Russian Journal of Physiotherapy, Balneology and Rehabilitation

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

Fizioterapiya, Bal’neologiya i Reabilitatsiya
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 6 (2020)

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Original studies

Options of modeling diet-induced and combined metabolic syndrome
Abramtsova A.V., Efimenko N.V., Reps V.F., Kaisinova A.S.

Background. Due to the fact that it is not always possible to reproduce all known manifestations of carbohydrate and lipid metabolism disorders, for example, in rodents, it is necessary to verify individual pathogenetic links in animals when modeling the metabolic syndrome in order to select the most optimal natural biotropic factors for studying the effect on them.

Aims: To analyze metabolic disorders in the modeling of metabolic syndrome of alimentary genesis in comparison with the combined effect of alimentary factor and chemical agents to select the most appropriate model in the study of natural and weak preformed physical factors.

Materials and methods. Metabolic syndrome was modeled in 47 sexually mature outbred white male rats using a hypercaloric diet (HD) of various duration and medications. The first series was the 1st control group (CG1) and the 1st experimental group (EG1). They received HD during 180 days, they were withdrawn from the experiment 30 days after the cancellation of HD. The second series was the 2nd control group (CG2) and three experimental groups. They received HD for 60 days, where the 2nd group (EG2) in association with HD received Mercazolil (10 mg/kg of animal weight) intragastrically for 14 days starting from the 21st day; the 3rd group (EG3) had the same scheme of treatment as in EG2, besides, after taking Mercazolil, they were intramuscularly injected with Nitox 200 at 25 mg/kg once per day during 5 days. Animals of EG2 and EG3 were withdrawn from the experiment 60 days after ending of HD. Animals of the 4th experimental group (EG4) got HD and the same medicine as in EG3. They left the experiment 30 days after ending HD. The content of hormones and biochemical parameters of protein, fat, and carbohydrate in peripheral blood was evaluated using multiple inter-group comparisons and intra-group relationships by Spearman’s rank correlation method.

Results. There have been detected a large number of biochemical signs of dependence of metabolism regulation on leptin level after long-term HD (180 days), while there were fewer biochemical signs of protein exchange disorder less than with the combined use of HD (60 days) and drugs.

Conclusion. It is more appropriate and promising to use a long-term HD as a model of MS close to the natural conditions of its formation, to study the influence of natural and weak preformed physical factors.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):346-354
pages 346-354 views
Assessment of the dynamics of dermatologic index indicators of symptom scale and dermatologic quality of life index under the influence of complex phototherapy in patients with a combination of rosacea subtypes
Novikov K.A., Tamrazova O.B., Matushevskaya Y.I.

Background. Taking into account the data of recent studies on the treatment of rosacea, the development of new methods of treating this dermatosis using complex physiotherapeutic approaches and their synergism is of scientific and practical interest. In this work, we took into account the synergism of physiotherapeutic effects exerted by intense pulsed light and submilisecond neodymium 1064 nm laser radiation, as well as an increase in the destruction of pathologically altered vessels observed with the sequential use of both procedures.

Aims: to assess the effect of complex phototherapy on changes in the indicators of the dermatological index of the symptom scale and the dermatological index of quality of life, reflecting the effect of the therapy on the clinical manifestations of the disease and the patient's subjective assessment of the skin condition.

Material and methods. In the period 2017–2020 we conducted a randomized controlled study in which 130 patients with a combination of rosacea subtypes took part. All patients were divided into 4 groups. In each separate group, the following types of therapy were used: in group I — laser therapy and 1% metronidazole cream; in group II — phototherapy and 1% metronidazole cream; in group III — complex photo-laser therapy and 1% metronidazole cream; in the comparison group (IV), patients received only 1% metronidazole cream. The treatment included 6 sessions with an interval of 2 weeks, with a total duration of 3 months. The effectiveness of therapy was assessed according to the results of the dermatological index of quality of life (DQL) and the dermatological index of the symptom scale (DYS) before and after treatment.

