[The effect of rehabilitation with sensory glove and virtual reality on concentration of brain-derived neurotrophic factor and event related potential P300 in the early rehabilitation period after ischemic stroke]. / Vliyanie reabilitatsii s sensornoi perchatkoi i virtual'noi real'nost'yu na dinamiku neirotroficheskogo faktora golovnogo mozga i kognitivnykh vyzvannykh potentsialov P300 v rannem vosstanovitel'nom periode ishemicheskogo insul'ta.

OBJECTIVE: To study the effect of rehabilitation with sensory glove (SG) and virtual reality (VR) on changes in brain-derived neurotrophic factor (BDNF) concentration and amplitude and latency of event related potential (ERP) P300 in the early rehabilitation period after hemispheric ischemic stroke (IS). MATERIAL AND METHODS: Ninety patients (mean age 58.0±9.7 years, time after stroke onset - 3.8±1.6 months) were randomized into intervention (IG) and control (CG) groups. Patients in both groups received 15 sessions of rehabilitation (30 min, 3 times a week). Patients in the IG (n=46) received rehabilitation with SG and VR. Patients in CG (n=44) received individualized physical therapy. The end points were a change in the MMSE, MoCA, 10-word Luria test, subtests of Wechsler Adult Intelligence Scale IV (WAIS IV) test, amplitude and latency of P300, and BDNF concentration on admission and at the end of rehabilitation. RESULTS: There was an improvement on MoCA test (p=0.049) and working memory index of the WAIS IV test (p=0.045) iIn the IG after completing rehabilitation the improvement on MoCA test (p=0.049) and working memory index of the WAIS IV test (p=0.045) was observed. There was aA trend tendency towards an significant increase on MMSE (p=0.093) and 10-word Luria test (p=0.052) was observed. In CG, an improvement with a trend towards significant differences (p≤0.12) on all above mentioned tests was also observednoted. In both groups there were no significant changes in the amplitude or latency of P300. Concentration of BDNF increased significantly in the IG (p=0.042), while in the CG a tendency (p=0.064) was observed (p=0.064). By the end of rehabilitation, the delta between groups in the increase of BDNF concentration was 17.9%, p=0.072. In both groups, there was a correlation between scores on cognitive tests and BDNF concentration. Absence/presence of cognitive disorders was not associated with initial or final BDNF concentrations or delta between groups. RESULTS: In the IG after completing rehabilitation the improvement on MoCA test (p=0.049) and working memory index of the WAIS IV test (p=0.045) was observed. There was a tendency towards significant increase on MMSE (p=0.093) and 10 word Luria test (p=0.052). In CG an improvement with a trend towards significant differences (p≤0.12) on all above mentioned tests was also observed. In both groups there were no significant changes in the amplitude or latency of P300. Concentration of BDNF increased significantly in the IG (p=0.042), while in the CG a tendency was observed (p=0.064). By the end of rehabilitation, the delta between groups in the increase of BDNF concentration was 17.9%, p=0.072. In both groups there was a correlation between scores on cognitive tests and BDNF concentration. Absence/presence of cognitive disorders was not associated with initial or final BDNF concentration or delta between groups. CONCLUSION: VR and SG in the early rehabilitation period after IS is are as equally effective as rehabilitation with individualized physical therapy (aerobic training) in increasing BDNF concentration and in improvement on cognitive tests.

[Physical activity in sarcopenia: rehabilitation approaches in prevention and treatment of age-related muscle disorders]. / Fizicheskaya aktivnost' pri sarkopenii: reabilitatsionnye podkhody v profilaktike i lechenii vozrastnoi patologii myshechnoi tkani.

