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Vol 19, No 2 (2020)

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Original studies

Assessment of quality of life and psychoemotional state of patients with psoriasis against the background of standard medicamentous therapy and the differentiated photochromotherapy use

Petrova E.V., Kir'yanova V.V., Egorova Y.S., Tsyganova O.D., Mar'yekha G.L., Gurkovskaya Y.Y., Smirnova N.V., Petrov D.A.


Background. Psoriasis is a systemic disease with the presence of comorbid pathology, which is the cause of serious psychological problems.

The aim of the study was to assess the quality of life and psychoemotional status of patients with psoriasis against the background of standard drug therapy with the inclusion of photochromotherapy (PCT).

Methods. The randomized controlled study included 144 patients (mean age 48.34 ± 13.51 years) with psoriasis in the advanced stage. Patients, depending on the method of treatment, were divided into 4 groups, comparable by clinical and functional characteristics. For all groups, standard drug treatment was prescribed, including antiinflammatory, hyposensitizing, detoxification and external therapy, while additionally for 10 days, patients of the 2nd group (n = 47) received PCT with narrow-band optical radiation (NOR) 540 nm, patients of the 3rd group (n = 48) — PCT with NOR 650 nm, patients of the 4th group (n = 21) — imitation of PCT (placebo). Patients of the 1st group (n = 28) received only standard treatment.

Results. The positive effect of NOR 540 nm on the psychoemotional state and NOR 650 nm on the quality of life of patients with psoriasis has been demonstrated.

Conclusion. Thus, taking into account the significant positive effect of green radiation (NOR 540 nm) on the indicators of the psychoemotional state of patients with psoriasis in the advanced stage and the positive effect of red radiation (NOR 650 nm) on the indices of integral dermatological index of quality of life (improving the quality of life), NOR with these wavelengths can be recommended in the complex therapy of patients with exacerbation of psoriasis to increase the overall effectiveness of treatment.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):72-77
pages 72-77 views

Assessment of safety of influence of radiation of lengths of waves of 410, 580, and 630 nanometers for skin and a mucous membrane

Kholupova L.S., Surkichin S.I.


Background. The safety effects of individual emission spectra of visible light are currently not well understood. Based on the above works, one can only indirectly judge the presence or absence of an adverse effect of the selected spectrum during mototherapy.

Aims: in our work, the goal was to detect the presence of a negative effect of certain wavelengths (410 nm, 580 nm and 630 nm) during mono-exposure to mucous membranes and skin.

Methods. At the first stage, the effect of radiation with wavelengths of 410 nm and 630 nm on the mucous membrane of the oral cavity of laboratory animals was determined. At the second stage of the study, 30 women aged 35−45 years with signs of photodamage of the skin took part.

Results. No undesirable consequences were recorded either immediately after the procedure, or after 20 days. The results of histological examination at all stages of the study indicated the absence of pathological changes.

Conclusions. The results showed that mono-exposure with wavelengths of 410 nm, 580 nm and 630 nm is safe and can be recommended for further study and practical application.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):78-82
pages 78-82 views

The combined use of a fermentoterapiya and carboxytherapy at complications of planimetric plasticity of area of a brush in cosmetology

Aksenenko I.P.


Background. In recent years, cosmetology has become increasingly popular procedures for the introduction of various fillers to correct age-related changes in the hands (visualization of veins and tendons) to compensate for the amount of fat lost with age in the back of the hand. At the same time, the number of complications after contouring the hand area is also increasing, due to non-compliance with the insertion technique, ignorance of the anatomical features of the corrected area, and a number of other factors.

Aims: to study the effectiveness of a combined method that includes a course of collalizine diadinamophoresis in combination with injection carboxytherapy for the correction of complications that occurred on the back of the hand when injecting fillers based on calcium hydroxyapatite.

Methods. There were 28 women under observation, with an average age of 41.5 ± 4.6 years, with a complication after administration of a drug based on calcium hydroxyapatite on the back of the hand. Were allocated to 3 groups that received a course of carboxytherapy, the rate of diadynamophoresis collalizine and their combination.

Results. The use of a combined course of collalizine diadinamophoresis with injectable carboxytherapy provides a pronounced analgesic effect, stabilizes the psychoemotional state and gives a pronounced effect of reducing the thickness of the dermis and increasing the dermis density coefficient, especially in the early stages of observation, which is probably due to a decrease in intra-dermal edema that occurs as a reaction to a filler injected either too deeply or in large quantities. In addition, this combined technique significantly accelerates both the biodegradation of the previously introduced filler, and affects pathological fibrosis around calcium hydroxyapatite crystals.

