Russian Journal of Physiotherapy, Balneology and Rehabilitation

ISSN:
1681-3456 (Print)
2413-2969 (Online)

Fizioterapiya, Bal’neologiya i Reabilitatsiya
Founder:
OAO Izdatelstvo Meditsina
Launch Year: 2002
Frequency: 6 issues per year

The journal is aimed at a wide range of physical therapists, health resort specialists, exercise therapy specialists, and rehabilitation specialists who focus on a variety of diseases. The journal features the latest data on prevention and treatment methods that employ natural and preformed physical factors. It publishes research results on this topic and data from allied clinical disciplines, shares practical experience, and explores means of improving health resort, physical therapy and rehabilitation services. The journal also publishes material concerning debatable topics and issues, lectures, thematic reviews, information on meetings and conferences.

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Vol 19, No 5 (2020)

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Original studies

Personalized high-intensity laser therapy for patients with abnormal skin scars
Kurganskaya I.G.
Abstract

Background. Scars are an inevitable consequence and the final outcome of the restoration of the skin, after injuries, thermal effects on the skin, and are also formed as a result of the resolution of rash elements in various infectious skin diseases, with adverse wound healing after plastic surgery and cosmetic procedures. According to WHO data for 2020, scar complications affect about 10% of the world's population, which is approximately 600 million people. High-intensity laser therapy technologies are considered by experts to be the "gold" standard in the correction of pathological scars, but a significant number of them are updated by the personalized approach developed in the last decade, aimed at individualizing treatment, searching for predictors of the effectiveness of various methods, taking into account a number of basic mechanisms of pathogenesis.

Aims: Scientific substantiation of the concept of personalized high-intensity laser therapy for patients with pathological skin scars.

Materials and methods. We studied 306 patients with atrophic (n=115), hypertrophic (n=100) and keloid (n=91) scars, which were divided into subgroups with emerging (formation period up to 1.5 years) and mature scars. Genetic, phenotypic, clinical, instrumental, laboratory, and medical-sociological methods were used to study the patient's condition and scar tissue. Laser therapy combinations were used: fractional ablative photothermolysis, homogeneous photothermolysis, planar ablative photodestruction, selective angiophotothermolysis, and fractional selective photothermolysis.

Results. It was found that various combinations of high-intensity laser therapy in patients with pathological skin scars cause a significant regression of clinical signs, restore the microrelief of tissues, improve the functional properties of scars (elasticity, elasticity, moisture, vascularization, etc.), which is accompanied by an improvement in the quality of life of patients. The complex of laser technologies forms a pronounced refibromodeling therapeutic effect in patients with pathological skin scars.

Conclusion. The concept of personalized (variant) high-intensity laser therapy in patients with atrophic, hypertrophic and keloid scars, which determines the dependence of the effectiveness of various options for laser correction of pathological scars on the genetic, phenotypic, clinical, morphofunctional and medical-sociological characteristics of patients, is scientifically substantiated. The determinants of the effectiveness of laser technologies have been identified, taking into account which allows the productive use of high-intensity laser radiation in patients with atrophic, hypertrophic and keloid skin scars.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):278-285
pages 278-285 views
The state of systemic immunity under the influence of polarized light and an immunomodulator in patients with HPV-associated cervicitis
Moseshvili G.G., Korchazhkina N.B., Dugieva M.Z., Mikhailova A.A., Portnov V.V.
Abstract

Background. According to current epidemiological studies, 94.9% of women suffering from sexually transmitted infections are diagnosed with the presence of human papillomavirus (HPV) DNA during the examination.

Aims. The aim of the study was to study the effect of combined exposure to blue monochromatic polarized incoherent light and polychromatic visible and infrared polarized light in combination with imihimod 5% cream for external use on the state of systemic immunity in patients with HPV-associated cervicitis.

Materials and methods. The study included 60 patients aged 20–35 years with an HPV-associated cervicitis with a history of at least 1 year, who were randomly divided into 3 groups: in the main group (n=20), course effects of blue monochromatic polarized incoherent light on the projection of the carotid arteries and polychromatic visible and infrared polarized light on the cervix in combination with imihimod 5% cream for external use (complex 1); in the comparison group (n=20) — exposure to polychromatic visible and infrared polarized light on the cervix in combination with imihimod cream for external use 5% (complex 2); in the control group (n=20) — a course of local exposure to the cervix with imihimod cream 5%. The data of the survey of 20 healthy women of the same age were taken as the values of the norm. The state of systemic immunity in patients with HPV-associated cervicitis before treatment and after the course was evaluated by the indicators of mature T-lymphocytes (CD3+), CD4+, CD8+, immunoregulatory index (IRI = CD4+/CD8+), CD16+ (natural killer cells) and CD20+ (B-mature lymphocytes) in peripheral blood.

Results. Before the start of treatment, the patients showed low levels of CD3+-lymphocytes and a decrease in the immunoregulatory index, which is the ratio of CD4+/CD8+ against the background of an increase in the relative content of CD16+ and CD20+, which indicates an imbalance in the cellular immunity. After the course of treatment, the most pronounced results were obtained under the influence of complex 1: a significant increase in the relative content of CD3+ and normalization of IRI against the background of a decrease to the reference values of the initially elevated levels of CD16 (%) and CD20 (%) in both the percentage and absolute ratio of these populations in peripheral blood. Patients treated with complex 2 also showed a positive, but less pronounced, trend towards an increase in CD3+ and IRI and a decrease in elevated CD16+ levels after the course of treatment. In the control group, there was no statistically significant difference between the indicators before and after treatment, and only a slight positive trend was observed for some of them.