Results. The developed complex method of combination of rosacea subtypes therapy demonstrated maximum efficiency, which was reflected in the maximum (by 55.21%) decrease in DYS in group III compared with the other three groups: in group I, the decrease in DYS was 30.54%, in II — 21.51%, in IV — 21.56%. The DQL in group III decreased by 67.4%, which was significantly higher than the indicators of the other three groups: in group I, DQL decreased by 31.3%, in group II — by 27.4%, in IV — by 20.7%.

Conclusion. After the course of complex phototherapy in the group of patients with combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of the disease, as well as an increase in the quality of life of patients according to the data of the DYS and DQL, respectively.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):355-365
pages 355-365 views
Combined use of laser therapy and autologous plasma with cells in patients with post-acne atrophic scars
Talibova A.P., Gryazeva N.V.

Background. Acne scar formation is a common consequence of acne vulgaris, in most cases atrophic scars resulting from tissue loss caused by inflammation of the pilosebial units.

Aims: To study the effectiveness of combined laser therapy with Nd:YAG laser and Er: YAG laser with autologous plasma with cells in patients with different phenotypes of post-acne atrophic scars.

Materials and methods. Depending on the method of treatment of post-acne scars, the patients were divided into 2 groups: Group 1 (n=28) with ice pick scars — 10 patients; boxcar — 9 patients; rolling — 9 patients and group 1 (n=30) among them with ice pick scars — 10; boxcar — 9; rolling — 11 patients. In group 1A, phototherapy was performed using a combination of Nd:YAG laser and Er:YAG laser. Immediately after laser exposure, autologous plasma was applied to the skin of the face of group 1B patients. To assess the effectiveness, the Manchester scale of assessment of scar deformities was used. The effectiveness was also evaluated using the Global Aesthetic Scale (GAIS) on a 3-point system. In this study, cutometry and ultrasound were performed to assess the elasticity of the skin in the foci of atrophy.

Results. The indicator "color" on the MSS scale improved in the 1st group by 54.8%, in the 2nd — by 83.7%, the indicator "texture" — by 57.1 and 78.1%, the indicator "relief" — by 43.8 and 66.7%, the indicator "displacement" — by 54.9 and 82.1%, respectively. There were no patients with a deterioration or lack of effect on the GAIS scale in any of the study groups. According to the ultrasound scan data, the greatest effectiveness was observed in the group of complex treatment .

Conclusion. Complex treatment, including the use of combined laser therapy (erbium and neodymium lasers) and autologous plasma with cells, is a highly effective technique for the treatment of atrophic post-acne scars.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):366-370
pages 366-370 views
Comparison of the effectiveness of treatment and the effect on the composition of the microbiota in patients with acne when using isotretinoin monotherapy and its combination with phototherapy with broadband incoherent light
Kolodiy A.A., Kruglova L.S., Gryazeva N.V.

Background. Laser and LED light sources operating in the range of 400–700 and 800–1400 nm can affect the links of the pathogenesis of acne (they destroy the pathogenic bacterial flora and lead to atrophy of the sebaceous glands due to heating of the vessels feeding the glands, which ultimately reduces the production of sebum) and can be very effective in the treatment of patients with acne.

Aims: To evaluate the effectiveness of the combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin compared with standard isotretinoin monotherapy, as well as the effect on the composition of the microbiota in patients with acne.

Materials and methods. 78 patients with a diagnosis of acne, papulo-pustular form, moderate severity were monitored on an outpatient basis. Depending on the method of therapy, patients are divided into 2 groups. The dermatological status of patients was assessed taking into account the dermatological index GSS (Global Severity Ssore), the dermatological index of acne (DIA), the IGA scale (Investigator's Global Assessment), the quality of life index (QOL). To study the composition of the skin microbiota in all patients before and after therapy, an analysis was performed using the method of chromatography-mass spectrometry of microbial markers.

Results. Both methods are effective, but according to the global scale of severity (GSS), clinical remission was significantly more frequent in the combination therapy group compared to the motor therapy group (88 and 74%, respectively, p <0.05). In addition, in the group of patients who received the combined method of treatment, there was a more pronounced positive dynamics of DIQH compared to the group of patients who received monotherapy — 76 and 84%, respectively (at p <0.05, compared with the indicators before treatment). After treatment, there was a pronounced positive dynamics and normalization of most indicators of the microbiota of the skin of the face, but the number of some targeted microorganisms was slightly higher than normal after therapy.

