Russian Journal of Physiotherapy, Balneology and Rehabilitation

Metabolic dysfunction–associated steatotic liver disease is currently regarded as one of the most prevalent metabolic disorders, closely linked to obesity, insulin resistance, and disturbances of the gut microbiome. Physical exercise is a key nonpharmacological strategy capable of modulating energy and metabolic homeostasis through its effects on interorgan communication along the gut–liver axis. This review summarizes experimental and clinical evidence regarding the effects of different types of physical activity, such as moderate-intensity continuous training and high-intensity interval training, on intestinal barrier integrity, hepatic lipid metabolism, mitochondrial and endoplasmic reticulum homeostasis, and systemic inflammation. Preclinical studies demonstrate that both training modalities increase the expression of tight junction proteins (ZO-1, occludin, JAM-A), enhance gut microbiota diversity, reduce endotoxemia, and attenuate the severity of steatosis. High-intensity interval training was superior in stimulating mitochondrial biogenesis, β-oxidation, and irisin secretion, as well as in reducing endoplasmic reticulum stress and macrophage-mediated inflammation. Clinical data confirm that regular physical activity, regardless of intensity, decreases hepatic fat accumulation and improves insulin sensitivity and cardiovascular function. However, clinical evidence remains limited, underscoring the need for further investigation of the molecular regulation mechanisms of the gut–liver axis. Overall, physical activity, particularly high-intensity interval training, is an effective, safe, and affordable approach for the prevention and treatment of metabolic dysfunction–associated steatotic liver disease, contributing to the restoration of metabolic balance and hepatic homeostasis.

This review presents an analysis of Russian and international publications on the use of ozone in ophthalmologic diseases, highlighting its pronounced antibacterial and antiviral effects, ability to suppress inflammation, improve local hemodynamics and microcirculation, and normalize impaired blood rheological parameters. A beneficial effect of ozone on metabolic and reparative processes has been established. Course administration of this method was shown to reduce lipid peroxidation activity while simultaneously stimulating the antioxidant system. A positive effect of local ozone therapy techniques has been demonstrated in intraocular infections. Experimental and clinical studies have elucidated the mechanisms of the therapeutic action of ozone in fungal and viral keratitis and in patients with ischemia–reperfusion retinal injury. Ozone has been shown to be an effective therapeutic modality for neurodegenerative disorders at early stages of age-related changes before progression to severe pathology. Ozone therapy for uveitis of various etiologies reduces the time to resolution of choroidal infiltration and the overall duration of treatment. The beneficial role of ozone therapy has been confirmed in high myopia and glaucoma, as well as its successful application in hemophthalmos, particularly in the early period after hemorrhage. Favorable clinical outcomes have been reported with both local and systemic ozone therapy techniques in patients with diabetic retinopathy. The multifactorial mechanisms underlying the therapeutic and preventive effects of ozone, ease of administration, good tolerability, and availability of modern equipment allow for the broad use of this method in ophthalmologic practice.

BACKGROUND: The prevalence of sexual disorders among women in Russia is high (16.7%). Despite the lack of active healthcare-seeking behavior, these data are consistent with epidemiological studies from other countries.

AIM: This study aimed to evaluate the effectiveness of non-pharmacological methods for restoration of sexual function in women.

METHODS: This prospective, comparative, randomized study included 90 women aged over 18 years with complaints of sexual dysfunction, who were divided into three equal groups. In group 1, patients underwent high-intensity magnetic stimulation of the pelvic floor muscles; in group 2, radiofrequency lifting; in group 3, patients received combined non-pharmacological treatment using both methods. Medical history, clinical and instrumental data were analyzed. Female Sexual Function Index (FSFI) and Sexual Quality of Life-Female (SQOL-F) questionnaires were assessed at baseline and 1 and 3 months after treatment.

RESULTS: Improvement in sexual function was observed in all women in group 3, and the effect persisted at the 3-month follow-up. The probability of achieving a favorable outcome according to the FSFI and SQOL-F questionnaires in the combined therapy group was higher than in group 2 and was similar to that in group 1 (log-rank test for groups 2 and 3, p = 0.016). The combined therapy method was more effective than that used in group 2 (odds ratio 3.60 [1.22–10.64], p = 0.035). An FSFI score ≥ 13.5 one month after the start of therapy may serve as a criterion of treatment effectiveness. Factors associated with a favorable treatment outcome may include more than six sexual intercourses per month, and perineometry values >10.5 mmHg one month and >12.5 mmHg 3 months after the start of therapy.

CONCLUSION: A combined course of high-intensity magnetic stimulation of the pelvic floor muscles and radiofrequency therapy has a positive effect on sexual function in women, may be recommended as a non-pharmacological treatment method for sexual dysfunction, and the effect persists for up to three months.

BACKGROUND: Rehabilitation of patients with severe residual deficits after an acute cerebrovascular accident (stroke) is frequently insufficiently effective, necessitating the search for new therapeutic approaches. Hypoxic conditioning using intermittent hypoxic–hyperoxic exposures (IHHE) has demonstrated efficacy in improving physical and mental performance in various patient populations. However, this approach has not previously been applied in post-stroke rehabilitation.

AIM: The study aimed to evaluate the efficacy and safety of incorporating IHHE into comprehensive rehabilitation programs for patients in the late post-stroke period (≥ 6 months) regarding exercise tolerance, psychoemotional state, and cognitive status.

METHODS: This prospective study included 50 patients who had an ischemic or hemorrhagic stroke ≥ 6 months ago. Patients were randomized to either the treatment group (n = 20) or the control group (n = 30). The treatment group received a standard 3-week rehabilitation program plus 10–12 IHHE procedures (hypoxic phase, FiO₂ = 0.11–0.12; hyperoxic phase, FiO₂ = 0.35–0.40). The control group received the standard rehabilitation program only. The following parameters were assessed before and after the intervention: six-minute walk test (6MWT) score, work performed (W), Borg scale score, heart rate, blood pressure, oxygen saturation, psychoemotional state (DASS-21, Epworth Sleepiness Scale), quality of life (SF-12), functional independence (Barthel Index), and cognitive function (USEFO test).

RESULTS: The treatment group showed a more pronounced increase in exercise tolerance, with an increase in 6MWT distance of 58.9 ± 24.3 m vs. 15.8 ± 18.7 m (p = 0.005) and work performed of 7.7 ± 3.8 vs. 3.7 ± 3.1 (p = 0.018). A clinically relevant improvement (≥ 35 m) was achieved in 60% of patients in the treatment group compared with 16.7% in the control group. Furthermore, a greater reduction in depression, anxiety, and stress severity according to DASS-21 (p <  0.05), decreased daytime sleepiness, increased SF-12 scores, and improved Barthel index were observed. IHHE procedures were well tolerated; adverse effects were minimal and transient, occurring during the first 1–3 procedures.

CONCLUSION: Adding a personalized IHHE course to standard post-stroke rehabilitation resulted in pronounced improvements in exercise tolerance, psychoemotional state, quality of life, and functional independence. The method was safe and well tolerated. Larger-scale studies are required to confirm long-term efficacy.