Vol 17, No 4 (2018)

Cover Page

Original studies

Physical rehabilitation of patients with shoulder joint dysfunction after coronary artery bypass surgery

Arkhipova N.V., Pomeshkina S.A., Inozemtseva A.A., Barbarash O.L.


Background. Use of a complex of special exercises with a low-load long-term regime of tissue stretching in exercise therapy (ET) after a coronary artery bypass surgery is an effective method that enables not only to reduce and even eliminate completely pain sensations, but also to start the recovery process in the joint.

Aim: to evaluate the effectiveness of the low-load long-term regime of tissue stretching using special exercises in exercise therapy in patients with adhesive capsulitis of the shoulder joint that developed after coronary artery bypass surgery.

Methods. The study included 97 patients with coronary heart disease, who underwent coronary artery bypass surgery. At the inpatient rehabilitation stage 2, the patients were randomized into two comparable groups, namely the main group which received in addition to the standard rehabilitation program the therapy classes exercises aimed at relaxing, sparing stretching the shoulder girdle muscles and increase in the amplitude of movements in the shoulder joint, and the comparison group which was engaged in the traditional program. The patients’ condition was evaluated 12 and 26 days after the coronary artery bypass surgery. All patients underwent a comprehensive examination.

Results. When assessing the changes in time of exercise load tolerance, evaluated by the six-minute walk test, in patients of both compared groups, this indicator increased significantly in comparison with the initial level, however, in patients who practiced special exercises within ET, the increase was more pronounced. In addition, in patients who performed special exercises within ET, exercise tolerance was significantly higher before discharge at the stage II of rehabilitation in comparison with patients who applied traditional ET methods. When analyzing the changes in time of the severity of the range of motion limitation in the shoulder joint and the respiratory excursion index, their significant increase was noted only in the group with special exercises. In the group with traditional ET methods, these indicators have not been changed. After a month, these indicators in patients with traditional methods of exposure were significantly lower than in the group with special exercises.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):172-177
pages 172-177 views

Balneotherapy and physiotherapy in treatment of cognitive and psychoemotional disorders in patients with chronic cerebral ischemia

Cherevaschenko L.A., Serebryakov A.A., Kulikov N.N., Tereshin A.T., Cherevashchenko I.A.


Background. Chronic cerebral ischemia, or discirculatory encephalopathy, is one of the most common neurological diagnosis in Russia. This condition is defined as a chronic, progressive, non-stroke-related vascular lesion of the brain, which is manifested predominantly by cognitive impairment. Therapeutic measures for cognitive impairment include, first of all, the prevention of acute cerebrovascular accidents and chronic vascular cerebral insufficiency. The development and implementation of highly effective non-drug treatment methods, having few side effects, is an urgent problem in contemporary medicine. Such treatment methods can include balneotherapy and physiotherapy.

Aim: to justify the possibility and expediency of applying at the health resort treatment stage the combined use of iodine-bromine baths and a pulsed low-frequency electrostatic field in patients with chronic cerebral ischemia in order to correct cognitive and psychoemotional disorders and improve the quality of life.

Methods. The study included 90 patients with chronic cerebral ischemia, who were randomly divided into 3 treatment groups. The control group patients received iodine-bromine baths, the comparison group patients received exposure to an alternating pulsed low-frequency electrostatic field using the HIVAMAT-200 apparatus, and the main group patients received iodine-bromine baths and exposure to a pulsed low-frequency electrostatic field. The cognitive and emotional-volitional sphere was studied using standard neuropsychological techniques, namely the minimum cognitive deficit scale Mini Mental State Examination (MMSE); Luria’s test, the Clock Drawing test, Schulte tables, and Yu.L. Hanin’s anxiety scales. The study of quality of life was performed using the Russian version of the general questionnaire MOS SF 36 Iterm Short-Form Health Survey.

Results. It has been proved that as a result of treatment, disorders of memory and attention are reduced, the general cognitive status of patients is improved, which slows down the disease progression, reduces the risk of vascular catastrophes and dementia.

Conclusion. New medical technologies developed for the treatment of patients with chronic cerebral ischemia at the health resort treatment stage are highly effective, pathogenetically substantiated, and can be recommended for widespread use in a network of health resort institutions and rehabilitation and preventive institutions of practical health care.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):178-184
pages 178-184 views

Magnetotherapy in patients with knee osteoarthrosis: thermographic efficacy indicators

Gerasimenko M.Y., Glushkova E.P., Gorbunova D.Y., Byalovsky Y.Y., Bulatetskiy S.V., Ivanov A.V.


Background. Osteoarthrosis is characterized by wide prevalence, especially among patients of older age groups, a high risk of restrictions on the musculoskeletal system function, which results in the patients’ impaired ability to work and reduced quality of life.

Aim: investigate the possibilities of thermographic assessment of efficiency of magnetotherapy of the articular syndrome in osteoarthrosis of the knee joints.

