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Vol 15, No 4 (2016)

Articles

The sociological assessment of the quality of physiotherapeutic treatment

Fedotchenko A.A.

Abstract

This questionnaire study involving 3105 patients has demonstrated the importance of physiotherapy as a highly efficient method of rehabilitation medicine. The positive therapeutic outcome has been reported by 92.1% of the participants with 90.4% of them being totally satisfied with the quality of treatment and care provided to them. It is concluded that the temporal dosimetric parameters of the treatment courses applied in physiotherapy are clinically well-substantiated and satisfy the majority of the patients. The results of the sociological questionnaire studies with the special emphasis placed on the quality of the provided medical assistance are considered to be the most important component of its comprehensive assessment.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):172-174
pages 172-174 views

The analysis of the experience gained by the multidisciplinary team during the 5 year work in compliance with the protocol of FAST-TRAC - therapy following the surgical interventions for total endoprosthetics of the hip and knee joints based at the clinic of the federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

Koneva E.S., Serebryakov A.B., Shapovalenko T.V., Lyadov K.V.

Abstract

This article was designed to report the results of the analysis of the duration of the hospital stay for the patients admitted to a surgical department and its grading taking into consideration the experience of the surgeons. It was shown that the patients operated on by the surgeons having the total period of service below 5 years had the shortest time of hospitalization because many of them presented with concomitant diseases and had to be referred for the further treatment to the more experienced specialists. The questionnaire study carried out within 3-6 weeks after surgery has demonstrated that 31% of the patients treated in compliance with the principles of fast-track therapy remained fully mobile without any restrictions on the distances they were able to cover. The mobility of 53% of the treated patients was confined to their personal apartments and the adjacent courtyards while 31% of them could move only within their apartments. The analysis of the degree of satisfaction of the patients with the medical assistance provided to them showed that 26% of the patients experienced the substantial improvement of their health status, 74% described the improvement as moderate, and 4% appeared unsatisfied with the outcome of the treatment. The analysis of pain sensations in the treated patients revealed the absence of pain in 46% of them whereas 36% estimated the intensity of pain syndrome as 1-5 scores based on the NRS scale whereas 17% estimated pain intensity as being higher than 5 scores. The analysis of the social competence and household skills of the treated patients showed that 38% of them expressed the desire to resume their routine professional activities within 1-2 months after the completion of the treatment, another 34% were prepared to do the same within 2-4 months, and the remaining 27% were ready to work again within 6 months after surgery. Only 2% of the patients did not plan to return to their habitual mode of life. The article expounds the main differences of the concept of fast-track therapy being realized at the clinic of the federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health, from that adopted in analogous foreign healthcare facilities. It is concluded that the modified concept based at our clinic provides a safe and efficient tool for the management of surgical patients.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):175-182
pages 175-182 views

The physiotherapeutic methods applied for the combined treatment of the patients presenting with chronic constipation associated with colonic malformations

Litvinova O.N.

Abstract

The objective of the present study was the development and application of various physiotherapeutic procedures and therapeutic strategies on an individual basis with a view to improving the outcome of the treatment of chronic constipation associated with colonic malformations. The experience in the management of 389 patients with this condition is summarized and reported. Taking into consideration the clinical form of constipation, we used the procedures of electrical stimulation differing in the mode of placement of the electrodes, characteristics of the stimulating current, and total duration. The commercial Endoton 01-B apparatus was employed for the purpose. The therapeutic impact was focused on the restoration of the propulsive properties of the colon. It was shown that the primary role in the combined treatment of chronic constipation belongs to electrical stimulation of the colon and rectal sphincters used in different modifications. The most popular of them is rectal stimulations performed in the form of a few courses. The criterion for the adequacy of the procedure was the achievement of the maximum isolated contraction under effect of the minimal current strength. The application of the above procedures yielded good and satisfactory results. The choice of the physiotherapeutic procedure depended on the clinical form of constipation. We consider the rectal and anal electrical stimulation to be the method of choice for the treatment of chronic constipation associated with colonic malformations. The most pronounced permanent effect of the combined conservative treatment was documented in the patients at the age between 18 and 35 years.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):182-184
pages 182-184 views

Cutaneous toxicity of antineoplastic therapy and approaches to its correction

Shatochina E.A., Kruglova L.S., Kotenko K.V.

Abstract

The predictable side effects in the form of cutaneous toxicity sometimes do not allow to carry out the adequate course of antineoplastic therapy. The most frequent adverse reactions of the skin to such treatment include xerosis and pruritus. We observed 18 patients given various antineoplastic preparations who developed manifest xerosis and pruritus. The combined treatment included infrared therapy (in the frequency range of 590-620 nm) and an agent for the topical application containing 2% urea. A course of adjuvant therapy resulted in all the patients in the reduction of the severity of clinical symptoms of cutaneous toxicity of the antineoplastic preparations. In addition, certain subjective sensations (such as pruritus, skin tightness and hypersensitivity) were eliminated which significantly promoted tolerability to the course of the antineoplastic treatment. It is recommended to supplement the antineoplastic therapy by a course of phototherapy using orange light in combination with the application of a moistening agent for the external use.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):185-187
pages 185-187 views

The application of photodynamic therapy in the case of insufficient effect of the inhibitors of tumour necrosis factor in the patients with psoriasis

Ponich E.S., Sokolovsky E.V., Kruglova L.S.

