute walk test. There was a decrease in FC heart failure. CONCLUSION: ECP is an effective, non-invasive treatment in patients with heart failure.

[Efficiency of magnetic therapy techniques in the treatment and rehabilitation of patients with joint diseases from the standpoint of evidence-based medicine]. / Éffektivnost' metodov magnitoterapii v lechenii i reabilitatsii patsientov s zabolevaniiami sustavov s pozitsii dokazatel'noi meditsiny.

This article provides information on currently proven effective treatment methods for patients with joint diseases, by using magnetic fields with various physical characteristics. A wide range of biotropic parameters allows obtaining various primary physicochemical changes in biological tissues, which was a rationale for including magnetic therapy (MT) in the combination treatment of degenerative-dystrophic and inflammatory diseases. Analysis of scientific publications suggests that there are a large number of randomized, placebo-controlled studies providing evidence for reduced pain, improved joint functional activity and quality of life in patients with knee osteoarthritis under magnetic fields with varying inductions, frequencies, and exposures. There are few randomized clinical trials identifying the efficiency of MT for a number of other joint diseases and after arthroplasty. Despite the fact that there are differences in methodological approaches, it is possible to draw a general conclusion on the scientific validity of using MT in the complex treatment and rehabilitation programs for patients with joint diseases and on the prospects of further developments in this area.

[The application of instrumental physiotherapy for the treatment of the patients with erectile dysfunction]. / Primenenie apparatnoi fizioterapii u bol'nykh s érektil'noi disfunktsiei.

This article presents information on the application of apparatus physiotherapy for the treatment of the patients with erectile dysfunction. The authors report the results of the analysis of scholarly research designed to confirm the effectiveness of the physiotherapeutic methods applied for the treatment of the patients presenting with this pathology. Special attention is given to the mechanisms underlying the influence of the procedure with the use of local negative pressure-LOD therapy and shock wave therapy on the main pathogenetic components of erectile dysfunction. In addition, the article provides information about the effectiveness of the modern combined physiotherapeutic techniques including sinusoidal modulated current (SMT) electrophoresis of vasoactive substances and vibromagnetic-laser therapy in the combination with the general purpose methods as exemplified by intravenous laser irradiation. Based on the evidence presented in the article, the authors arrive at the conclusion about the prospects for further research on the development of new physiotherapeutic modalities and their introduction in the practical treatment of the patients with erectile dysfunction.

[The application of combined low-intensity laser therapy for the treatment of the patients presenting with trophic ulcers associated with chronic venous insufficiency of the lower extremities]. / Kombinirovannaia lazernaia terapiia v lechenii patsientov s troficheskimi iazvami nizhnikh konechnostei.

AIM: The objective of the present study was the evaluation of the effectiveness of the combined treatment of the patients presenting with trophic ulcers associated with chronic venous insufficiency of the lower extremities of venous etiology with the application of low-intensity laser therapy (LILT) at different wavelengths. MATERIAL AND METHODS: The study included the patients presenting with chronic venous insufficiency (CVI) (class C6 in accordance with the CEAP clinical classification). The ultrasonic Doppler examination (USDG) of the lower extremities revealed valvular insufficiency in the saphenous veins in 98.8% of the examined patients, in the deep venous system in 58% of them, and in the perforating veins in 72% of the cases. The laser Doppler flowmetry technique was used to assess the state of the microcirculation. Group 1 was comprised of 34 (43.59%) patients undergoing the traditional conservative treatment that consisted of pharmacotherapy (including antibiotic therapy, depending on the sensitivity of microflora assessed by the culture technique), the local treatment in the form of dressing in compliance with the standard surgical treatment schemes depending on the phase of the wound healing process, and elastic compression of the lower extremities. The main group 2 consisted of 44 patients (56.41%) who were treated, in addition to the traditional conservative therapy, with the use of LILT according to the new technique that combines the external laser exposure of the trophic ulcer region using the 'LASMIK' laser device during a single 2 minute session per zone in the pulsed mode (light pulse duration of 100-130 ns, frequency 80 Hz), at a wavelength of 635 nm, by a matrix emitter (consisting of eight laser diodes with the surface area of 8 cm2), at a distance up to 7 cm, with pulsed power of 40 W, power density of 5 W/cm2, and the intravenous laser blood illumination (fiber output power 2 mW) with a wavelength of 365 nm (UV range) and 525 nm (green spectrum) alternately, every other day. Each patient underwent 12 daily procedures per course. RESULTS: Combined low-intensity laser therapy promoted the rapid recovery of the sympathetic regulation of the microvascular tone and normalization of arteriolar-venular relationships which contributed to the improvement of blood supply to the tissues, the reduction of inflammation, enhanced activation of the reparative processes, and acceleration of epithelialization of trophic ulcerous defects. CONCLUSION: The combined strategy makes it possible to carry out the more effective treatment of the patients presenting with trophic ulcers with the three-fold reduction of the ulcer healing time and the pronounced stimulation of the persistent adaptation of the physiological responses preventing the development of the relapses.

