Russian Journal of Physiotherapy, Balneology and Rehabilitation

Peer-review bimonthly medical journal.

Editor-in-chief

Journal founders

  • Izdatelstvo "Meditsyna"
  • Eco-Vector Publishing Group

Publisher

About

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.

Types of accepted articles

  • reviews
  • systematic reviews and metaanalyses
  • original research
  • clinical case reports and series
  • letters to the editor
  • short communications
  • clinical practice guidelines

Publications

  • in English and Russian
  • bimonthly, 6 issues per year
  • continuously in Online First
  • with Article Submission Charge (ASC)
  • distribution in hybrid mode - by subscription and/or Open Access
    (OA articles with the Creative Commons Attribution 4.0 International License (CC BY-NC-ND 4.0))

Indexation

  • Russian Science Citation Index (Web of Science)
  • Russian Science Electronic Library (eLibrary.ru)
  • Google Scholar
  • Ulrich's Periodicals directory
  • WorldCat
  • Crossref

 

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Current Issue

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Vol 20, No 4 (2021)

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Original studies

Physiotherapy in patients with degenerative-dystrophic diseases of the spine in the presence of vertebral hemangioma
Titov A.A., Grushina T.I.
Abstract

BACKGROUND: In the arsenal of a physiotherapist, there are many methods of non-drug rehabilitation. As contraindications to their use, spinal neoplasms, benign formations with a tendency to growth are indicated, among other things. At the same time, there is no data in the literature on contraindications to physiotherapy in the presence of non-aggressive vertebral hemangioma. As well as there are no scientific studies with a proven absence of a negative effect on the course of this tumor.

AIMS: scientific substantiation of the use of physical methods of treatment of patients with degenerative-dystrophic diseases of the spine in the presence of non-aggressive vertebral hemangioma.

MATERIAL AND METHODS: The study involved 154 patients with degenerative-dystrophic diseases of the spine and non-aggressive vertebral hemangioma. 94 patients were analyzed retrospectively, 60 took part in a prospective study. The following methods of physical therapy were used in the treatment of all patients: magnetotherapy, electrotherapy, physical therapy and massage. All patients underwent computer or magnetic resonance imaging of the spine before the start of treatment and 1 year after the end of treatment with an assessment of the presence or absence of hemangioma growth in dynamics.

RESULTS: In 94 patients with degenerative-dystrophic diseases of the spine in combination with non-aggressive vertebral hemangioma, who received various methods of physiotherapy, a different proportion of cases of increase in the size of vertebral hemangioma was noted upon repeated examination after 1 year. At the same time, in no case did the vertebral hemangioma acquire signs of aggressiveness. The minimum frequency of increasing the size of vertebral hemangioma was noted in patients after magnetic therapy, therapeutic gymnastics and massage. As a result of the use of magnetotherapy, electrotherapy, therapeutic gymnastics and massage in 60 patients, the growth of vertebral hemangioma was detected only in 1 case.

CONCLUSION: In patients with degenerative-dystrophic diseases of the spine, local low-frequency electrotherapy, magnetic therapy, physical therapy and therapeutic back massage did not significantly affect the frequency of cases of increase in the size of vertebral hemangioma. The possibility of using other methods of physiotherapy in the treatment of patients with degenerative-dystrophic processes of the spine in the presence of non-aggressive vertebral hemangioma requires further research.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):277-282
pages 277-282 views
Combined use of combined laser therapy and autologous plasma with cells in patients with post-acne atrophic scars
Talibova A.P., Gryazeva N.V.
Abstract

BACKGROUND: The formation of atrophic post-acne scars often leads patients to severe psychological depression and social exclusion. To date, many post-acne treatment options have been described, in particular fractional non-ablative laser resurfacing, exposure to platelet-rich plasma, but there is still no standard line of therapy.

AIMS: to study the effectiveness of combined therapy with neodymium (Nd:YAG) and erbium (Er:YAG) lasers and autologous platelet-rich plasma in patients with various phenotypes of atrophic post-acne scars.

MATERIAL AND METHODS: The study involved patients (n=58) over the age of 18 with different types (cleaved, rectangular, navicular) of atrophic post-acne scars, who were divided into 2 groups depending on the method of therapy. Group 1A (n=28) received phototherapy using combined exposure to neodymium (Nd:YAG) and erbium (Er:YAG) lasers; Group 1B patients (n=30) were treated with autologous platelet-rich plasma immediately after laser treatment.