Methods. The study included 57 patients (46 women and 11 men) with osteoarthrosis of the knee joints (mean age 61.2±7.4 years). The patients were divided into two groups. In the group 1 (n=29), magnetotherapy with the ALMAG-01 apparatus was used, while in the group 2 (n=28), the placebo apparatus was applied.

Results. The inclusion of magnetotherapy in the complex therapy of osteoarthrosis of the knee joints, according to thermographic data, increases significantly the efficiency of treatment and differs significantly from the placebo magnetotherapy procedures. In patients with osteoarthrosis of the knee joints of the X-ray stages I and II, a combination of course treatment using a traveling pulsed magnetic field and standard drug therapy revealed a positive dynamics in normalization of the temperature balance of the joints. In patients with osteoarthrosis of the X-ray stage I, the minimum efficiency of magnetotherapy was revealed according to thermography, which indicates low severity of the inflammatory joint syndrome.

Conclusion. The method of infrared thermography can be used as a diagnostic technique, as it reflects the degree of activity of the inflammatory process in the joints with osteoarthrosis.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):185-191
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Physiotherapy in the early rehabilitation of patients with bone sarcomas after endoprosthetic replacement of large bones and joints

Grushina T.I., Teplyakov V.V.


Background. The literature evidences the absence of negative effect of low-frequency electric and magnetic therapy in the treatment of late complications of onco-orthopedic surgeries on the course of a number of bone sarcomas. This enabled for the first time to include local low-frequency magnetotherapy, low-intensity infrared laser radiation, electroneuromyostimulation, and therapeutic exercises in the early rehabilitation of 36 patients with primary malignant and metastatic bone tumors, with the history of endoprosthetic replacement of large bones and joints with the inclusion of reconstructive grafting component.

Aim: to develop and evaluate the efficiency of the complex of early rehabilitation of patients with bone tumors after endoprosthetic replacement of large bones and joints.

Methods. Physiotherapy started from the day 1 after the surgery and lasted for 10 days. In a prospective, open, nonrandomized controlled cohort study, the control methods included the baseline state control, active control, and historical control. To assess the functional result, the international MSTS scale was used.

Results. The combined application of the reconstructive grafting component during curative surgery and physiotherapy enabled to obtain good functional result in 63.9% of the patients at the time of discharge, and satisfactory functional result was registered in 36.1% of patients on the MSTS scale. The function of the preserved limb in 10 patients after distal femoral bone excision with knee joint replacement amounted to 80%, and in 7 patients after proximal tibia excision, it was 72%; in 13 patients after proximal excision of the femoral bone with hip replacement, it was 59%; in 5 patients after proximal excision of the upper arm bone with the shoulder joint replacement, it was 61.3%; and in 1 patient after proximal excision of the ulnar bone with the elbow joint replacement, it amounted to 70% of the normal function. A multidisciplinary approach to the early rehabilitation of patients with bone tumors enabled to achieve good functional results in a short time, reduce the time spent by patients in the surgical department, without increase in the number of postoperative complications.

Conclusion. Given the preliminary results obtained, further research is required with a larger number of patients and with a long follow-up period.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):192-198
pages 192-198 views

Rehabilitation of patients after septoplasty

Gililov V.I., Egorov V.I.


Background. In recent years, in the general structure of the incidence of ENT organs diseases, the pathology of the nasal cavity and paranasal sinuses has firmly ranked first both in terms of visits to the clinic and in the group of patients undergoing inpatient treatment, which indicates a trend in an increase in the incidence rate. Septoplasty is one of the most commonly performed rhinological surgeries.

Aim: to analyze the effectiveness of complex treatment on the state of cerebral hemodynamics in patients with septal deviation after septoplasty.

Methods. Rehabilitation of patients was performed in several stages. Preoperative preparation included low-intensity laser exposure along with drug therapy. In this study, in order to prevent complications and activate reparative processes, patients of the main group (n=40) received additional bipolar-pulse irritative current therapy, while the control group patients (n=10) received only standard drug therapy.

Results. Patients of the main group showed an increase in treatment efficiency, a significant improvement in the clinical condition and indicators of cerebral hemodynamics compared with the control group.

Conclusion. To prevent complications and activate reparative processes in modern rehabilitation, it is necessary to integrate therapeutic measures, which can include, in addition to surgical methods, drug therapy (anti-inflammatory drugs, antihistamines, anticholinergics, etc., as well as physical factors (medicinal electrophoresis, ultraphonophoresis, laser therapy, magnetotherapy, etc.).

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):199-203
pages 199-203 views

Musculoskeletal disorders and the possibility of using neuromuscular electrical stimulation

Lazarenko N.N., Gerasimenko M.Y., Tigay Z.G., Dogotar O.A.


Background. The study of the musculoskeletal disorders is relevant not only due to the limitation of the motor activity of patients and possible disability, but also due to the widespread prevalence of this pathology.

Aim: to study the effect of neuromuscular electrical stimulation in patients with moderate adhesive capsulitis with subcompensated type 2 diabetes mellitus in order to develop a new comprehensive treatment.