Sarcopenia is a widespread condition in the elderly people, that occurs as a result of impaired muscle structure and function and is significantly associated with reduced quality and time of life. This review represents current approaches to the diagnosis of sarcopenia with reference to recent European and Asian consensus. They include rules for the evaluation of the main muscle strength and function tests (hand dynamometry, sit-to-stand test, 6-minute walk test, physical performance battery tests, etc.), physical and instrumental methods of muscle mass analysis (densitometry, bioimpedance analysis, magnetic resonance imaging). Furthermore, the pathogenetic relationship between the lack of physical activity and muscle dysfunction in elderly people is broached, including in particular the role of myostatin, interleukin-6, somatotropin and insulin resistance. The article represents possibilities of impact of aerobic, strength and neuromuscular physical exercises on prevention and correction of sarcopenic changes in different age groups based on the analysis of current clinical studies.

[Multimodal technology in the correction of post-stroke motor disorders]. / Mul'timodal'naya tekhnologiya korrektsii postinsul'tnykh dvigatel'nykh narushenii.

OBJECTIVE: To evaluate the effectiveness of a comprehensive rehabilitation program with the inclusion of programmable FES and BFB-stabilometric training in patients with post-stroke statolocomotor disorders in the late recovery period of ischemic stroke (IS). MATERIAL AND METHODS: The study included 120 patients in the late recovery period of IS, 57 women and 63 men, average age 58.4±6.4 years. The duration of the stroke was 228.59±31.9 days. The main group (MG) included 30 patients who underwent FES and BFB-stabilometric training. Comparison group 1 (CG1, n=30) received computer stabilometric training with BFB. Comparison group 2 (CG2, n=30) received FES. The control group (CG3, n=30) received a standard rehabilitation program. MR programs were carried out for all patients in the amount of 15 procedures every other day (5 weeks). RESULTS: The complex of rehabilitation measures with the inclusion of FES and BFB-stabilometric training significantly improve the function of walking in the form of restoration of the motor stereotype by the 5th week of the study, which was confirmed by neurological scales and stabilometry data. CONCLUSIONS: The inclusion of FES and BFB-stabilometric training methods in the rehabilitation process leads to earlier motor adaptation of the patient, restoration of impaired balance function and quality of life, which is associated with an increase in plastic and associative processes of the brain.

[Effectiveness of rehabilitation with virtual reality and biofeedback in recovery of hand function after stroke]. / Effektivnost' reabilitatsii s virtual'noi real'nost'yu i biologicheskoi obratnoi svyaz'yu v vosstanovlenii funktsii kisti posle insul'ta.

OBJECTIVE: To evaluate the effectiveness and safety of the rehabilitation glove (RG) with virtual reality (VR) and biofeedback (BFB) on recovery of the hand function in patients during the late recovery period after first hemispheric ischemic stroke (IS). MATERIAL AND METHODS: The study was randomized and controlled. One hundred and six patients (age 58.8±4.3 years, time after stroke onset - 8.7±2.1 months) were included in the final analysis. The intervention group (n=56) received rehabilitation with RG and VR. The control group (n=50) received individualized physical therapy. The primary end points were a change in the Fugl-Meyer scale score (FMA-UE), in the Action Research Arm Test (ARAT), and in the nine holes peg test (NHPT). Secondary end points included changes in MRCS, MAS, MoCA, HADS, modified Barthel index (MBI) and quality of life (EQ-5D-5L). RESULTS: Improvement of the motor function in the intervention group on FMA-UE scale (an increase of ≥7 points in sections A-D) was observed in 46.4% of patients, on ARAT (an increase of ≥5 points) in 53.6% of patients. There was a significant decrease in time from 36.8±6.3 sec. to 22.0±3.9 sec. on NHPT. A negative correlation was observed between the average ARAT score and anxiety (r=-0.7; p<0.05) and depression (r=-0.67; p<0.05). There was also a significant increase in EQ-5D-5L (VAS) by the end of rehabilitation in both groups with better scores in the intervention group (p=0.03). CONCLUSION: Rehabilitation based on VR, RG, and BFB is effective in the rehabilitation of dexterous hand function in patients with first hemispheric IS.

[Capacity of vibroacoustic therapy for correction of respiratory manifestations of post COVID-19 syndrome]. / Vozmozhnosti vibroakusticheskoi terapii v korrektsii respiratornykh proyavlenii postkovidnogo sindroma.