To assess the effectiveness of therapy, the Manchester scale of scar deformities was used according to five indicators ― color, texture, relief, displacement of surrounding tissues, density (MSS) and the International Global Aesthetic Improvement Scale (GAIS). Indicators of skin elasticity in the foci of atrophy were determined using cutometry; epidermal-dermal structure (thickness, echogenicity) was assessed by ultrasound. The clinical picture was assessed before and after treatment.

RESULTS: The effectiveness of therapy was confirmed by the dynamics of symptoms on the MSS scale, in particular, an improvement in the "color" indicators by 54.8% in group 1A, by 83.7% in group 1B, "texture" ― by 57.1 and 78.1%, "relief" ― by 43.8 and 66.7%, "displacement" ― by 54.9 and 82.1%, respectively. The proportion of patients with an optimal result according to GAIS in group 1A was 50%, in group 1B ― 90%; with a significant improvement ― 50 and 10%, respectively. Cutometry and ultrasound data also showed better results in the autologous platelet-rich plasma supplemented group.

CONCLUSION: Thus, complex treatment, including the use of combined laser therapy (erbium and neodymium lasers) and autologous plasma with cells, is a highly effective method for the treatment of atrophic post-acne scars.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):283-288
pages 283-288 views
Evaluation of the effectiveness of a combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin compared with monotherapy with standard doses of isotretinoin in patients with acne
Kolodiy A.A., Gryazeva N.V., Kruglova M.S.
Abstract

BACKGROUND: Long-term experience of clinical use of isotretinoin for acne indicates that it has a good safety and efficacy profile; however, against the background of taking standard doses of isotretinoin, pronounced adverse events that are dose-dependent are noted. Therefore, the search for new combined treatment regimens that reduce the dose of isotretinoin is an urgent task.

AIMS: The aim of our work was to evaluate the effectiveness of a combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin (0.1–0.3 mg/kg of body weight per day) compared with monotherapy with standard doses of isotretinoin (0.5–1 mg/kg of body weight per day) in patients with acne.

MATERIAL AND METHODS: During the study, the dermatological status of patients was assessed taking into account the dermatological index GSS (Global Severity Scog), dermatological acne index (DIA), IGA scale (Investigator's Global Assessment). For a comparative analysis of the impact of various techniques on the quality of life, a high-valid quality of life index (HQIQ) was used. Dermatological status and quality of life were assessed in patients before and after 6 months of therapy. 12 months after the end of therapy, patients were invited to the clinic to identify delayed relapses.

RESULTS: Evaluating the overall results of treatment of patients with moderate severity of acne by isotretinone monotherapy and combination therapy with low doses of isotretinoin and broadband incoherent light, the effectiveness of both methods can be noted, however, according to the global severity scale (GSS), clinical remission was significantly more often observed in the combination therapy group compared with the motor therapy group (88 and 74%, respectively, p <0.05). In addition, no relapses were detected after 12 months in the combination therapy group, and adverse events caused by the use of isotretionine were also less frequent.

CONCLUSION: Thus, the combination therapy of acne with low doses of isotretinoin and broadband incoherent light is more effective.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):289-296
pages 289-296 views
Clinical efficacy of electrophoresis of hydrobiont collagenase isoenzymes at the rehabilitation stage in women with vulvar lichen sclerosus
Ignatovskiy A.V., Kruglova L.S.
Abstract

BACKGROUND: Due to insufficient effectiveness of currently known methods of treatment of patients with scleroatrophic lichenes of the vulva, as well as the lack of reasonable ways to manage patients at the stage of rehabilitation, there is a need to search for new approaches to solve this problem.

AIMS: to study the possibility to apply electrophoresis of the enzyme preparation from hydrobiont collagenases at the stage of rehabilitation of women with scleroatrophic lichenes of the vulva.

MATERIAL AND METHODS: In a group of 86 female patients with scleroatrophic lichenes of the vulva (mean age 49±13 years) a comparative assessment of the efficacy of traditional approach to scleroatrophic lichenes of the vulva treatment and staged treatment using electrophoresis of the enzyme preparation at the stage of rehabilitation was carried out.

