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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Physiotherapy, Balneology and Rehabilitation</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Physiotherapy, Balneology and Rehabilitation</journal-title><trans-title-group xml:lang="ru"><trans-title>Физиотерапия, бальнеология и реабилитация</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1681-3456</issn><issn publication-format="electronic">2413-2969</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">653387</article-id><article-id pub-id-type="doi">10.17816/rjpbr653387</article-id><article-id pub-id-type="edn">HQFLPN</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Case raports</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Клинические случаи</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>Case raports</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Multifactorial physiotherapy and dynamic modeling of femoral head in post-contusion femoroacetabular impingement of knee joint (case report)</article-title><trans-title-group xml:lang="ru"><trans-title>Многофакторная физиотерапия и метод динамического моделирования головки бедренной кости при постконтузионном импинджмент-синдроме коленного сустава (клинический случай)</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>多因素物理治疗与股骨头动态建模法在膝关节挫伤后撞击综合征中的应用（临床病例）</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-0374-6763</contrib-id><contrib-id contrib-id-type="spin">1827-7880</contrib-id><name-alternatives><name xml:lang="en"><surname>Kulikova</surname><given-names>Natalya G.</given-names></name><name xml:lang="ru"><surname>Куликова</surname><given-names>Наталья Геннадьевна</given-names></name><name xml:lang="zh"><surname>Kulikova</surname><given-names>Natalya G.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><bio xml:lang="zh"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><email>Kulikovang777@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3643-982X</contrib-id><contrib-id contrib-id-type="spin">3434-9150</contrib-id><name-alternatives><name xml:lang="en"><surname>Al-Zamil</surname><given-names>Mustafa Kh.</given-names></name><name xml:lang="ru"><surname>Аль-Замиль</surname><given-names>Мустафа Халилович</given-names></name><name xml:lang="zh"><surname>Al-Zamil</surname><given-names>Mustafa Kh.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor of the Department</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор кафедры</p></bio><bio xml:lang="zh"><p>MD, Dr. Sci. (Medicine), Professor of the Department</p></bio><email>alzamil@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-9246-5640</contrib-id><contrib-id contrib-id-type="spin">7571-0085</contrib-id><name-alternatives><name xml:lang="en"><surname>Mansur</surname><given-names>Numman Yu.</given-names></name><name xml:lang="ru"><surname>Мансур</surname><given-names>Нумман Юсефович</given-names></name><name xml:lang="zh"><surname>Mansour</surname><given-names>Numman Yu.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), Associate Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><bio xml:lang="zh"><p>MD, Cand. Sci. (Medicine), Associate Professor</p></bio><email>rocstar-fo@to.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8506-8562</contrib-id><contrib-id contrib-id-type="spin">6126-1475</contrib-id><name-alternatives><name xml:lang="en"><surname>Tkachenko</surname><given-names>Albina S.</given-names></name><name xml:lang="ru"><surname>Ткаченко</surname><given-names>Альбина Сергеевна</given-names></name><name xml:lang="zh"><surname>Тkаchenkо</surname><given-names>Albina S.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), Associate Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><bio xml:lang="zh"><p>MD, Cand. Sci. (Medicine), Associate Professor</p></bio><email>rocstar-fo@to.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-4036-2526</contrib-id><contrib-id contrib-id-type="spin">5184-8161</contrib-id><name-alternatives><name xml:lang="en"><surname>Naydenov</surname><given-names>Pavel V.