The search for therapeutic strategies for the correction of post COVID-19 syndrome is an urgent task of medicine. One of the frequent manifestations of post COVID-19 syndrome is the prolonged persistence of respiratory syndromes - dyspnea and cough. Vibroacoustic therapy is promising methods in the complex effect on broncho-pulmonary symptoms of COVID-19. OBJECTIVE: To study the effect of vibroacoustic pulmonary therapy implemented through the BARK VibroLUNG apparatus on the clinical and instrumental parameters of patients undergoing COVID-19 with residual respiratory symptoms. MATHERIAL AND METHODS: The effect of vibroacoustic therapy (5-day course of 2 sessions) on dyspnea and cough and respiratory function in 60 patients aged 18 to 75 years who underwent COVID-19 of varying severity for more than 12 weeks before the start of the study, with the presence of distant respiratory symptoms, was investigated. Patients were divided into two equal and age-matched groups - without (1st) and with (2nd) chronic bronchopulmonary pathology. RESULTS: Analysis of comorbidity of patients with respiratory phenotype of post COVID-19 syndrome showed frequent presence of concomitant cardiovascular pathology (76.7%). The predominant patient complaint was dyspnea (93.3% in both groups): 29 patients (96.7%) in the non-lung group, and 27 patients (90%) in the chronic lung group. The mean mMRC dyspnea score for all patients was 1.1±0.49 points (1.2±0.5 points in the first group and 1.0±0.45 points in the second group). Cough was observed less often - in 18 patients of both groups (30%), mainly in the second group. During the course of vibroacoustic therapy in the 1st group, the number of patients with dyspnea decreased from 96.7 to 30%, in the 2nd group - from 90 to 10%, the total mean mMRC dyspnea score decreased to 0.2±0.4 (Δ 82%), and a complete regression of cough syndrome was achieved in both groups. Also, an increase in forced expiratory volume in 1st second and peak expiratory flow indicators was revealed both in the general group of patients and in the group of patients without chronic lung pathology. CONCLUSION: The results obtained during the study of the use of vibroacoustic therapy in patients with respiratory manifestations of post-COVID syndrome, including the presence of chronic bronchopulmonary pathology, allow us to conclude on the effective correction of dyspnea and cough during treatment. Vibroacoustic therapy is a promising non-drug method of exposure to bronchopulmonary manifestations of post-COVID syndrome in patients during rehabilitation.

[Virtual reality technology in medical rehabilitation of patients with ischemic stroke]. / Tekhnologiya virtual'noi real'nosti v meditsinskoi reabilitatsii bol'nykh s ishemicheskim insul'tom.

Rehabilitation of patients after an ischemic stroke is a complex and time consuming process that requires coordinated interaction between specialists of different specialisations. Functional outcomes in patients can vary from asymptomatic lesions to complete incapacity and depend on the location of the stroke, premorbid background, the time of initiation of therapy, its duration, and other factors. Goals of medical rehabilitation include not only motor rehabilitation, but also the restoration of cognitive, affective, visual, speech and many other disorders. The development of rehabilitation methods that have a minimum number of contraindications or no contraindications remains relevant. One of the promising methods that complement traditional rehabilitation is virtual reality technology. The article describes modern technologies of virtual reality and methods of their application in medical rehabilitation.

[Innovative technologies and multimodal correction in medical rehabilitation of motor and neuropsychological disturbances due to stroke]. / Innovatsionnye tekhnologii i vozmozhnosti mul'timodal'noi korrektsii postinsul'tnykh dvigatel'nykh i neiropsikhologicheskikh narushenii.

