Medical rehabilitation strategies in complex assistance of people with COVID-19. Literature review

Covid-19 infection is a challenge for the medical system. The development of programs and strategies for the rehabilitation of people in different stages of the disease is relevant and current. The study is a bibliographic synthesis that aimed to analyze the methods and strategies of medical rehabilitation of patients with the new “coronavirus infection”. Data were collected from the academic databases PubMed, PubMed Central, Google, collecting relevant articles from 2019-2021, using the keywords: [“Covid-19” or “Covid 19” or “2019- CoV” or “SARS- CoV” or“ new coronavirus” or “SARS-CoV-2”] and [“rehabilitation ”or“ physical medicine”]. Th e aim of the study was to estimate the consequences of COVID-19 and to identify methods of recovery treatment. Because Covid-19 severely affects the respiratory system, pulmonary rehabilitation interventions with respiratory techniques and postural drainage combined with other physiotherapeutic methods may be used for a patient with COVID-19. The wide range of clinical manifestations in COVID-19 reveals the importance of adapting the rehabilitation program to functional deficits and patient needs. Multifactorial programs combined with active and supportive methods (physical therapy, exercise, occupational therapy, reflex therapy) are effective and can be used in the complex care of patients with COVID-19 at all stages of treatment.

The role of scientists of the Department of Psychiatry of the S.M. Kirov Military Medical Academy in the development of domestic narcology and pharmacological methods of treating this pathology

The study covers the history of the formation and development of narcology in the Russian Empire and the USSR. The role of the heads and psychiatrists of the Department of Psychiatry and the Clinic of Mental and Nervous Diseases of the S.M. Kirov Military Medical Academy in the fight against alcoholism in the country and the organization of drug treatment was identified. Particular emphasis was laid on the work of Vladimir Mikhailovich Bekhterev, a prominent Russian and Soviet psychiatrist, neuropathologist, physiologist and psychologist, the founder of reflexology and pathopsychological direction in Russia. It was V.M. Bekhterev who did everything to reverse public views on alcoholism and transfer it from the category of moral turpitude to the status of the disease; he organized the research and treatment for alcoholic patients. This paper considers the aspects of scientific development of issues related to narcology by the staff and heads of the department. The priority of domestic psychiatrists in the theoretical justification and practical application of conditioned reflex therapy for alcoholism has been shown.

Combined reflex therapy

According to VM Bekhterev (Vesti. Sovr. Med., 1925, No. 11), this therapy, being close in nature to suggestion, differs from it in a more mechanized character that deprives the patient of the possibility of counter-suggestion.

Effectiveness of Foot Reflex Therapy in Post-Operative Pain among Patients Subjected to Major Abdominal Surgery

BACKGROUND Most patients experience post–operative pain and it is unavoidable. It is the duty of the nurses to ensure that patients' pain is assessed and managed effectively when they are at the hospital. Foot reflex therapy is one effective way nurses can adopt to manage the patient with pain after surgery. We wanted to evaluate the effectiveness of foot reflex therapy on post-operative pain in patients who are subjected to major abdominal surgery. METHODS This is a descriptive randomized control study that was conducted at Sri Ramachandra Medical College and Hospital, among 360 patients who underwent major abdominal surgery. They were equally divided into two groups as control and study groups and the results were analyzed statistically. RESULTS Majority of the patients in the study group showed a positive effect on pain control during 4th and 5th [ (Mean: 1.27 with SD: 1.12) (Mean: 0.03with SD: 0.32) at p < 0.001] post-operative day following foot reflex therapy. CONCLUSIONS The existing pain and the post-operative pain can be managed by nurses, patients, their care takers or families together, whenever appropriate, in a multidisciplinary manner. Foot reflex therapy is one such alternative complementary therapy which the nurses can adopt to implement the techniques independently. KEY WORDS Foot Reflex Therapy, Foot Reflexology, Alternative Medicine, Complementary Therapy, Post-Operative Day (POD)

Comparative efficiency of various accupucture methods in early rehabilitation of patients after ischemic stroke