RESULTS: The developed approach to the treatment of patients with scleroatrophic lichenes of the vulva with application of electrophoresis of the enzyme complex after stabilization of the cutaneous process by glucocorticosteroids at the rehabilitation stage effectively reduces severity and activity of cutaneous manifestations of scleroatrophic lichenes of the vulva that was reflected in the index (LS-A) from 22, the index (LS-A) from 22.70±4.71 to 7.45±1.90 and the dermatological quality of life index (DIQL) from 22.77±4.86 to 4.95±1.10, in comparison with the patients in the control group, where the conventional therapy was conducted, where the LS-A index showed dynamics from 19.67±4.34 to 12.69±3.35, and the DIQL significant differences between the groups by 16 weeks of follow-up (p <0.001).

CONCLUSION: During staged treatment, a more pronounced and long-lasting effect is observed in the group of patients with electrophoresis of the enzyme complex during the rehabilitation stage as compared to the group with emollients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):297-302
pages 297-302 views
General magnetic therapy and electrostatic field after radical surgical treatment of breast cancer at the 1st stage of medical rehabilitation
Evstigneeva I.S.
Abstract

BACKGROUND: Various methods of physical therapy have been proposed for the rehabilitation of patients with breast cancer. However, a staged approach to prescribing physiotherapeutic factors in the early period after surgical treatment of breast cancer has not been developed enough.

AIMS: to develop a staged approach to the appointment of physiotherapeutic factors at different times after surgical treatment of breast cancer.

MATERIALS AND METHODS: Examination and treatment of 64 patients aged 30 to 70 years after surgical treatment for breast cancer were carried out. All patients underwent medical rehabilitation: individual exercise therapy, balanstherapy, sessions with a medical psychologist, course exposure to an alternating low-frequency electrostatic field and general magnetotherapy. The main group consisted of 33 patients who underwent a 2-stage course of medical rehabilitation: the 1st course on days 2–4 after the operation and the 2nd course after 1–1.5 months against the background of adjuvant radiation therapy. The control group — 31 women, underwent physiotherapy placebo procedures.

RESULTS: I was found that two-stage physical rehabilitation improves the quality of life, reduces swelling, increases the range of motion, decreases pain, decreases the number of postoperative complications, and shortens the duration of lymphorrhea.

CONCLUSION: The inclusion of exposure to an alternating low-frequency electrostatic field and general magnetotherapy in the early stages (2–4 days) and 1–1.5 months after surgical treatment has broad functionality and allows you to obtain a pronounced functional and stable clinical result.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):303-314
pages 303-314 views
Application of suspension systems with rigid elastic elements in the physical rehabilitation of patients with amputation defects of the lower extremities
Bolotov D.D., Starikov S.M., Zakharova Y.N.
Abstract

BACKGROUND: Exercise on suspension systems (gravitational neuromuscular activation) is a highly effective means of physical rehabilitation for patients with various pathologies. Modernization of these products through the use of rigid elastic slings or equipping standard simulators with elastic elements expands the capabilities of this type of equipment, allows you to master new types of exercises, positively affecting the strength, tone and endurance of muscle groups.

AIMS: to study the impact of the inclusion of suspension systems with rigid elastic elements (slings) in physical rehabilitation programs for patients with amputation stumps at the hip level.

MATERIAL AND METHODS: Twelve patients were tested before and after repeated prosthetics in the conditions of the FB MSE Clinic, which, due to the use of suspension systems, including elastic elements, not only increased strength, endurance and coordination relationships of muscles, but also changed the structure of their walking. The active part of the course of physical rehabilitation with the inclusion of suspension systems with elastic elements was less than two weeks. Setting the patient the task of increasing the speed of movement on the prosthesis in the long term, in the near future we focused exclusively on the correctness of the step structure and subjective sensations.

RESULTS: The technical improvement of suspension systems due to elastic elements increases the convenience of their use, the speed of mastering by patients and the degree of efficiency, determining a high percentage of achieving the planned result. Inclusion in the course of training on the simulator with the use of elastic slings allows the patient to master and confidently perform various complexly coordinated movements, including squats, to participate in new types of game activities, which contributes to an increase in his adaptation and socialization in society. Subjectively, patients note greater strength of muscle groups that have undergone additional stress on these systems, improved coordination of movements and endurance when walking on a prosthesis as a whole, as well as a sense of "correctness" of walking, which is confirmed by clinical examination methods and the results of biomechanical tests (increased pace and speed of walking with a decrease in the duration of the step cycle).