</given-names></name><name xml:lang="ru"><surname>Найдёнов</surname><given-names>Павел Васильевич</given-names></name><name xml:lang="zh"><surname>Naydenov</surname><given-names>Pavel V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>pnaidenov@mos.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University</institution></aff><aff><institution xml:lang="ru">Первый Московский государственный медицинский университет им. И.М. Сеченова</institution></aff><aff><institution xml:lang="zh">I.M. Sechenov First Moscow State Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Peoples' Friendship University of Russia</institution></aff><aff><institution xml:lang="ru">Российский университет дружбы народов им. Патриса Лумумбы</institution></aff><aff><institution xml:lang="zh">Peoples' Friendship University of Russia</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Rozanov Moscow Regional Hospital</institution></aff><aff><institution xml:lang="ru">Московская областная больница им. проф. В.Н. Розанова</institution></aff><aff><institution xml:lang="zh">Rozanov Moscow Regional Hospital</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-04-15" publication-format="electronic"><day>15</day><month>04</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-06-15" publication-format="electronic"><day>15</day><month>06</month><year>2025</year></pub-date><volume>24</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>208</fpage><lpage>215</lpage><history><date date-type="received" iso-8601-date="2025-02-03"><day>03</day><month>02</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-02-21"><day>21</day><month>02</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2025,</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://eco-vector.com/for_authors.php#07</ali:license_ref></license></permissions><self-uri xlink:href="https://rjpbr.com/1681-3456/article/view/653387">https://rjpbr.com/1681-3456/article/view/653387</self-uri><abstract xml:lang="en"><p><bold>BACKGROUND:</bold> The growing number of patients requiring restoration of ligament function in the knee joint due to sports injuries highlights the relevance of developing non-pharmacological rehabilitation methods. The clinical profile of the patient (young age, complicated course of an unconfirmed sports-related injury), as well as the broader objective of improving national health and quality of life, underscore the relevance of systemic analysis in the training of medical personnel within the framework of professional development and scientific research on sports testing methodologies.</p> <p><bold>AIM:</bold> The work aimed to evaluate the efficiency of multifactorial physiotherapy (phonophoresis and optical irradiation) and physical exercises for dynamic modeling of knee joint structures and resolution of bone marrow edema of the medial femoral condyle, as detected by magnetic resonance imaging in a young football player.</p> <p><bold>METHODS:</bold> A case is described involving a 19-year-old male football player presenting with risk of aseptic necrosis of the femoral head, structural ligamentous changes in the knee joint, and joint effusion. The patient experienced sudden severe knee pain and inability to bear weight during intensive training. Assessment criteria were used to monitor outcomes before and after implementation of a personalized rehabilitation model.</p> <p><bold>RESULTS:</bold> New data were obtained on the combined use of four simultaneous modalities (therapeutic exercise, ultrasound and the Artra chondroprotector via phonophoresis, red and infrared spectra of non-coherent optical irradiation), which led to pain relief on the visual analog scale without pharmacological agents, resolution of bone marrow edema by day 7 of treatment, and full return to athletic activity within 3 months. Emphasis was placed on the stepwise application of autogravitational and post-isometric relaxation exercises in the developed multimodal rehabilitation protocol.</p> <p><bold>CONCLUSION:</bold> The integration of customized physical exercises and concurrent application of four physiotherapeutic factors constitutes a highly effective adaptive regimen. When initiated during the acute phase, it enhances clinical outcomes and reduces the risk of developing femoral head aseptic necrosis.