Conclusion. The combined use of blue monochromatic polarized incoherent light on the projection of the carotid arteries in combination with polychromatic visible and infrared polarized light and imihimod 5% cream for external use on the cervix in patients with chronic cervicitis associated with papillomavirus infection, to a greater extent than the local use of polarized light in combination with imihimod 5%, has a pronounced immunocorrective effect on the cellular link of immunity.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):286-292
pages 286-292 views
Pharmacological potential strengthening of drug therapy in treating patients with chronic pancreatitis by using therapeutic physical factors
Mallaeva R.M., Makhinko A.N., Uzdenov M.B.
Abstract

Background. The steady increase in the incidence of chronic pancreatitis, its aggressive course in recent years, as well as the insufficient therapeutic effect of standard techniques determine the relevance of the search for new approaches to the treatment and medical rehabilitation of this category of patients.

Aims. To improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs.

Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG; n=39) received standard drug therapy; 1st comparison group (GC1; n=38) additionally received TPF; (GC2, n=40) in addition to treatment in GC1 had drinking mineral water "Slavyanovskaya"; in main group (n=42) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation.

Results. In MG, clinical symptomatology leveling was by 78.2% (р <0.01), in GC1 — by 71.5% (р <0.01), GC2 — by 62.3% (р <0.01), CG — by 57.2% (р <0.01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34.4% (р <0.01), after 12 months — by 24.0% (р <0.05); mental — by 32.3% (р <0.01) and 22.5% (р <0.05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators.

Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):293-298
pages 293-298 views
Features of medical rehabilitation of patients who have suffered an ischemic stroke and have a history of obstructive chronic disorders of the respiratory system without exacerbation.
Vygovskaya S.N., Voropaev A.A., Konchugova T.V., Styazhkina E.M.
Abstract

Background. To date, the study of respiratory function in the clinic is limited, as a rule, to the determination of bronchial conduction indicators, as well as bronchodilation tests, which at the present stage is insufficient for a deep assessment of the functional state of patients with chronic obstructive pulmonary disease.

Aims. The development of personalized medical rehabilitation programs for patients who have undergone ischemic stroke at various stages of rehabilitation, including spa.

Materials and methods. The article considers the effectiveness of the new method of treating neurological disorders in patients suffering from acute cerebral circulation disorder and having respiratory system function disorder at different stages of rehabilitation, based on the complex application of physiobalneotherapy, LFC and mechanotherapy in sanatorium and resort conditions.

Results. After the course of using physical methods of treatment, patients with comorbid pathology showed improvement in health, relief of breathing, reduction of shortness of breath, cough, sputum production, disappearance of wheezing in the lungs.

Conclusion. Patients in the early and late recovery period after acute cerebral circulation disorder with accompanying clinical-functional manifestations of respiratory pathology are shown to include in the rehabilitation complex general gas–air carbon dioxide baths, nebulizer inhalations of broncho- and mucolytic preparations, as well as classes on a rowing simulator (rowing) against the background of standard drug therapy and therapeutic exercise in the hall.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):299-304
pages 299-304 views

Clinical notes and case reports

Practical aspects of using exercise therapy methods for the rehabilitation of patients with COVID-19
Samoilov A.S., Khan A.V., Nazaryan S.E., Pustovoit V.I., Petrova M.S., Novikova A.A.
Abstract

In the article it is discussed about the approved methods of using physical therapy on patients with different forms of COVID-19 at the stage of inpatient treatment. The study involved 86 patients with varying degrees of lung tissue damage (CT2–CT4), the main group included 49 patients, and the control group included 37 patients. A scheme of rehabilitation measures that can be used in patients with SARS-CoV-19 is proposed. Methods of therapeutic and respiratory gymnastics for both passive and active work with patients to restore muscle strength, improve sputum outflow, prevent deep vein thrombosis and bedsores with various degrees of lung tissue damage are described. The importance of performing physical therapy techniques in the early stages, when the patient is still in bed, is shown. Using the modified Questionnaire "quality of life" (GAD-9), the effectiveness of respiratory and therapeutic exercises was confirmed.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):305-311
pages 305-311 views
Regression of spinal demyelination in a patient with leber's disease during long-term therapy with acupuncture and transcutaneous electroneurostimulation
Al-Zamil M.K., Kulikova N.G., Vasilieva E.S.
Abstract

In this paper, we demonstrate the effectiveness of the complex use of acupuncture and direct transcutaneous electroneurostimulation of the median, ulnar, tibial and peroneal nerves in treatment of patient with a demyelization changes in the spinal cord. At the same time, it was possible not only to reduce the severity of motor and sensory deficits, but also of Limb Spasticity, and also to cause a complete regression of demyelization changes in MRI.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):312-316
pages 312-316 views
Broadband modulation currents in physiotherapy and rehabilitation
Maximov A.V., Kir'yanova V.V.
Abstract

The mechanisms of the physiological and therapeutic effects of broadband modulation currents, the peculiarities of their impact on the main functional and regulatory systems of the human body, as well as therapeutic techniques, indications and contraindications for therapeutic use, the fundamentals of physics and biophysics of medium-frequency electrical exposure have been studied. The technique and methods of carrying out medical procedures using the modern domestic apparatus "Nadezhda" for treatment with broadband modulation currents are presented.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(5):317-342
pages 317-342 views

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