Physical factors in medical rehabilitation of children with spinal osteochondropathies

The article is devoted to a targeted search of scientific literature sources aimed at compiling a review of data on the use of physiotherapy methods in the medical rehabilitation of children with spinal osteochondropathy. One of the most urgent and socially significant issues of modern medicine is the widespread prevalence of orthopedic pathology, among which the leading positions are taken by diseases of the spine. Recently, in the population of children and adolescents, there has been a steady increase in pain syndromes of a vertebrogenic nature, leading to impaired physical functioning. According to various population studies, the prevalence of this nosological form ranges from 0.42 to 37% among the child population. The prevalence of Scheuermann — Mau disease in the general population of children and adolescents ranges from 0.4–8.3%. This pathology is the most common among all children osteochondropathies. To date, the etiology of spinal osteochondropathy is still unclear. Due to the asymptomatic course, the disease is not always diagnosed in the early stages of development, which creates certain difficulties in diagnosing and prescribing an effective treatment for the disease. Medical rehabilitation of children with osteochondropathy of the spine is aimed at preventing further progression of deformity, improving posture, respiratory function and cardiovascular system and includes: a rational exercise regime and nutrition, bracing and cold water treatment procedures, conservative orthopedic measures (wearing a corset, staying in a plaster bed), active correction of deformity (kinesiotherapy), hydrokinetic therapy, massage, passive correction of deformity (treatment by position), physiotherapy (electrical muscle stimulation), sports (skiing, swimming).

New opportunities of halotherapy in the prevention and medical rehabilitation of children

The article is devoted to new possibilities of using halotherapy in the prevention, treatment and medical rehabilitation of children. In recent years, active work has been carried out to develop new effective methods of reproducing the aerodispersed medium in the form of haloingalation therapy or by group method — in the conditions of a halochamber. The therapeutic effect of halotherapy is determined by the biophysical properties of a dry highly dispersed aerosol of sodium chloride. The paper presents the biophysical properties of the main active factor of halotherapy, i.e. a dry highly dispersed aerosol of sodium chloride, and reveals some aspects of the formation of the mechanism of therapeutic action. The anti-inflammatory, draining, mucolytic, immunomodulatory, sanogenetic effect of haloaerosol is shown. In pediatric practice, haloaerosol therapy is used for medical rehabilitation of children with respiratory diseases (bronchial asthma, bronchitis), ENT pathology (rhinosinusitis, tonsillitis, pharyngitis), skin diseases. Halotherapy is the method of choice in the prevention of acute respiratory diseases and improving the health of children in general education institutions. The high efficiency of the complex application of halotherapy in various diseases in children has been established. A promising direction for the development of halotherapy is the development of combined exposure technologies. The high efficiency of the use of haloingalation therapy in combination with magnetic therapy in the treatment of acute rhinosinusitis in children has been proven. Based on the conducted studies, a favorable effect of the use of halotherapy and flutter therapy on clinical and functional parameters in children with bronchial asthma was revealed. The data on the possibility of combined use of halotherapy with a pulsed low-frequency electrostatic field in the medical rehabilitation of children suffering from bronchial asthma are presented. Simplicity, safety, the possibility of personalization of exposure and good tolerability by children expands the possibilities for using halotherapy in pediatric practice.

Possibilities of using neodymium laser to improve the condition of vaginal mucosa in women of various ages with initial stages of genital prolapse

Genital prolapse is a sort of epidemic and is registered today in 30% to 56% of women of both reproductive and menopausal ages. Until now, the initial stages of prolapse were not taken into account; as a rule, the correction began immediately with surgical treatment, the results of which were not always satisfactory, and the recurrence rate with plastic correction with one’s own tissues ranged from 37 to 45%. One of the main manifestations of prolapse of the vaginal walls, especially n perimenopause, is vulvovaginal mucosal atrophy, which directly depends on the pH in the vagina. The study is devoted to the analysis of the effectiveness of using neodymium laser to improve the condition of the vaginal mucosa in women of different age groups with initial degrees of genital prolapse. Purpose: scientific substantiation of using neodymium laser in patients of different age groups with grade I–II cysto-rectocele. Material and research methods. Studies were carried out in 69 women aged 31 to 52 years with cysto-rectocele of grade I–II (ICD-10 code N81.6), with the duration of the disease from 4 to 15 years. All patients, depending on their age and the method of treatment used, were divided into 2 groups comparable in terms of clinical and functional characteristics — the main and control groups, each of which had 2 subgroups. In the main group: subgroup 1 included 27 patients of reproductive age with grade I–II cysto-rectocele, who underwent a neodymium laser course with Magic Gyno, consisting of 3 intravaginal procedures with an interval of 28 days; subgroup 2 included 22 patients of perimenopausal and menopausal age with grade I–II cysto-rectocele, who underwent a course of 3 intravaginal procedures with Magic Gyno neodymium laser with an interval of 28 days. The control group included 20 patients with grade I–II cysto-rectocele, who underwent a special complex of exercise therapy; depending on their age, they were also divided into two subgroups: 1 (10 patients) — of reproductive age, 2 (10 patients) — of perimenopausal and menopausal age. The results obtained indicate a pronounced effect of the course application of intravaginal exposure by a neodymium laser on the state of the vulvovaginal mucosa in patients with grade I–II cysto-rectocele, of both reproductive and, most importantly, peri-menopausal age, which was manifested in the normalization of the pH of vaginal discharge and elimination of signs of atrophy of the mucous membrane of the vulva and vagina and was confirmed by the data of pH-metry and the Vaginal Health Index Score. Conclusion. The course use of a neodymium laser in patients of different age groups with grade I–II cysto-rectocele contributes to the formation of a pronounced tropho-stimulating effect, which is manifested in the normalization of the pH of the vaginal discharge and the elimination of signs of atrophy of the mucous membrane of the vulva and vagina.