Three hundred and thirty patients aged 3579 years, who underwent early rehabilitation in the primary vascular department, participated in a randomized controlled trial. In 220 patients (the main group of the study), non-drug rehabilitation (in the form of a combination of physiotherapy and exercise therapy) was optimized using various reflex therapy methods. The effectiveness of including them in rehabilitation schemes was analyzed in seven subgroups. One hundred and ten patients (the comparison group) underwent comprehensive non-drug rehabilitation without the inclusion of reflex therapy. The effectiveness of rehabilitation measures was evaluated by assessing dynamics (on the first day and after two weeks) according to the National Institutes of Health Stroke Scale, Barthel index, Beck questionnaires (level of depression), Spielberger-Hanin (level of reactive anxiety), and the Motivation for Success and Motivation for Fear of Failure (level of motivation) questionnaire tests. The best indicators on almost all scales were obtained in groups where patients underwent combined reflex therapy techniques: dynamic electroneurostimulation (DENS) in combination with classical acupuncture, su jok therapy in combination with classical, auricular acupuncture and craniopuncture, and prolonged craniopuncture in combination with corporal and auricular acupuncture. Indicators were slightly lower in the cases when separate methods were applied: DENS or su jok, and in subgroups where corporal and auricular acupuncture were combined with craniopuncture (according to the methodology of Professor Yu Zhi Shun, China), or craniopuncture according to classical methodology. The lowest indicators were in the group of patients who did not use methods of reflex therapy. This study confirmed the need to integrate acupuncture techniques in the schemes of early neurorehabilitation schemes of post-stroke patients for whom combined technologies are most effective.

Effect of Reflex Therapy on Stress and Blood Pressure among Older Adults with Hypertension

Aims: Reflex therapy relieves tension, relaxes the mind, improves the circulation of the body. In hypertension, vascular resistance increases the pressure of the blood vessels. The study was aimed to assess the pretest and post-test levels of stress and blood pressure (BP), evaluate the effectiveness of the reflex therapy among older adults with hypertension, and to associate the level of stress and BP with demographic variables. Study Design: Community-based randomized controlled trial was adopted. Place and Duration of Study: The urban area, Poonamallee, in Chennai, between October to December 2019. Methodology: Among 100 older adults, 50 participants were selected in each experimental and control group by using simple randomization. Perceived Stress Scale (PSS) and dual function BP monitor was used to assess the stress and BP respectively. Reflex therapy was provided for 6 weeks to the older adults with hypertension, who had low and moderate levels of stress in the experimental group. The different pressures such as 100%, 75%, and 50%, that was applied in the foot for 15 minutes weekly twice by reflexology stick, when the participants were in an empty stomach. The data were analyzed using descriptive and inferential statistics. Results: The mean and standard deviation value of pretest and post-test stress level was 14.84±6.02, 9.4±4.73 in experimental group, 13.32±5.3 and 13.04±5.09 in control group respectively. This proves that reflex therapy was effective in reducing stress levels which was statistically significant (P=0.001). Mean and standard deviation of systolic BP in pretest and post-test was 142.74±5.98 and 137.78±5.69; 141.11±6.18 and 142.03±6.29, and diastolic BP was 98.21±3.28; 97.31±3.15 and 97.94±3.59; 98.96±3.34 in experimental and control group respectively indicated that the reflex therapy helps to reduce the level of BP (P=0.001). Conclusion: Reflex therapy is beneficial to older adults particularly with hypertension for relieving stress and reducing systolic and diastolic BP.

Pharmacopuncture in common pathological conditions*

Clinical recommendations have been developed based on the analysis of Russian and international experience in the use of pharmacopuncture which is a contemporary medical technology combining the therapeutic possibilities of reflex therapy and clinical pharmacology. The first part of the recommendations sets out general provisions on the document structure and content that meet the requirements of GOST R 56034-2014 Clinical recommendations (treatment protocols). * Pharmacopuncture in common pathological conditions: clinical recommendations. M., 2017 p. 39. Available at: https://docplayer.ru/53018894-Klinicheskie-rekomendacii-farmakopunktura-pri-rasprostranennyh-patologicheskih-sostoyaniyah.html. Link active on 06/15/2018.