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование.</bold> Увеличение числа пациентов, нуждающихся в коррекции связочного аппарата коленного сустава в связи со спортивной травмой, определяет высокую актуальность поиска немедикаментозных методов реабилитации. Особенность клинического статуса пациента (молодой возраст, осложнённое течение неустановленной спортивной травмы), а также повышение уровня общенационального состояния здоровья и качества жизни определяют важность системного анализа обучения кадров в рамках профессионального развития и научных работ по систематике тестирования в спорте.</p> <p><bold>Цель.</bold> Оценить влияние многофакторной физиотерапии (фонофорез и оптическое излучение) и физических упражнений для динамического моделирования структур коленного сустава и устранения отёка костного мозга медиального мыщелка бедренной кости, выявленных по данным магнитно-резонансной томографии у молодого футболиста.</p> <p><bold>Материалы</bold><bold> </bold><bold>и</bold><bold> </bold><bold>методы.</bold> Описан клинический случай наблюдения за молодым (19 лет) спортсменом-футболистом с риском развития асептического некроза головки бедренной кости, структурными изменениями связочного аппарата коленного сустава и выпотом. На фоне высокой спортивно-соревновательной нагрузки у пациента внезапно возникла резкая боль в коленном суставе и невозможность наступить на ногу. Приведены оценочные критерии в динамике наблюдения до и после персонифицированной модели реабилитации.</p> <p><bold>Результаты.</bold> Получены новые данные о сочетанном воздействии одновременно четырёх факторов (ЛФК, ультразвук и хондропротектор «Артра» в методике фонофореза, красный спектр и инфракрасный спектр некогерентного оптического излучения) при реабилитации, что обеспечило не только устранение боли по визуально-аналоговой шкале без лекарственных препаратов и отёка костного мозга на 7-й день лечения, но и полное восстановление режима спортивных нагрузок через 3 мес. Сделан акцент на последовательном характере проводимых аутогравитационных и постизометрических релаксирующих физических упражнений в разработанном многофакторном комплексе.</p> <p><bold>Заключение.</bold> Комплексирование специально подобранных физических упражнений и одновременное воздействие четырёх факторов физиотерапии формируют высокоэффективный адаптивный режим, который при раннем использовании (острая фаза) обеспечивает повышение клинической эффективности лечения и устраняет риск развития асептического некроза головки бедренной кости.</p></trans-abstract><trans-abstract xml:lang="zh"><p>背景。因运动损伤而需进行膝关节韧带结构矫正的患者数量显著增加，使寻找非药物康复手段成为高度关注的方向。患者的临床特点（年轻，运动损伤病因未明且病程复杂）、俄罗斯社会在关注从事高强度体育训练的儿童与青少年健康方面的意识提升，以及提升全民健康水平与生活质量的国家目标，共同凸显出在职业发展框架内对康复专业人才培训和运动测试系统化研究进行系统分析的重要性。</p> <p>目的。评估多因素物理治疗（超声导入与光照治疗）及在膝关节结构动态建模框架内进行的运动训练，对磁共振成像显示的股骨内侧髁骨髓水肿消退的影响及其合理性。</p> <p>材料与方法。本研究报告一例（19岁）青年足球运动员的临床病例，其表现为股骨头无菌性坏死的风险、膝关节韧带结构改变及关节积液。在高强度竞技训练背景下，患者突发膝关节剧烈疼痛并无法负重。列出了个性化康复模式实施前后动态观察中的评估指标。</p> <p>结果。联合采用四种干预手段（功能锻炼、超声导入软骨保护剂"Artra"、红光及红外非相干光照射），在未使用药物的情况下，于治疗第7天实现疼痛缓解（Visual Analog Scale评分）和骨髓水肿消退，并于3个月后完全恢复运动训练负荷。强调该多因素康复方案中自身体重牵引与后等长放松训练的阶段性与系统性特征。</p> <p>结论。精选的个体化运动疗法与三种物理治疗手段的同步应用可形成一种高效的适应性康复方案，在急性期早期介入条件下显著提升治疗效果，并可降低股骨头无菌性坏死的发生风险。</p></trans-abstract><kwd-group xml:lang="en"><kwd>knee joint</kwd><kwd>femoral head</kwd><kwd>visual analog scale pain</kwd><kwd>non-coherent infrared optical therapy</kwd><kwd>red laser spectrum</kwd><kwd>physical exercise</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>коленный сустав</kwd><kwd>головка бедренной кости</kwd><kwd>боль по системе VAS</kwd><kwd>оптическая инфракрасная некогерентная терапия</kwd><kwd>красный спектр лазерного излучения</kwd><kwd>физические упражнения</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>膝关节</kwd><kwd>股骨头</kwd><kwd>VAS评分的疼痛</kwd><kwd>红外非相干光治疗</kwd><kwd>红光激光治疗</kwd><kwd>体育锻炼</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Hamstra-Wright KL, Bliven KCH, Napier C. 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