Russian Journal of Physiotherapy, Balneology and Rehabilitation

Intermittent hypoxia-hyperoxia therapy has been proposed as a potential method for influencing aging processes, enhancing quality of life in older adults, and reducing morbidity in this population. Even short-term intermittent hypoxic exposure is a sufficient stimulus for the accumulation of reactive oxygen species, the upregulation of hypoxia-inducible factor 1-alpha (HIF-1α), and the subsequent activation of adaptive mechanisms that enhance resistance to hypoxia and oxidative stress. Another well-studied physiological phenomenon induced by intermittent hypoxia is long-term facilitation, which is characterized by reduced motor neuron activity and modulated lung ventilation, primarily manifesting as an increase in tidal volume. Increased serotonergic activity induced by intermittent hypoxia-hyperoxia therapy promotes the synthesis of brain-derived neurotrophic factor, which plays a crucial role in higher neural functions. Brain-derived neurotrophic factor deficiency is associated with the development of various psychiatric and neurodegenerative disorders, as well as brain aging. intermittent hypoxia-hyperoxia therapy has demonstrated beneficial effects on clinical markers of heart failure, lipid and glucose metabolism disorders, inflammatory processes and liver enzymatic activity. Thus, the primary theoretical justification for intermittent hypoxia-hyperoxia therapy is to enhance the body’s adaptive capacity and increase resistance to hypoxia, which plays a key role in the course of various pathological conditions.

BACKGROUND: At present, various physical therapy methods have been proposed for the rehabilitation of breast cancer patients. However, a key issue in oncological rehabilitation is that modern protocols often do not take into account functional impairments that arise during combined treatment. Yet minimizing the adverse effects and complications of radical therapy is essential for restoring the function of affected tissues, organs, and systems.

AIM: To clarify the mechanisms of action of general magnetotherapy and low-frequency electrostatic field therapy, and to justify their application starting on postoperative days 2–4 in breast cancer patients as part of two consecutive courses of medical rehabilitation.

MATERIALS AND METHODS: The study included 78 female patients who underwent surgical treatment for confirmed stage IIB (T2N1M0; T3N0M0) or stage IIIA (T3N1M0; T1–2N2M0) breast cancer. The patients were divided into two groups (main and control) using simple randomization. The groups were comparable in terms of age and clinical and functional indicators, differing only in the prescription of physiotherapeutic methods during the two-stage course of medical rehabilitation.

RESULTS: It was established that two courses of medical rehabilitation in breast cancer patients, conducted in the early postoperative period (days 2–4) and again 1–1.5 months after surgery, contributed to the reduction of pain and postoperative edema, improvement in shoulder joint mobility, prevention of severe lymphedema, and enhancement of quality of life. These effects were confirmed by clinical and functional assessments, including laser Doppler flowmetry and electromyographic evaluation of shoulder muscles. Patients in the main group showed better restoration of shoulder joint mobility on the operated side.

CONCLUSION: General magnetotherapy exerts a normalizing effect on autonomic and psychoemotional status by selectively modulating hypothalamic excitability in cortical and subcortical brain structures. Low-frequency alternating electrostatic field therapy reduces the formation of protein-rich edema, normalizes neuromuscular excitability, promotes the restoration of tissue elasticity, improves functional tissue condition, and enhances local hemodynamics and microcirculation.

BACKGROUND: Resistant hypertension is strongly associated with an increased risk of cardiovascular complications, poor prognosis, and reduced quality of life, remaining a major global medical and social challenge. Standard antihypertensive therapy is often insufficiently effective. In this context, physiotherapeutic methods such as intravenous laser blood irradiation, known for its pleiotropic effects, represent a promising therapeutic approach.

AIM: To evaluate the impact of intravenous laser blood irradiation as an adjunctive treatment to standard antihypertensive therapy on the achievement of target blood pressure levels and plasma levels of β-adrenergic reactivity of erythrocyte membranes (β-AREM), nitric oxide (NO), and endothelin-1 (ET-1) in patients with resistant hypertension.

MATERIALS AND METHODS: The study included 100 ambulatory patients aged 18–45 years with resistant hypertension, randomized into: main group (n=50, receiving intravenous laser blood irradiation in addition to standard antihypertensive therapy) and comparison group (n=50, receiving only standard antihypertensive therapy). Assessments were conducted at baseline and after two months, including: 24-hour BP monitoring, plasma β-AREM, NO, and ET-1 levels. The control group (n=45) included patients with controlled hypertension.

RESULTS: After two months, the main group demonstrated a statistically significant improvement in number of patients achieving target BP levels (p <0.05), as well as in β-AREM (p=0.002), NO (p=0.028), ET-1 (p=0.006).

CONCLUSION: Intravenous laser blood irradiation may serve as an effective adjunctive therapy in the pathogenetically oriented management of resistant hypertension in outpatient settings.

BACKGROUND: Early postmenopausal women are particularly vulnerable to treatment variability due to age-related and physiological changes, which influence the active adhesion of Candida spp. and the subsequent development of recurrent vulvovaginal candidiasis. Spa therapy is a promising approach for managing this condition, offering significant health-promoting and adaptogenic effects.