Effectiveness of foot reflex therapy in postoperative pain among patients subjected to major abdominal surgery (Preprint)

BACKGROUND Most of the patients experience post – operative pain and it is unavoidable. It is the duty of the nurses to ensure that patients' pain is assessed and managed effectively when they are at the hospital. Foot reflex therapy is one effective way the nurses can adopt to manage post-operative pain in patients. OBJECTIVE This study aims to prove the effectiveness of foot reflex therapy in post-operative pain in patients who are subjected to major abdominal surgery METHODS This is a descriptive randomized control study that was conducted in the period month of Jan 2012 to Sep 2013 at Sri Ramachandra Medical College and Hospital among 360 patients who underwent major abdominal surgery. They were equally divided into two groups as control and study group and the results were analyzed statistically. RESULTS A majority of the patients in the study group showed a positive effect in the 4th and 5th post-operative day following foot reflex therapy. CONCLUSIONS The pre – existing pain and the post – operative pain is managed as collaboration along with nurses, patients, their care takers or families whenever appropriate in a multidisciplinary manner. Foot reflex therapy is one such alternative complementary therapy which the nurses can adopt to work in this accord. CLINICALTRIAL Not Required. Ethics Committee Approval Obtained

Effectiveness of Foot Reflex Therapy in Postoperative Pain among Patients Subjected to Major Abdominal Surgery (Preprint)

BACKGROUND Most of the patients experience post – operative pain and it is unavoidable. It is the duty of the nurses to ensure that patients' pain is assessed and managed effectively when they are at the hospital. Foot reflex therapy is one effective way the nurses can adopt to manage post-operative pain in patients. OBJECTIVE This study aims to prove the effectiveness of foot reflex therapy in post-operative pain in patients who are subjected to major abdominal surgery. METHODS This is a descriptive randomized control study that was conducted in the period month of Jan 2012 to Sep 2013 at Sri Ramachandra Medical College and Hospital among 360 patients who underwent major abdominal surgery. They were equally divided into two groups as control and study group and the results were analyzed statistically. RESULTS A majority of the patients in the study group showed a positive effect in the 4th and 5th post-operative day following foot reflex therapy. CONCLUSIONS The pre – existing pain and the post – operative pain is managed as collaboration along with nurses, patients, their care takers or families whenever appropriate in a multidisciplinary manner. Foot reflex therapy is one such alternative complementary therapy which the nurses can adopt to work in this accord. CLINICALTRIAL NOT REQUIRED

Enuresis: modern aspects of etiology, pathogenesis, psycho-, pharmaco-, physical therapy and phytotherapy (part 2)

In the second part of the review, the current state of the pharmacological, psycho-, physical therapy and phytotherapy of enuresis is analyzed in detail. An algorithm for the treatment of bedwetting, recommended by experts from the International Children's Continence Society, based primarily on behavioral therapy, alarm-therapy (“bedwetting alarm clock”), pharmacotherapy, is considered. Methods of psychotherapy are discussed in detail: behavioral therapy, in particular the token system, as well as the differentiated application of the method of suggestion (hypnotic, "maternal suggestion", the method of "hypnosis-repose", self-hypnosis). The using of play therapy, cognitive-behavioral, family-, art therapy, and a child variant of gestalt therapy in psychotherapy of neurotic disorders in case of enuresis is substantiated. The date showing the effectiveness of alarm therapy (a lower rate of subsequent relapses and a lower risk of side effects compared with the widespread treatment with desmopressin) are given. The main targets of pharmacotherapy and the corresponding drugs are analyzed in accordance with the etiology and pathogenesis of the disease. The use of psychostimulants, tricyclic antidepressants for normalization of the sleep depth, nootropic drugs (especially calcium hopantenate) in neurosis-like enuresis, and anxiolytics and sedatives in the relatively rare neurotic form is substantiated. New approaches to pharmacotherapy are discussed, including the use of uroselective antagonists of M3-cholinergic receptors (tolterodine, solifenacin), α1-adrenoblockers, non-steroidal anti-inflammatory drugs in the off label format. A critical analysis of treatment with desmopressin is given. The features of differentiated physical therapy of enuresis (high frequency current, electrophoresis with antispasmodics, magnetic therapy, thermal procedures, electric sleep, reflex therapy, exercise therapy, biofeedback method) are considered. The analysis of traditional approaches to herbal medicine as an auxiliary method of enuresis treatment using neurotropic, anticholinergic, antispasmodic properties of plants is presented. Strategies for increasing compliance and creating a therapeutic alliance are discussed. The researches supporting the benefits of early treatment of bedwetting are analyzed.