CONCLUSIONS: Suspension systems are most useful for the prevention and elimination of atrophy of the muscles that support the movement of the pelvic girdle, in comparison with conventional dynamic training and walking on a prosthesis. Modifications of suspension systems by including elastic elements in them allow functional training not only using static, but also dynamic exercises, expanding their application possibilities in medical and complex rehabilitation, adaptive physical culture and adaptive sports.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):315-323
pages 315-323 views
A study of the quality of knowledge about child autism among doctors of different specialties planning to work in the field of physical and rehabilitation medicine
Zaytseva T.N., Gerasimenko M.Y.
Abstract

BACKGROUND: In recent decades, a steady increase in the prevalence of autism spectrum disorders around the world has been reported. It is known that autism spectrum disorders requires early diagnosis and medical intervention. By identifying the risks of autism spectrum disorders, doctors can help the child and family get qualified help as soon as possible. Given the variety of functional disorders in autism spectrum disorders, these patients require special rehabilitation programs and therefore physicians planning work in the field of physical therapy and medical rehabilitation should be oriented in this problem.

AIMS: To determine the level of awareness of the problem of autism spectrum disorders among doctors of different specialties planning to work in the field of physical and rehabilitation medicine.

MATERIAL AND METHODS: A survey was conducted on the KCAHW questionnaire of 105 doctors of 8 medical specialties who underwent primary retraining in the cycle "Physical and Rehabilitation Medicine" at the Department of Physical Therapy, Sports Medicine and Medical Rehabilitation of the Russian Medical Academy of Continuous Professional Education.

RESULTS: According to the results of filling out the KCAHW questionnaire, the median of correct answers was 14 [7; 19] out of 19 possible, which is the average value of the level of knowledge about autism spectrum disorders. Our research shows that there is a lack of knowledge in the relationship between autism and epilepsy and mental retardation, as well as the relationship between the disease and poor nutrition. Among the respondents, there was also a misunderstanding about the age of the child at which the first signs of autism spectrum disorders can be suspected: 60 (57.1%) of the survey participants correctly determined that autism begins in childhood, 35 (33.3%) of the surveyed doctors believed that autism occurs in infancy, and 10 (9.5%) people indicated the neonatal period.

CONCLUSION: The KCAHW questionnaire is a reliable tool for assessing health care providers' knowledge of childhood autism. The conducted research allows us to conclude that doctors are not sufficiently knowledgeable in the field of knowledge about autism spectrum disorders. The totality of all the respondents' answers indicates the importance of additional information about modern research on the problem of autism spectrum disorders for all doctors planning further work in the field of physical and rehabilitation medicine.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):325-331
pages 325-331 views
The use of heated oxygen-helium mixture in patients with arterial hypertension
Bobkina N.V.
Abstract

BACKGROUND: The spread of arterial hypertension is associated with the presence of such risk factors as smoking, excess body weight, violation of lipid metabolism, the current psycho-emotional load.

AIMS: to assess the effectiveness of the use of heated oxygen-helium mixture in the rehabilitation of patients with arterial hypertension at the outpatient polyclinic stage.

MATERIAL AND METHODS: The supervision was 67 people aged from 40 to 56 years (48.25±4.12 years old) with a verified diagnosis: arterial hypertension I and II art., Low and medium risk, the duration of the disease was 7 years to 15 years (8.98±2.2 years). Patients were divided into two groups: I Group (n=35) — the main, patients underwent a course of rehabilitation with the inclusion of oxygen-helium mixture; group II (n=32) — comparisons, patients underwent a course of rehabilitation without the use of mixture. Breathing was carried out in cyclical and fractionated mode: the breathing mixture is 5 minutes then breathing with atmospheric air 5 minutes (one cycle), 3 such cycles for the procedure. The course of treatment consisted of 1 procedure per day within 10 days from the first day of the study.

To assess the clinical efficiency of reducing treatment, the study was carried out before the start of regenerative treatment and at the end of the course. The effectiveness of this method was assessed by the following indicators: assessment of vegetative status using cardiac rhythm variability indicators; evaluation of blood flow and elastic-elastic properties in the distal arteries of the lower extremities; evaluation of the adaptation of the cardiovascular system to physical exertion with the help of the Harvard Step test, a 6-minute walking test; the level of cortisol in saliva was determined using the immunosyluminescence method; the level of depression and anxiety.