The article presents an overview of innovative technologies based on the methods of sensorimotor retraining of the patient using various types of biofeedback (BFB) as the most promising in the medical rehabilitation (MR) of patients with cerebral stroke (CS). The works of a high level of evidence (RCTs, national and international clinical guidelines, meta-analyses, systematic reviews) of the Medline, Pubmed, PubMed Cochrane Library databases are analyzed, ClinicalTrials.gov. It is emphasized that training with multisensory effects on visual, auditory, vestibular and kinesthetic analyzers have a beneficial effect on cognitive-motor training and retraining, neuropsychological status of the patient and increase the level of motivation to achieve success in the rehabilitation process. The synergy of multimodal effects of digital technologies, BFB, virtual reality, and the brain-computer interface will expand the capabilities and improve the efficiency of MR of after stroke-patients.

[Implementation of robotic mechanotherapy for movement recovery in patients after stroke]. / Primenenie robotizirovannoi mekhanoterapii dlya vosstanovleniya dvizheniya u patsientov posle insul'ta.

Lower extremity dysfunction after a stroke can vary from mild to extremely severe and significantly reduce the functional independence of patients. The restoration of walking is one of the key components of rehabilitation, it requires a balanced approach and the participation of a multidisciplinary team. In the last decade, new rehabilitation methods have appeared that meet high safety standards and have a minimum set of contraindications. One of the promising methods is robotic mechanotherapy. The article presents an overview of modern technologies of robotic mechanotherapy, its types and recommendations for use in medical rehabilitation.

[Meteocorrective effect of physical and balneal factors in patients with joint diseases]. / Meteokorrigiruyushchee deistvie fiziobal'neofaktorov u patsientov s zabolevaniyami sustavov.

The environment has the potential to adversely affect human health. Among the variety of adverse factors, one of the leading is the weather, including its abnormal patterns, helio- and geomagnetic disturbances, and extreme hydrometeorological phenomena. Currently, the study of mechanisms of weather and climate factors impacting sick and healthy organisms is warranted by the need to determine the main clinical types of meteotropic (pathological) reactions and development of scientific-based programs for their prevention and treatment with the use of non-drug methods. OBJECTIVE: To identify the patterns of meteotropic reactions to biotropic weather conditions and evaluate the meteocorrective efficacy of physical and balneal factors in patients with joint diseases. MATERIALS AND METHODS: We studied the features of weather-related disorders in 165 patients diagnosed with osteoarthrosis/osteoarthritis, including those after total hip and knee arthroplasty. Most patients (55.7%) had cardiovascular comorbidities. All patients received balneal and physiotherapeutic procedures in addition to background drug therapy and exercise therapy. The patients were divided into 3 groups: Group 1 (55 patients) received general sodium chloride baths and exposure to alternating magnetic field (AMF); Group 2 (54 patients) received «dry¼ carbon dioxide baths and AMF; Group 3 (56 patients) received general baths with the antioxidant and antihypoxic agent Mitofen, and AMF. The weather-sensitivity and severity of meteorological reactions were evaluated using questionnaires, and self-observation diaries, correlated with medical and meteorological weather forecasts. We used the WAM method (well-being, activity, mood), the Abbreviated Multifactor Personality Inventory (AMPI), and the Hospital Anxiety and Depression Scale (HADS). Medical and meteorological weather assessment was performed using a modern medical and meteorological complex (AMMC). RESULTS: Increased weather sensitivity of varying severity was confirmed in 140 (84.8%) patients, and 25 (15.2%) patients were classified as conditionally weather-sensitive. The most severe meteotropic reactions were noted in patients with cardiovascular comorbidities (55.7%) and older individuals with a compromised medical history (29.1%). The use of balneal and physiotherapeutic methods in the medical rehabilitation programs had a positive effect on the manifestations of autonomous disorders and psychological dysadaptation; also, they contributed to the increase of adaptation and functional reserves of the organism exposed to biotropic weather conditions. The effects of the factors were manifested by the reduction of severity of meteotropic reactions. The high effectiveness of general baths with antioxidant and antihypoxic action was revealed in 71.8% of patients with cardiovascular comorbidities. The meteocorrective effect of sodium chloride baths was less pronounced (29.7%), although the majority of patients after the treatment course showed an improvement in their psychoemotional status (39.7%) and a decrease in severe weather-related exacerbations during spastic weather (from 17.6 to 6.7%). CONCLUSION: The meteocorrective efficacy of complex non-drug methods in patients with joint diseases, including concomitant cardiovascular diseases, has been proved.