Conclusions. Thus, the combined treatment with IPL and low doses of systemic isotretinoin is a safe and effective method of treating moderate acne.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):371-379
pages 371-379 views
Psychocorrective effect of application of combined medical rehabilitation methods in patients with ischemic stroke
Mikhailova A.A., Korchazhkina N.B., Koneva E.S., Kotenko K.V.

Background. The annual death rate from stroke in Russia remains the highest in the world.

Aims: To study the influence of combined methods of medical rehabilitation on the psychological status and functional independence of patients with post-stroke spasticity.

Materials and methods. The article presents data on the effectiveness of the influence on the psychological status and functional independence of the combined methods of medical rehabilitation in 60 patients with ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone by the type of spasticity in the long-term period. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics: the main group (n=30), who received combined methods of physiotherapy (thermotherapy, oxygen therapy, oxyhyperthermia, vibrotherapy, aromatherapy) from the Alpha LED Oxu Light Spa™ apparatus in addition to the standard rehabilitation complex , which includes exercise therapy, medical massage, kinesitherapy, and a control group (n=30), who received only a standard rehabilitation complex. To assess the initial psychological status and functional independence of the observed patients undergoing medical rehabilitation in the period from 3 to 6 months after the disease, the SAN method (well-being, activity, mood) and the FIM scale were used.

Results. Before the start of rehabilitation in all patients included in the study. Тhere was a moderate degree of deterioration in well-being, a decrease in activity and mood, as well as a decrease in indicators of independence in everyday life. After the course of treatment (on day 14) and in the long-term period (after 8 months) the patients of the main group had a pronounced positive dynamics of the psycho-emotional status, which was manifested in an improvement in the indicators of well-being — by 1.93 times (by 28%), activity — by 1.95 times (by 29.6%) and mood — by 2.01 times (by 29.8%) points. In the control group, after the standard course of treatment, there was less pronounced dynamics of psychometric indicators. When evaluating the results of functional independence on the FIM scale, there was a significant improvement in the indicators of independence in everyday life by 32%.

Conclusion. The use of combined methods of medical rehabilitation in patients with post-stroke spasticity contributes to a significant increase in their quality of life and psychological status, which is confirmed by the FIM and SAN tests.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):380-383
pages 380-383 views
Clinical and electromyographic evaluation of the effectiveness of the use of interference currents and traction therapy in the treatment of patients with vertebral radiculopathy
Akhundov P.Y., Huseynova S.G.

Background. Relevance of elaboration of lumbosacral radiculopathy (LSR) treatment methods is сonditioned by widespread of this pathology. Pain syndrome (PS) reducing activity and life quality of workable patients is the most prevailing clinical manifestation of this disease. Сonservative treatment methods of LSR directed to decrease pain, oedema and compression of nerve roots as well as contributing to сonductivity improvement include medication, physiotherapeutic and orthopaedic treatment.

Aims: Clinical neurophysiological justification of combined use of interference therapy (IT) and spine traction (ST) in complex treatment of vertebral LSR.

Materials and methods. The first-control group (n=32) who were treated by using ST as a treatment. The second ― treatment group (n=32) included those who were treated by using the IT and ST on the same day. All patients had radicular syndromes. All patients passed the lumbar MRI scan. PS was estimated according to the visual-analogic scale (VAS) and McGill’s questionnaire. Estimation of life quality of patients was based on Roland-Morris questionnaire. Electromyography registered dynamics of impulse conduction on motor fibres, as well as parametеrs of compound muscle action potential and H-reflex.

Results. Positive effect of combined use of interference therapy with spine traction in complex treatment of vertebral radiculopathy patients are proved. It has been established that the therapeutic effect of the complex application of IT and ST lies in the improvement in the afferent and efferent links of the neuromotor apparatus, as well as the functional state of the spinal alpha-motoneurons associated with the acceleration of the regenerative processes.