Physiotherapy technologies in rehabilitation programs in patients with urolithiasis before and after percutaneous nephroscopy

Urinary stone disease (urolithiasis) is one of the most common urological diseases, the prevalence of which is growing every year, despite the development of new approaches to treatment. In recent decades, various endoscopic methods of treating urolithiasis, in particular, percutaneous nephroscopy, have become the most popular, however, even with such minimally invasive and non-invasive methods, the percentage of complications ranges from 5% to 11%. Despite the fairly widespread use of various physical factors in the urolithiasis treatment, it is still not possible to reduce the incidence rate. All this dictates an urgent need to search for new, more effective and safer, mainly non-drug technologies for the treatment of urolithiasis and prevention of the disease recurrence and postoperative complications. The aim of the study was to assess the effectiveness of the combined use of intravascular laser blood irradiation, ozone therapy, and light therapy (bioptron zepter) in the complex treatment of patients with urolithiasis after percutaneous lithotripsy, according to the data of ultrasound examination of the kidneys. Research materials. The study included 60 patients with urolithiasis who underwent percutaneous nephroscopy in the Urology Department of the PHI Railway Clinical Hospital “RZhD Meditsina”, Rostov-on-Don, in 2019–2020, with subsequent rehabilitation. The patients were divided into three relatively equivalent groups according to age, calculus size (from 7 to 20 mm), and stone composition. In the first (control) group, patients received standard therapy after surgery: antispasmodics, antibiotic therapy taking into account the bacterial culture of urine, non-steroidal anti-inflammatory drugs, which served as a background in the main group and the comparison group. In addition to the standard therapy, the patients in the second group (comparison group) underwent intravenous laser blood irradiation (ILBI) and ozone therapy. The patients of group 3 (main group) received intravenous laser blood irradiation (ILBI) and ozone therapy — 6 procedures each in the preoperative period against the background of standard therapy; polarized light and ILBI — 6 procedures each in the early postoperative period. Results. The article shows a higher efficacy of the combined use of ILBI, ozone therapy and light therapy in the complex treatment of patients with urolithiasis before and after percutaneous nephroscopy. Conclusion. Combined use of a course of intravenous laser blood irradiation (ILBI) and ozone therapy in the preoperative period and a course of polarized light and ILBI in the early postoperative period after percutaneous nephroscopy against the background of standard therapy in patients with urolithiasis contributes to a significant improvement in blood flow in the kidney and a reduction in the recovery period of the renal parenchyma, which made it possible to reduce the patient’s stay in the hospital, due to the prevention of the development of postoperative complications.

Therapeutic physical factors in restorative treatment of patients with nonalcoholic steatohepatitis combined with biliary sludge

Purpose of the study. To study the effectiveness of restorative treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge at the inpatient stage when low-mineralized mineral water and preformed peloid therapy are included in the basic scheme. Material and methods. A total of 119 patients with nonalcoholic steatohepatitis in combination with biliary sludge were observed and distributed into 3 randomized groups: in the main group, 39 patients received basic drug therapy in accordance with the Federal Clinical Recommendations, «Sernovodskaya» mineral water for ingestion and in the form of gallbladder cleanse, and preformed application peloid therapy; in the comparison group, 40people received only pharmacotherapy and balneotherapy, in the control group — pharmacotherapy. The control of the effectiveness of the treatment was carried out according to the dynamics of clinical, biochemical and functional studies. Results. The inclusion of medium-mineralized mineral water «Sernovodskaya» in the form of drinking treatment and cleanse and preformed peloid therapy in the complex of therapeutic measures for patients provides a significant decrease in the intensity of clinical manifestations by 54.4% versus 40% with the use of pharmaco- and balneotherapy and 28,8% — with only drug therapy; cytolysis and cholestasis syndromes — by 46,2; 39,8 and 28.9%, respectively. Restoration of the contractile function of the gallbladder is observed in 78,8% of cases versus 65.6% when using only pharmacotherapy. The duration of hospitalization in the main group was reduced by 3 days, and in the comparison group — by 1,5 days, compared with the indicators in the control group. Conclusion. The developed new medical technology for the treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge with the combined use of mineral waters and preformed peloid preparations against the background of basic pharmacotherapy at the inpatient stage provides a significant increase in the efficiency of therapeutic measures.