[Medical rehabilitation for children with scoliosis]. / Meditsinskaya reabilitatsiya detei so skoliozom.

The article presents a literature review on the prevalence, relevance, social significance, and principles of medical rehabilitation of children with different types of scoliosis in scoliotic disease. The current classification, diagnostics features, and clinical course of the disease are addressed. Current approaches to the choice of medical rehabilitation methods for scoliotic disease in children are described: therapeutic exercise, hydrokinesiotherapy, massage, physiotherapeutic treatment, kinesiotaping, and corseting. Special consideration is given to postoperative management and stages of medical rehabilitation of children with scoliosis, including resort treatment.

[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.

[Effectiveness evaluation of the psychological support inclusion in the correction of pain syndrome in patients with movement disorders at the stage of medical rehabilitation using the virtual reality technology]. / Otsenka effektivnosti vklyucheniya psikhologicheskogo soprovozhdeniya s ispol'zovaniem tekhnologii virtual'noi real'nosti v korrektsiyu bolevogo sindroma u patsientov s narusheniyami dvigatel'nykh funktsii na etape meditsinskoi reabilitatsii.

OBJECTIVE: Evaluation of the comparative effectiveness of various methods of psychological support in the correction of pain syndrome in patients with degenerative-dystrophic diseases of big joints and spine in the process of medical rehabilitation. MATERIAL AND METHODS: In conditions of hospital, the 70 patients with degenerative-dystrophic diseases of the big joints and spine who received drug and non-drug treatment were examined. The dynamics of the psycho-emotional state, subjective assessment of well-being and pain was studied in three groups: the main group (24 patients) where the psycho-correction plan included classes with a medical psychologist using a high-tech VR tool - «Vive Focus Plus EEA virtual reality helmet¼. A comparison group (24 patients) who received a standard format of psychological support within the patient-centered approach. The control group (22 patients) where only psycho-diagnostic measures were carried out. The «Tamp Kinesiophobia Scale¼, «Visual Analogue Scale of Well-Being Evaluation¼, «McGill Pain Questionnaire¼ were used as diagnostic tools. When comparing the effects of the interventions the nociceptive or mixed nature of pain was taken into account. RESULTS AND CONCLUSION: It has been shown that psychological support improves the effectiveness of pain therapy while the inclusion of a high-tech VR tool in psycho-correctional programs is expedient for overcoming the fear of movement and pain of neuropathic and mixed genesis but ineffective for relieving nociceptive pain, i.e. pain where there is no psychological component.

[COVID-19-associated diarrhea].

In addition to the typical clinical picture of respiratory symptoms and intoxication, the SARS-CoV-2 virus is also characterized by a gastroenterotropic effect. Diarrhea is one of the most common gastroenterological symptoms of COVID-19 and is detected, according to the various authors, in 2-49.5% of cases, including children. The presence of diarrhea aggravates the patient's clinical condition, limits the possibility of carrying out the necessary diagnostic manipulations, and complicates the selection of therapy. The article provides an overview of the scientific literature on the formation of diarrheal syndrome in patients with COVID-19. Objective. Analysis of scientific publications studying the pathogenesis, incidence, clinical features, aspects of diagnosis and therapy of diarrhea in patients with COVID-19. Material and methods. A search was made for scientific publications on the electronic resources PubMed, Google Scholar and eLIBRARY.ru. Results. The pathogenesis of diarrhea in a new coronavirus infection is complex and includes, among other things, the effect of the virus on the angiotensin-converting enzyme 2 receptors, inducing an inflammatory process in the gastrointestinal tract mucosa, neurotropic effect on the autonomic regulation of intestinal motor activity, disturbance of the colon microbiota, liver and pancreas damage. Another important pathogenetic aspect of diarrhea in COVID-19 is iatrogenic one, i.e. a side effect of drugs used in the treatment of a new coronavirus infection and its complications, and the activation of opportunistic clostridial intestinal flora against the background of antibiotic therapy. The variety of pathogenetic mechanisms of diarrheal syndrome formation allows us to speak of "COVID-associated diarrhea" as an independent clinical phenomenon characteristic for the new coronavirus infection. Mandatory diagnostic algorithm of a patient with COVID-19 and diarrhea is the fecal analysis test for toxins Cl. difficile, while the possibility of endoscopic examinations during the pandemic is limited. Compliance with the hygiene measures, diet correction and nutritional support, rational antibiotic therapy of COVID-19 complications, careful use of antiperistaltic antidiarrheal drugs, nonspecific therapy (antiviral, rehydration, adsorbents) are considered as the main therapeutic approaches for diarrheal syndrome against the background of COVID-19. The administration of probiotics and antibacterials should be considered in case of confirmed clostridial co-infection. Conclusion. Diarrhea is a frequent clinical manifestation of COVID-19 and can affect the course of the disease. The complex genesis of diarrheal syndrome requires further study of therapeutic strategies and nutritional support for patients after COVID-19.