Methods. The study included two groups of patients with adhesive capsulitis with subcompensated type 2 diabetes mellitus, in which, before treatment, reduced spastic type electroexcitability in the infraspinatus muscle and the supraspinous muscle was predominant without qualitative changes; the group 1 (control) included 30 patients, the group 2 (main) included 120 patients. All patients had limited movement in the shoulder joint, pain syndrome, the presence of trigger points in the muscles of the shoulder girdle. To determine impaired muscle function, we used the classical electrodiagnostics method with the determination of electroexcitability of the infraspinatus and supraspinatus muscles.

Results. The state of electroexcitability of the muscles under consideration, having trigger points, reflected the presence of spasticity in them, which was accompanied by an increase in the performance of all types of currents used. Currently, a wide range of drugs is known, which efficiency is limited by their side effects, therefore, in this work, for the group 2 of patients, the standard treatment additionally included neuromuscular electrical stimulation using the OMRON E-4 device. It has a wide range of frequencies, which creates an analgesic effect in the treatment, normalizes the electroexcitability of the neuromuscular apparatus, and increases the range of motion in the shoulder joint. A comparative analysis of the treatment efficiency in two groups of patients revealed the advantage of a course of comprehensive treatment (using the electrical stimulation indicated) with compensation in 86.7% of patients of the group 2, which was confirmed by clinical, electrodiagnostic and regression analysis, with a positive long term prognosis.

Conclusion. The inclusion of neuromuscular electrical stimulation in the comprehensive treatment enables to reduce the pain syndrome and restore the movement pattern in the shoulder joint, as well as achieve overall compensation for the clinical condition.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):204-210
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Immediate and long-term results of physiotherapeutic treatment of patients with chronic constipation in abnormal development of the colon

Litvinova O.N.


Background. Currently, the issue of effective conservative treatment of constipation in cases of colon developmental abnormalities remains open.

Aim: to study the immediate and long-term results of the treatment of chronic constipation in case of colon development abnormalities, through individualization of the physiotherapeutic methods used, depending on the type of pathology.

Methods. The article presents the experience of treatment in the Department of Internal Medicine of the Lugansk Republican Clinical Hospital, from 2013 to the present, of 389 patients with chronic constipation in colon developmental abnormalities. We used types of electrical stimulation, different in the method of applying electrodes and the stimulating current parameters. In the work, we used the serial apparatus “Endoton 01-B”. We evaluated the immediate and long-term results of treatment in the period from 6 months to 3 years.

Results. After 3–4 courses of rectal electrostimulation of patients with compensated and subcompensated forms of the disease, for 6–7 months, 346 (88.95%) patients had regular independent defecation with an interval of 24–36 hours. The remaining 43 (11.05%) patients with subcompensated and decompensated forms of the disease received 5–6 courses of rectal electrical stimulation during the year. A persistent positive effect was obtained, namely independent defecation with an interval of 36–48 hours.

Conclusion. Rectal electrical stimulation for this pathology is considered the method of choice. The functional immediate and long-term results of rehabilitation of patients confirmed the correctness of the approach chosen.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):211-213
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Peculiarities of training in rehabilitation of patients with Cerebral Palsy

Zyukov I.М.


In the article the features of training in rehabilitation of patients with cerebral palsy. On the basis of literature analyses the peculiarities of rehabilitation of children with cerebral palsy. Revealed that the majority of children with cerebral palsy face problems because they are associated with delayed development or abnormal development of the statokinetic reflexes, disorders of muscle tone, paresis. The goal of treatment and rehabilitation of children with cerebral palsy is to reduce the degree of disability, improving self-service capabilities, i.e. the maximum adjustment to daily life. Accordingly, the physical rehabilitation in a specialized clinic is important, because it improves physical condition contributes to effective correction of the functional deficiency of the locomotor apparatus, provides training cardiovascular and respiratory systems, leading to better activity of the child in learning activities and adaptation in society.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):214-218
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Clinical Guidelines

Pharmacopuncture in common pathological conditions*

Agasarov L.G., Gerasimenko M.Y., Konchugova T.V., Maryanovsky A.A., Drobyshev V.A., Vasilyeva E.S., Safiullina G.I., Tardov M.V., Tyan V.N., Boldin A.V., Bokova I.A., Dashina T.A., Chigarev A.A.


Clinical recommendations have been developed based on the analysis of Russian and international experience in the use of pharmacopuncture which is a contemporary medical technology combining the therapeutic possibilities of reflex therapy and clinical pharmacology. The first part of the recommendations sets out general provisions on the document structure and content that meet the requirements of GOST R 56034-2014 “Clinical recommendations (treatment protocols)”.


* Pharmacopuncture in common pathological conditions: clinical recommendations. M., 2017 p. 39. Available at: https://docplayer.ru/53018894-Klinicheskie-rekomendacii-farmakopunktura-pri-rasprostranennyh-patologicheskih-sostoyaniyah.html. Link active on 06/15/2018.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018;17(4):219-224
pages 219-224 views

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