Analysis of the mechanisms of synergistic effect in the combined use of physiotherapy factors

The study is devoted to the analysis of the internal mechanisms of the realization of biological effects of the combined use of a low-frequency alternating electrostatic field and transcranial magnetic stimulation with a running magnetic field in patients with metabolic syndrome. The results obtained allow concluding that the simultaneous course effect of these physiotherapeutic factors is accompanied by the development of a synergistic effect, objectively assessed by a set of parameters characterizing the state of the microcirculatory-tissue system, metabolic processes and peroxide metabolism. The quantitative assessment carried out using the synergy factor allowed classifying the type of interaction of physical factors as potentiation. The analysis of the internal mechanisms of supraadditive interaction made it possible to establish that this phenomenon can be most accurately explained from the standpoint of epigenetic regulation, which is a change in gene expression with the preservation of the DNA sequence and which determines the phenomenon of functional cumulation during the course of physiotherapeutic factors. The epigenetic model of the realization of synergy acts as a molecular evidence base for the sanogenetic effects observed in patients with metabolic syndrome under the systemotropic effect of physiotherapeutic factors.

Study of the effectiveness of post-burn scars correction using Er:YAG laser

The purpose of this study was to investigate the effectiveness of post-burn scars laser correction using an Er:YAG laser (2936 nm) with an SMA module (6mm). 112 women aged 16–50 years were monitored on an outpatient basis. All patients were diagnosed with post-burn scars of the face and body. The main inclusion criteria were post-burn scars; non-inclusion criteria were other types of scars, previously performed procedures for the correction of scars by physiotherapy, general contraindications to laser therapy. During the study, high efficacy and safety of this method was demonstrated in 112 patients. The dynamics of changes were evaluated according to the Dermatology Life Quality Index (DLQI), Dermatological Symptom Scale Index and special research methods (ultrasound scanning, photographing). The follow-up period ranged from 3 to 7 months. Patients underwent from 2 to 6 laser procedures on the face and body with an interval of 1 month. The study is prospective and is planned to be continued. At the moment, a cross-section of the results is presented. During the course of laser procedures, 13 patients dropped out, 99 continue treatment.

Application of phytocomplex and nordic walking in dyslipidemia

The results of assessing the effectiveness of using the original phytocomplex in combination with physical training in the form of Nordic walking in 78 men with dyslipidemia are presented. It was found that in the main group (n=39), against the background of the use of phytocomplex and physical training, there is a decrease in the content of atherogenic lipid fractions and the atherogenic coefficient, an increase in physical performance, and an improvement in the indicators of the adaptive reserve of the cardiovascular system. In the control group (n=39), against the background of a hypolipidemic diet and climatotherapy, less significant dynamics of the parameters is noted.

Transcranial magnetic stimulation in neurorehabilitation: experience and prospects

Diagnostic transcranial magnetic stimulation (TMS) is a valuable neurophysiological technique. The use of TMS has fundamentally changed the therapy and diagnosis of nervous diseases, introducing the possibility of direct assessment of conduction along the motor pathway in the central region, neuroplasticity, the ratio of central inhibition and excitation, and the effect on neuroplasticity and neurogenesis. The technique is safe, has a low cost and there is no need to purchase expensive consumables, it is applicable for a wide range of diseases in both adult and pediatric practice. The issues of the TMS use in CVA, depression, cerebral palsy and neurodegenerative diseases (amyotrophic lateral sclerosis, parkinsonism) have been studied to the greatest extent. When carrying out TMS in children, it should be borne in mind that signs of incomplete myelination of the motor pathways, which are normally observed, may look like pathological changes (demyelination or axonal disorders). The basic principles of TMS in both adults and children have been established and known, and the age norms have been determined, which makes it possible to widely implement this technique in applied neurophysiological practice. In the rehabilitation process, TMS can be used as a tool for personalizing and monitoring the effectiveness of rehabilitation treatment.

The effect of the combined application of a low-intensity infrared laser and normobaric hypoxia on the clinical picture of chronic generalized periodontitis

Chronic generalized periodontitis still occupies a leading position among dental diseases, but the effectiveness of drug therapy is insufficient. One of the promising methods of non-drug treatment is the use of factors of various physical nature, which allows to have a therapeutic effect on various functional systems. The combined use of normobaric hypoxia and a low-energy infrared laser significantly increases the effectiveness of complex treatment of patients with chronic generalized periodontitis. At the same time, the regression of clinical signs of the disease was noted to a greater extent when using laser radiation compared to hypoxic exposure. Taking into account the fundamentally different mechanisms of realization of the biological potential of a low-energy infrared laser and normobaric hypoxia, it can be assumed that the increase in the effectiveness of treatment of patients with chronic generalized periodontitis is due to the additive or potentiating nature of the therapeutic effect when they are combined.