[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.

[To the question of the possibility of using selective chromotherapy for allergic diseases in children]. / K voprosu o vozmozhnosti primeneniya selektivnoi khromoterapii pri allergicheskikh zabolevaniyakh u detei.

Allergic diseases are a common pathology in childhood. In the comprehensive medical rehabilitation of children with allergic pathology, non-drug methods of treatment are widely used, which help to reduce the number of drugs used, achieve and prolong the remission of the disease, favorably affect the clinical and functional indicators. THE PURPOSE OF THE STUDY: Is the scientific justification for the use of selective chromotherapy in children with bronchial asthma (BA) and atopic dermatitis (AD). MATERIAL AND METHODS: The study included 120 children with allergic diseases (BA and AD). Among 100 patients with BA, the main group included 50 children, who received exposure to monochromatic polarized green light on biologically active zones for 10 days, 50 - a comparison group that did not receive physiotherapy. The main group of children with AD included 10 patients who received selective blue chromotherapy for foci of skin lesions; the comparison group included 10 children who used only moisturizers without physiotherapy methods. In order to assess the effectiveness of the impact of physical factors in all patients, clinical and functional studies were conducted in the dynamics before and after treatment. RESULTS AND DISCUSSION: The results of clinical and functional examinations showed high therapeutic efficacy of the use of monochromatic polarized green light in children with BA (92.0%). The effectiveness of treating children with blood pressure AD using monochromatic polarized light (blue) was 80%. Indications for the use of selective chromotherapy in children with allergic diseases have been developed. For children with BA, selective chromotherapy of the green spectrum is indicated in the presence of a mild to moderate course of the disease, a period of incomplete remission, and an increased level of anxiety. It is advisable to prescribe selective chromotherapy of the blue spectrum to children with a moderate and mild course of AD. CONCLUSION: The positive effect of selective chromotherapy of the green spectrum on the clinical course of BA in children, bronchial patency, the functional state of the central nervous system and its autonomic part, and the psychoemotional status of children have been identified. The use of selective blue spectrum chromotherapy in children with AD helps to decrease the severity of objective symptoms, reduce the intensity of itching and sleep disturbance, as well as a marked decrease in the area of skin lesion.

[Medical Rehabilitation after Hydronephrosis Surgical Treatment in Children].