RESULTS: In the main group of patients, there was a positive dynamics in the form of normalization of vegetative status, an increase in the activity of the parasympathetic department of the autonomic nervous system, a decrease in the tone of the sympathetic nervous system, the improvement of elastic properties at the level of the distal arteries of the leg (rear tibial artery, the artery of the foot). After the course of respiration, an increase in physical exhaust tolerance was revealed from the patients examined with arterial hypertension, which passed the respiratory rate of heated oxygen-helium mixture and increase the speed of adaptation processes of recovery of the cardiovascular system after exercise. This analysis of the dynamics of the level of cortisol in saliva demonstrated a tendency to reduce the level in patients of the main group. The results of the study indicate the improvement of the psycho-emotional state of patients with arterial hypertension.

CONCLUSION: The use of heated oxygen-helium mixture has a positive effect on the functional state of patients with arterial hypertension.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):333-340
pages 333-340 views

Review

General issues of spinal muscular atrophy (scientific review). Etiology, clinical features, approaches in rehabilitation and orthopedic treatment
Ponomarenko G.N., Koltsov A.A., Maltsev I.S.
Abstract

Spinal muscular atrophy is a significant medical and social problem and is one of the most common causes of child mortality caused by inherited neuromuscular diseases. The scientific review focuses on etiology, clinical features, as well as approaches in the rehabilitation and orthopedic treatment of patients with spinal muscular atrophy.

AIM: analysis of world literature on aspects of etiology, pathogenesis, clinical manifestations, approaches in rehabilitation and orthopedic treatment of patients with spinal muscular atrophy.

Search for literary sources in open electronic databases PubMed and eLIBRARY for the entire period available in these databases.

Spinal muscular atrophy is a heterogeneous group of hereditary diseases occurring with damage to the motor neurons of the anterior horns of the spinal cord. With predominant clinical signs in the form of muscle weakness, mainly in the lower extremities. Rehabilitation and orthopedic treatment should be carried out with a focus on the musculoskeletal system and related functional disorders

Analysis of various literary sources shows a rapid increase in the number of publications on spinal muscular atrophy, but a large layer of aspects remains that require clarification and more detailed study. A more detailed study of etiological factors, pathogenesis and clinical features of spinal muscular atrophy will allow a more extensive look at the problems of this disease in order to better understand the possible methods of diagnosis and treatment of patients with this pathology.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):341-355
pages 341-355 views

Обзоры литературы

Physical rehabilitation of elderly patients with acute cerebrovascular accident. Literature review
Martsiyash A.A., Moses V.G., Moses K.B., Lastochkina L.A.
Abstract

A sharp increase in life expectancy over the past century has led to a significant increase in demand for long-term medical and social care.

With aging, the reactivity of the body to the effects of the external environment changes, in particular, a decrease in resistance to pathogenic factors. Older people have chronic diseases (cardiovascular system, respiratory and digestive organs, central nervous system, joints, organs of vision and hearing, as well as diabetes, oncological diseases, etc.) that reduce physical and social activity.

Vascular diseases of the brain remain one of the most acute medical and social problems that cause enormous damage to society. A special place among them is occupied by cerebral stroke due to the high mortality rate, significant disability and social maladaptation of elderly patients. According to modern data, at least 1/3 of stroke patients develop motor function disorders on average. These disorders significantly worsen the daily functioning of the quality of life.

The aim of rehabilitation of elderly patients who have suffered a stroke is to return the patient to active social and household activities, create optimal conditions for his active participation in society and, ultimately, improve the quality of life of both the patient and his relatives. The task of psychological and physical recovery, social and labor adaptation of post-stroke patients is most successfully solved in the system of complex multidisciplinary rehabilitation. The lack of timely restorative treatment leads to irreversible anatomical and functional changes and a violation of the psychoemotional status of a person.

Evidence has been provided that physical rehabilitation measures for elderly patients can significantly improve the indicators of physical, mental and social functioning without increasing the risk of undesirable effects. Successful and safe interventions have made it possible to achieve the goal of rehabilitation, increasing the functional status of elderly patients and independence in everyday life, as well as reducing the burden of the disease for both the individual and his family and society as a whole.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(4):357-366
pages 357-366 views


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