Conclusion. Results of the clinical neurophysiological investigation, carried out before and after rehabilitative treatment allow to recommend combined therapy of IT and ST for treatment of vertebral LSR.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):384-390
pages 384-390 views


Balneotherapeutic factors of the North Ossetia — Alanya Republic
Kaisinova A.S., Gusova B.A., Mirzaeva L.M., Tsallagova L.V., Tsidaeva T.I.

The research objective is to determine the prospects for the development of balneology in the Republic of North Ossetia — Alania.

Mineral waters, therapeutic peloids (clay terclites), spa research, statistical methods. Pyatigorsk Scientific Research Institute of Resort Study developed a strategy of balneology development in Republic of North Ossetia — Alania. There have been conducted route studies of bioclimatic and microclimatic features of medical and health areas. Their modern landscape, climatic potential and prospects of resort methods of climate treatment and landscape therapy have been assessed. There have also been carried out a full physical and chemical study of samples of mineral waters (21 samples) and medical mud (2 samples) in native form in accordance with the regulatory and technical documents of the Russian Federation. The conducted analysis of mineral waters and peloids showed that in the Republic of North Ossetia — Alania there are mineral waters of various physical and chemical composition and mineralization and low-mineralized sulfate magnesium-calcium-sodium therapeutic clays-terclites having a high balneotherapeutic activity.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):391-394
pages 391-394 views
Expressive movement: an interdisciplinary view
Zaytseva T.N., Nizhelskoy V.A., Gerasimenko M.Y., Saito M.

The purpose of the rewiev is to familiarize the teaching community from the world of dance and theater, artistic sports, coaches, leading master classes, etc. with modern medical and physiological approaches to the study of the expressiveness of human body movements. The use of such knowledge in educational practice can contribute to achieving maximum results in professional activity, increasing the effectiveness of training, and reducing injuries in classes related to physical activity. Association of a wide range of specialists interested in the development of the technicality and virtuosity of the performance of movements, which form the basis of professional skill, discussion of topical issues of the use of modern technologies and their implementation in practice will allow specialists to form a comprehensive understanding of modern trends in the study of expressive movement in the aspect physiology and medicine, as well as at a qualitatively new level to develop general approaches to the translation of the knowledge gained.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):395-399
pages 395-399 views
Hyperthermia in the treatment of patients with non-oncological diseases (literature review)
Kurpeshev O.K.

An electronic search for publications on the results of the use of hyperthermia (HT) in medicine was carried out using the Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI, international and regional journals, materials of international congresses, congresses and conferences. The review analyzes the results of experimental and clinical studies on local hyperthermia (LHT) in inflammatory, allergic and other diseases. In vitro experiments have shown that LHT increases the antibacterial activity of serum, as well as the expression of anti-inflammatory cytokines. Clinical studies have established a therapeutic effect of LHT in rhinitis of various etiologies, purulent sinusitis, viral human papilloma, fibromyalgia, injuries of the musculoskeletal system, chronic prostatitis. Analysis shows that the therapeutic effect of LHT is associated not only with direct bacteriostatic and bactericidal actions, but also with an indirect effect on the course of the disease, namely, modulation of the activity of antigen-presenting cells, increased blood and lymph circulation, and increased metabolism. It is also important that LHT increases the effectiveness of antibiotic therapy in drug-resistant forms of the inflammatory process.

Thus, the wide range of biological action of LHT allows us to consider it as a promising therapeutic method in various fields of medicine.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):400-412
pages 400-412 views

Clinical Guidelines

Restorative technologies using physiotherapeutic factors in dermatocosmetology and aesthetic medicine
Vasilieva E.S., Al-Zamil M.K., Kulikova N.G.

The manual provides data on the use of physiotherapeutic factors in dermatocosmetology and provides guidelines for their use in the rehabilitation and rehabilitation treatment of patients after plastic surgery. The authors also paid attention to the peculiarities of their clinical use, taking into account microcirculatory changes and stages of the postoperative period.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(6):413-422
pages 413-422 views

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