AIM: To assess the effectiveness of spa therapy in early postmenopausal women with a history of recurrent vulvovaginal candidiasis.

MATERIALS AND METHODS: A total of 108 early postmenopausal women with recurrent vulvovaginal candidiasis were enrolled and randomly assigned to three groups: control group (n=36, group 3) received standard spa therapy protocols for gynecological conditions; comparison group (n=36, group 2) received pelotherapy in addition to standard spa therapy; main group (n=36, group 1) underwent endomassage and magnetic field therapy in combination with pelotherapy and standard spa therapy. The effectiveness of spa therapy was evaluated based on: vaginal microbiota analysis, degree of vaginal atrophy, medical and psychological assessments.

RESULTS: By the end of treatment and at the 6-month follow-up, an absolute normocenosis was observed in nearly half of the women in group 1, whereas at 12 months, microbiota shifted to an intermediate type, comparable to that of healthy early postmenopausal women. In group 2, a conditional normocenosis was identified after 18 days and persisted for 6 months, but with an intermediate smear type. Group 3 retained a dysbiotic profile throughout the follow-ups. At 6 months, both groups 1 and 2 showed positive shifts in vaginal atrophy; however, only group 1 exhibited minimal abnormalities. Quality of life indicators (well-being, activity, and mood) significantly improved in group 1, reaching normative values by the end of spa therapy. The well-being score in group 2 was interpreted as favorable but was statistically different from that in group 1. A statistically significant difference was observed between groups 1 and 3.

CONCLUSION: The newly developed spa therapy protocol for early postmenopausal women with recurrent vulvovaginal candidiasis sequelae promotes the restoration of vaginal microbiota, reduces vaginal atrophy, and significantly improves quality of life.

BACKGROUND: Anorectal malformations represent a significant group of congenital developmental anomalies in children. A critical issue in pediatric surgery is the development of effective rehabilitation strategies following proctoplasty. Medical rehabilitation aims to normalize bowel transit, restore the tone of the rectal sphincter and pelvic floor muscles, reestablish the defecation reflex, and reduce asthenovegetative dysfunctions.

AIM: To substantiate the use of extracorporeal magnetic stimulation in rehabilitation of children who underwent surgery for anorectal malformations.

MATERIALS AND METHODS: As part of an open controlled clinical study, 77 children (mean age 5.99±3.22 years) who had undergone surgery for anorectal malformations were monitored over time. They were included into either of two groups: 39 children received extracorporeal magnetic stimulation, whereas 38 children did not have any physiotherapeutic interventions. All children participated in therapeutic exercises for strengthening the pelvic floor muscles. To evaluate treatment efficacy, ultrasound imaging of the perineum and pelvic floor structures was performed, along with Doppler ultrasonography of the rectal vasculature.

RESULTS: Extracorporeal magnetic stimulation was associated with a positive clinical response, including improved colonic evacuatory function and decreased episodes of fecal soiling. Ultrasound demonstrated statistically significant increases in the anal canal width, levator muscle dimensions (p=0.04), external sphincter thickness on the right (p=0.004) and left (p=0.012) sides, and puborectalis sling size (p=0.009). A trend toward improved intramural blood flow parameters was observed based on Doppler ultrasonography of the pull-through rectum. However, long-term follow-up at 3, 6, and 12 months indicated a gradual decline in the achieved therapeutic effects.

CONCLUSIONS: The studies showed that extracorporeal magnetic stimulation has a positive impact on key clinical and functional parameters in children with anorectal malformations. Analysis of long-term outcomes supports the feasibility of repeated extracorporeal magnetic stimulation courses to maintain therapeutic benefits.

Thermal heliox therapy is an inhalation-based physiotherapy method with neuroprotective and cardioprotective effects. This study substantiates the use of thermal heliox therapy for correcting central hemodynamic disturbances caused by atrial fibrillation. A clinical case of comprehensive rehabilitation in a patient with acute cardioembolic stroke is presented. In a rehabilitation setting, the Simona 111 (integral monitoring system) was used to assess a patient with persistent atrial fibrillation, revealing central hemodynamic disturbances. A course of thermal heliox therapy was administered using the BreezeLite inhalation device to correct central hemodynamic disturbances. Inhalations of a helium-oxygen mixture heated to 70 °C (70% helium, 30% oxygen) were administered once daily for 14 days, with each session lasting 15 minutes. Following the course of thermal heliox therapy, improvements were observed in left ventricular performance, systolic and diastolic myocardial function, preload and afterload regulation, oxygen delivery, and pulse deficit reduction. After the rehabilitation course, improvements were noted in physiological functions across various body systems, including cognitive functions, as assessed using the International Classification of Functioning, Disability, and Health. We found that correcting central hemodynamic disturbances is a necessary condition for effective rehabilitation in patients recovering from cardioembolic stroke caused by persistent atrial fibrillation. Thermal heliox therapy may be a promising method for correcting central hemodynamic disturbances, requiring further research.