Abstract

Psoriasis is a systemic chronic inflammatory disease that affects in the first place the skin and occurs in 1-5% of the general population. The treatment of the patients presenting with this condition implies the application of the topical agent and biological preparations as well as phototherapy and systemic therapy. The patients suffering severe forms of psoriasis in whom systemic immunosuppressive therapy does not yield the desired effect are in need of the treatment with biological preparations. The use of the inhibitors of tumour necrosis factor-alpha produces the insufficient effect even in the case of the positive response, i.e. the psoriasis area and severity index (PASI) of approximately 50 scores (PASI 50). This article presents the results of the application of photodynamic therapy (PDT) for the treatment of 8 patients treated with the inhibitors of tumour necrosis factor-alpha in whom the PASI value of 50 was achieved within the first week after the onset of the treatment. In all these patients, a course of photodynamic therapy consisting of 2-3 procedures made it possible to increase the PASI values to 75 and even 100 scores. It is concluded that the patients showing positive but insufficient effect of biological therapy (PASI 50) need to be prescribed a course of photodynamic treatment in order to enhance the effectiveness of the biological therapeutic factors.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):188-190
pages 188-190 views

The technologies integrated into the phototherapy for the treatment the children suffering from the severe forms of psoriasis

Turbovskaya S.N., Kotenko K.V., Kruglova L.S.

Abstract

The last decades have witnessed the increased frequency of the cases of the severe clinical course of psoriasis in the children. The application of systemic immunosuppressive therapy for the treatment of such patients is limited due to the serious adverse reactions especially pronounced when such medicines as methotrexate, acitretin, and cyclosporine are prescribed. For this reason, the investigations aimed at the evaluation of the effectiveness and safety of the non-pharmacological therapeutic modalities including phototherapeutic technologies appear to be highly promising. In this context, the treatment of psoriasis with the use of ultraviolet radiation may find the wide application for the management of many dermatological problems provided it is performed under reliable control. The present study included 25 patients at the age below 18 years presenting with the severe forms of psoriasis and resistance to traditional pharmacotherapy. All of them were prescribed the combined treatment that consisted of EHF-therapy in the 311 nm frequency range together with the topical application of calcipotriol. This treatment was shown to be highly efficient and safe enough as far as the predictable early side effects are concerned. In the case of the torpid response of the disease to the standard therapy, it is recommended to prescribe the combined treatment with the use of 311 nm UVB-irradiation and the topical application of calcipotriol. The effectiveness of this therapeutic modality may be higher than 90%. None of the children treated in this way developed an early adverse reaction. The results of the present study give reason to recommend this approach as the method of choice for the treatment of the widespread forms of psoriasis affecting the children.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):191-194
pages 191-194 views

The application of EHF therapy for the combined treatment of severe poisoning with the scolding liquids

Badalyan A.V., Chukina E.A., Gol’dfarb Y.S., Shchetkin V.A., Borovkova N.V., Bitkova E.E., Klychnikova E.V., Tazina E.V., Andreev Y.V.

Abstract

The objective of the present study was to compare the results of the treatment and changes in the measurements of the laboratory characteristics in the patients suffering from severe poisoning with the scolding liquids under effect of the combined treatment including the application of extremely high frequency electromagnetic radiation (EHF therapy). The study included ten patients given a course of EHF therapy and 10 ones treated without it. The patients of the two groups developed the oppositely directed alterations in the rheological properties of blood and hemostasis including the elevation of the hemorheological viscoelastic constituent, erythrocyte and platelet aggregation, the increase in blood viscosity at a high shear velocity and, conversely, its decrease at the low and moderate shear velocities and hematocrit. Moderate leukocytosis was observed during this period along with the 3-4 rise in the concentration of lymphocytes involved in the apoptotic process and the substantial increase (1,4 - 8,1 times) in the values of parameters of endotoxicosis (the leukocytic index of intoxication and the erythrocyte sedimentation rate). The use of EHF therapy for the management of this category of the patients at the stage of their medical rehabilitation produced a modulating hemorheological effect manifested as the reduction of the elevated hemorheological characteristics, with the especially pronounced increase in the parameters below the respective normal values. In the group comprising the control patients, the undesirable changes occurred more frequently than in the previous one; specifically, deviations of the parameters of interest from their normal values were more pronounced. EHF therapy resulted in the reduction of the concentration of dead leukocytes in blood and a two-fold decrease in the amount of lymphocytes at the later stages of apoptosis whereas the concentration of the lymphocytes just entering apoptosis was elevated; this situation reflected the process of sanogenesis. In contrast, this parameter decreased in the patients of the group of comparison. The reduction in the level of endogenous intoxication under effect of EHF therapy manifested itself as a more significant decrease of leukocytic index of intoxication and erythrocyte sedimentation rate in the patients of the main group in comparison with those of the group of comparison. It is concluded that the inclusion of EHF therapy in the combined treatment of severe poisoning with the scolding liquids reduces the time of epithelization of gastrointestinal mucosa by 4.7 days on the average. Accordingly, the duration of the hospital stay can be decreased by 3.8 days.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):194-202
pages 194-202 views