[The application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities]. / Impul'snaia magnitoterapiia v lechenii patsientov s limfedemoi nizhnikh konechnostei.

AIM: The principal objective of the present work was to evaluate the influence of impulse magnetic therapy on the state of the microcirculatory system in the patients presenting with lymphedema of the lower extremities. MATERIAL AND METHODS: The study included 59 patients with stage of 1 and 2 lymphedema who were divided into two groups. Those comprising the first group had impulse magnetic therapy applied to their lower extremities while the patients making up the second group served as controls. All the patients were examined with the use of the laser Doppler flowmetry (LDF) that revealed the initially present pathological changes in the microcirculatory system of their lower extremities. RESULTS: The study has demonstrated that the application of impulse magnetic therapy produced a positive effect on all the constituent components of the microcirculatory blood stream of the patients suffering from lymphedema of the lower extremities. Specifically, the initially increased arteriolar tonus was decreased, the blood flow in the capillary vessels was improved, and congestive phenomena in the venular segments of the microcirculation blood stream were markedly reduced. The results of the LDF examination in the control group gave no evidence of significant changes in the patients' microcirculatory system. The results of the LDF examination of the patients of the control group suggested the absence of any appreciable changes in the microcirculatory system. CONCLUSION: The present study has demonstrated the advisability of the application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities as a minimally invasive technique for the evaluation of the condition of the microcirculatory system and the objective assessment of the effectiveness of the outcomes of physiotherapy in the patients with vascular pathology.

[The commonest therapeutic methods for laser irradiation of blood].

One of the most widely employed methods of laser therapy is laser irradiation of blood (LIB). There are two modifications of this technique, one being intravenous low-intensity laser irradiation of blood (ILIB), the other non-invasive blood irradiation(NLIB). The two methods have been developing independently since either has its advantages and disadvantages. The present article was designed to review the main currently available techniques for laser irradiation of blood which are presented in the form of tables (charts). Replacing the UV irradiation of blood with UV lamps by laser ultraviolet irradiation of blood (LUVIB®) has made it possible to significantly simplify the technique and enhanced its efficiency. The most effective options for ILIB are the combined techniques: ILIB-635 + LUVIB® and ILIB-525 + LUVIB. The most effective technique for ELIB is believed to be the use of low-intensity pulsed laser light with a wavelength of 635 nm and output power up to 40 W.

[The application of the preformed physical factors for the combined treatment of the patients presenting with chronic vesiculitis]. / Preformirovannye fizicheskie faktory v kompleksnoi terapii patsientov s khronicheskim vezikulitom.

UNLABELLED: The problem of the development of the new efficient methods for the treatment of the patients presenting with chronic bacterial vesiculitis (CBV) is currently considered among the important priorities. AIM: The objective of the present study was to provide a scientifically sound substantiation for the application of sinusoidal modulated currents (SMC), magnetic fields, and laser radiation in the combined treatment of the patients with CBV. PATIENTS AND METHODS: A total of 121 patients presenting with chronic bacterial vesiculitis were examined and treated during the latent phase of the inflammatory process. They were randomly divided into three groups. Group 1 (main) was comprised of 40 patients treated, in addition to basal pharmacotherapy, by supravascular contact laser irradiation of the cubital vein area followed after 2-3 hours by the application of sinusoidal modulated currents to the pubosacral region. Group 2 included 41patents given, besides basal pharmacotherapy, laser therapy in the same regimen as in group 1 supplemented after 2-3 hours by abdominal magnetic therapy. Group 3 (control) received traditional pharmacotherapy in the combination with antibacterial and anti-inflammatory medicines. RESULTS: It was demonstrated that the patients of group 2 exhibited the most pronounced positive dynamics of the clinical signs and symptoms estimated from the total National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and of the characteristics of the quality of life evaluated based on the QLS scale. The patients of the two former groups experienced a more conspicuous decrease in the activity of the inflammatory process in seminal vesicles, restoration of their structural and anatomical features (as shown by the transrectal ultrasound study), improvement of testosterone metabolism, and normalization of the spermogram characteristics in comparison with controls. The analysis of the spermograms revealed the tendency toward the increase in the number of actively motile spermatozoa only in the patients of group 2. The combined treatment of the patients of the two former groups resulted in the decrease of the level of sex hormone-binding globulin and the increase of the free androgen index. CONCLUSION: The results of the study indicate that the application of the preformed physical factors for the treatment of the patients presenting with chronic bacterial vesiculitis enhances the effectiveness of pharmacotherapy and decreases both the frequency and the duration of relapses of the disease.