The article presents modern technologies of medical rehabilitation of children operated for hydronephrosis. The importance of medical rehabilitation of children with hydronephrosis is associated with high incidence, possibility of developing chronic kidney disease, and early disability of these patients. After surgery on the ureter it is important to use medical rehabilitation technologies aimed at preventing urodynamics disorders of upper and lower urinary tract, and at stimulation of regenerative processes. In recent years, particular attention has been paid to high-intensity pulsed electromagnetic field therapy, which has a more significant and long-term stimulating effect compared to various types of electrical stimulation. Clinical studies were conducted in 80 children operated for hydronephrosis, aged 3 to 15. The main group consisted of 40 children who received high-intensity pulsed magnetic therapy, and 40 children were included in the control group (without physiotherapy). Basic treatment included uroseptics and exercise therapy. Effectiveness of the method was assessed using clinical, laboratory and ultrasound data, and Doppler ultrasound of the renal blood flow. The results of the study demonstrated the rationale of including high-intensity pulsed electromagnetic field therapy in medical rehabilitation of children operated for hydronephrosis. The positive effect of high-intensity pulsed electromagnetic therapy on the urodynamics of the urinary tract (reduction in the size of renal pelvis and calyx) and renal blood flow (restoration of blood flow to the renal cortex) were revealed. This method helped to reduce inflammation in the renal parenchyma (reduction of proteinuria, leukocyturia) in children operated on for hydronephrosis. A significantly higher effectiveness of medical rehabilitation with the use of high-intensity pulsed magnetic therapy was proved (87.5%).

[The application of the pulsed low-frequency electrostatic field in pediatrics]. / Primenenie impul'snogo nizkochastotnogo élektrostaticheskogo polia v pediatrii.

One of new methods for the physiotherapeutic treatment in pediatrics is the application of the pulsed low-frequency electrostatic field the action of which is based on the effects of deep resonant vibration on the affected tissue region with the minimal mecha-nical impact. Under the influence of the electrostatic field, the tissues at the site of interest become tightened and descend which causes their vibration due to the alternation of the pulses and intervals between them. The fast consecutive repetition of this process results in rhythmical deformation of the tissues. The electrostatic pulses are responsible for the increased friction between separate parts of the tissues while in the intervals between the pulses the tissue elastically resists their influence. In this way, the tissues subjected to such influence 'are pumped over' throughout their depth. It leads to the restoration of elasticity and mobilization of separate fibers and layers inside the tissue as well as to the development and improvement of the blood flow in the tissues and their blood supply. During the recent years, a large number of reports have been published in the literature concerning the possibilities of application of the pulsed low-frequency electrostatic field for the treatment and prevention of various di-seases in the children, including both monotherapy and its combination with other therapeutic modalities. The favourable action of the pulse low-frequency electrostatic field on the clinical course of bronchial asthma, mucoviscidosis, I and II degree scoliosis in the young children, remittent multiple sclerosis in the adolescents has been demonstrated. The data obtained give evidence of the high effectiveness of the proposed method, its excellent tolerance, and a wide range of beneficial effects on the main pathogenetic components of the diseases which creates the good prerequisites for the further active introduction of the therapeutic phy-sical factors in the practical work of the children's medical organizations.

[Main indicators of physical development and somatotypological features of men in older age groups].

The article presents the anthropometric indicators of 210 old age men (aged 60-74 years), 108 elderly men (aged 75-90 years) and 125 long-liver men (aged 90-98 years) of the Slavic ethnic group, living in Moscow and Moscow region. Significant differences in basic anthropometric parameters have been established in body weight and body mass index between the three age groups. Average values of body height in elderly men were lower by 0.6% (p>0.05), and in long-liver men were significantly lower by 4.6% than in old age men. Diameters did not have statistically significant differences in all age groups. Averages values of all circumferences of available limbs significantly differed in three age groups, averages values of waist and thigh circumference significantly differed only in the group of long-liver men and old age men. Averages values of breast circumference were not statistically different in three age groups. Average values of all eight skin-fat folds were significantly lower in long-liver men compared with old age men, whereas in elderly men only skin-fat folds of shoulder front and back, forearms, chest and lower leg were significantly less than in old age men. Somatotypological analysis revealed a different frequency of somatotype occurrence and the prevalence of 3 main types among men of older age groups (old age men, elderly men, long-liver men) - chest (18.5, 26.2 and 28.4%), abdominal-muscle (20.1, 15.4 and 16.8%) and abdominal (20.8, 22.2 and 19.4% respectively). Also the peculiarities of the component body composition of men of older age groups were revealed. Body composition analysis revealed a decrease in the average indicators of the absolute content of bone, fat and muscular body components from the old age to the period of longevity (long-liver men). Absolute content of bone tissue in elderly men (7.9±0.3 kg) didn't differ and in the period of longevity (6.8±0.2 kg) was less by 1.18 fold (p<0.05) than in old age men (8.0±0.3 kg). Absolute amount of body fat tissue in elderly men (16.1±1.2 kg) was less by 1.09 fold (p<0.05) and in long-liver men (12.5±1.0 kg) was less by 1.41 fold (p<0.05) than in old age men (17.6±1.4 kg). Absolute amount of body muscle tissue in elderly men (18.2±0.3 kg) was less by 1.17 fold (p<0.05) and in the period of longevity (16.3±0.2 kg) was less by 1.31 fold (p<0.05) than in old age men (21.3±0.2 kg). Average relative indicators of the major body components with aging undergo a number of changes, which are reflected in the reduction of quantity of bone and muscle tissue and increasing rates of adipose tissue.