The comparative study of the bactericidal properties of laser and photodiode radiation in the violet region of the spectrum (405 nm) on the bacteria of the mouth cavity

Lepilin A.V., Raigorodsky Y.M., Grigor’eva D.A., Erokina N.L., Kas’yan I.A., Abdrashitova A.S.

Abstract

The ever increasing number of the patients presenting with postoperative wound infections and abscess is attributed by the majority of the authors to the significant changes in microflora, the impairment of therapeutic effectiveness of broad-spectrum antibiotics, and the reduction of the immune responsiveness. The present study has demonstrated that the microorganisms present in the mouth cavity show high in vitro sensitivity to laser radiation in the violet range of the spectrum. Specifically, irradiation at a distance of 3 cm from the treated surface and the time of exposure 5 minutes (at the power density 70 mW/cm2) produced a well apparent bacteriostatic effect whereas irradiation of a surface positioned 1 cm from the emitting source at the power density of 150 mW/cm2 caused complete eradication of the microorganisms.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):202-206
pages 202-206 views

The application of the herbal tea for the combined treatment of the patients presenting with chronic acalculous cholecystitis

Gil’mutdinova L.T., Marakaeva E.A., Farkhutdinov R.G., Gil’mutdinov B.R.

Abstract

The objective of the present study was to evaluate the effectiveness of the application of the herbal tea having an original composition for the combined treatment of the patients presenting with chronic acalculous cholecystitis. A total of 84 patients with this condition at the age varying from 18 to 60 years were available for the examination. The patients of the control group (n = 42) were treated with the use of the basal pharmacotherapeutic modalities while those in the main group (n - 42) received. in addition. the herbal tea of original composition following the specially elaborated regimen for its consumption. It was shown that the inclusion of this herbal tea in the sstandard pharmacotherapy resulted in the significant reduction of the activity of the key enzymes of the hepatobiliary system. such as alanine aminotransferase. aspartate aminotransferase. alkaline phosphatase. and gamma-glutamyl transferase. Simultaneously. the motor function of the gallbladder was considerably improved while the severity of the clinical symptoms of the disease decreased. These beneficial changes were less apparent in the control patients treated with standard pharmacotherapy alone.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):206-209
pages 206-209 views

The prospects for the application of the electromagnetic waves in the terahertz frequency range for the purpose of physiotherapy (a retrospective review)

Kir’yanova V.V., Zharova E.N., Bagraev N.T., Reukov A.S., Loginova S.V.

Abstract

This review of the literature publications is focused on the articles in domestic and foreign editions devoted to the research on biological effects of electromagnetic radiation in the terahertz (THz) frequency range. It makes use of the Scopus, Web of Science, MedLine, RSCI, and other databases containing the relevant references for the period from 1970 up to the present days. This physical factor has found application in the Russian physiotherapeutic practice not very long ago. The main areas of its application include cardiovascular disease and neurological conditions. At the same time. the influence of electromagnetic radiation in the terahertz frequency range on human health and vital activity remains virtually unexplored. The available publications give evidence of the high biological activity of the terahertz electromagnetic waves which suggests the necessity of their further investigation.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):209-215
pages 209-215 views

The role of physiotherapy in the combined treatment of irritable bowel syndrome

Privalova N.I., Poddubnaya O.A.

Abstract

The treatment of irritable bowel syndrome is currently regulated based on the clinical guidelines for the management of the patients presenting with gastroenterological pathologies. Generally speaking, the pharmacotherapy is aimed at the main clinical symptoms of this condition (in the first place, constipation and diarrhea). Also important is the development of the therapeutic modalities designed for the correction of vegetative dysfunctions developing in the association with long-staying psychoemotional tension. At present, there are several factors exerting the corrective action on the vegetative system including magnetic therapy, electrically-induced sleep, and EHF-therapy. The present review of the literature does not exhaust all possibilities for the correction of the functional disorders associated with irritable bowel syndrome but emphasizes the necessity of the further investigation of this problem and the search for the new approaches to its solution.
Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):216-221
pages 216-221 views

The educational course “The management of comprehensive rehabilitation of the patients suffering from dizziness”

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Abstract

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Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(4):221-224
pages 221-224 views

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