[The application of the modern phototherapeutic technologies for the medical rehabilitation of the children].

This literature review is focused on the application of polychromatic and monochromatic polarized light for the treatment of various diseases of the childhood including those in the newborns and the premature babies. The analysis of the data of scientific research gives evidence of the beneficial effect of polychromatic polarized light on the clinical course of various skin diseases in the newborn children. Moreover, the improved immunological and reparative processes were revealed after the surgical interventions for congenital heart defects in the newborns. The light-induced changes in the skin contribute to the realization of therapeutic effects of polarized polychromatic light in such children's diseases as atopic dermatitis, bronchitis, bronchial asthma, neurogenic urinary bladder dysfunction, and the traumatic injuries of the limbs. The biologically positive physiological effects of monochromatic polarized light are known to contribute to the improvement of the clinical and functional status in the children presenting with bronchial asthma and in the patients frequently suffering from acute respiratory diseases. The versatility of the biological effects of polarized light taken together with the possibility of its application from the first days of the child's life, the short duration of the procedure, the absence of unpleasant sensations and contact between the damaged surface and the device as well as the simplicity of using the equipment determine the promising prospects for the use of the proposed method in the clinical pediatric practice.

[The application of the physical factors for the medical rehabilitation of the children presenting with neurogenic dysfunction of the bladder].

This article describes the modern technologies for the medical rehabilitation of the children presenting with neurogenic dysfunction of the bladder aimed at improving the act of urination at all levels of innervation. The most frequent variant of neurogenic dysfunction of the bladder in the children is the hyper-reflexive one; it is this variant in which the most pronounced disorders of urodynamics due to intravesical hypertension and detrusor hypoxia are observed. The urodynamic disorders are known to contribute to the formation of the characteristic clinical picture associated with the hyper-reflexive urinary bladder dysfunction in the children characterized by the mandatory urination syndrome, pollakiuria, imperative urges, and mandatory urinary incontinence in the combination with enuresis. The treatment of urinary bladder dysfunction includes both behavioural and medication therapeutic modalities. The "golden standard" for the pharmacotherapy of neurogenic bladder dysfunction of the hyper-reflexive type in the childhood is the use of M-cholinoblockers, such as oxybutynin. The popularity of the physiotherapeutic methods is attributable to their influence on the main links of pathogenesis, the absence of side effects, and the possibility of application in the children of the early age. The combined treatment of neurogenic bladder dysfunction includes the use of a wide range of physiotherapeutic methods the action of which is aimed at regulating the act of urination at all levels of innervation of the bladder, normalizing the tone of the muscles of the bladder, eliminating sphincter insufficiency, improving circulation and accelerating the maturation of the neuromuscular apparatus of the pelvic organs. At present, the natural and preformed methods of physiotherapy are finding the wide application for the management of neurogenic dysfunction of the bladder in the children in the conjunction with therapeutic physical exercises, massage, and the biological feedback (BFB) technique.