Conclusions. The combined use of collazine diadinamophoresis and injective carboxytherapy locally on lesions with complications in the form of edema, contouring and local neuropathic manifestations that occur when injecting fillers based on calcium hydroxyapatite to the back of the hand is a highly effective method of treatment, which is confirmed by relieving clinical symptoms and improving the quality of life of patients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):83-89
pages 83-89 views

Application of the heated oxygen-helium mixture in rehabilitation of military servicers with arterial hypertension at the ambulatory-polycinic stage

Bobkina N.V.


Background. The professional activity of military personnel is characterized by complexity, high requirements for the state of physical and mental health, therefore, maintaining health and professional longevity is a priority task for the law enforcement agencies of the Russian Federation.

Aims. The purpose of the study was to evaluate the effectiveness of the use of heated oxygen-helium mixture (OHM) in the rehabilitation of military personnel with arterial hypertension at the outpatient stage.

Methods. The study included 68 people aged 32 to 56 (43,7 ± 4,1) years. The patients were divided into two groups: Group I (n = 33) — practically healthy volunteers, Group II (n = 35) — patients with a verified diagnosis: arterial hypertension of I and II degrees, low and medium risk, the duration of the disease ranged from 1,5 to 18 (6.3 ± 1.3) years. All patients included in the study underwent a course of inhalation of a heated OHM (the temperature of the mixture in the mask was 50°С). Breathing was carried out in a cyclic-fractionated mode: breathing with a mixture — 5 minutes, then breathing with atmospheric air — 5 minutes (one cycle), 3 cycles per procedure. The course of treatment consisted of 1 procedure per day for 10 days from the first day of the study. The clinical efficacy of restorative treatment was assessed in three stages — before the start of therapy, after the 5th and 10th procedures according to the following indicators: assessment of vegetative status using indicators of heart rate variability; express diagnostics of the psychoemotional state using the SAN questionnaire (well-being, activity, mood); assessment of adaptation of the cardiovascular system to physical activity using Martine's test with 20 squats.

Results. In the second group, positive dynamics was noted in the form of normalization of the autonomic status, an increase in the activity of the parasympathetic division of the autonomic nervous system (an increase in SDNN, RMSSD indicators to 55 [48–68] and 40 [38–51 msec, respectively), a decrease in the tone of the sympathetic nervous system (normalization of the coefficient vagosympathetic balance LF/HF up to 1.1 [0.74–1.5]). The indicators of the SAN questionnaire have increased, which indicates an improvement in the psychoemotional state of servicemen. Patients with arterial hypertension, had positive dynamics in the rate of adaptive processes of restoration of the cardiovascular system after exercise (recovery time is 3.0 ± 0.5 after the course).

Conclusions. The use of a course of inhalations of a heated oxygen-helium mixture in the rehabilitation of servicemen with arterial hypertension has demonstrated its effectiveness in normalizing the psychoemotional state and vegetative status. In order to prevent the progression of arterial hypertension, this method can be included in rehabilitation programs at the outpatient and polyclinic stage.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):90-94
pages 90-94 views

Psychological aspects in the rehabilitation of patients with chronic back pain

Voropaev A.A., Gerasimenko M.Y., Ivanova G.E.


Background. The relevance of the work is associated with the high prevalence and socio-economic significance of chronic pain. The number of analgesics consumed in the world is estimated in the tens of tonns. Hardware effects, including neurosurgical interventions, are not always effective and are associated with many side effects of complications. Existing therapeutic and surgical approaches to the treatment of chronic pain require additions. In this regard, the information and structural theory of pain was developed, revealing the information processes occurring in the Central nervous system against the background of chronic pain, as well as the theory of psychological types and information metabolism. In this case, it is easier not to look for the right solution, but to create a mechanism that will come up with a method for finding the right solution. A neural network is one of the ways to implement artificial intelligence (AI). It studies methods for building algorithms that can learn independently. This is necessary if there is no clear solution to any problem.

Aims: based on the comparison of data from neuropsychological, clinical and neurophysiological studies, as well as mathematical (neural network) modeling of chronic pain, to identify information and structural justification and practical application of psychoalgology.

Methods. A total of A total of 105 patients diagnosed with Dorsopathy (M54.4; M51.1, M54.1) were studied. 50 men and 55 women, men: average age 49 ± 0.5 years; women: average age 52 ± 1.6 years. Assessment of the level of reactive and personal anxiety using the adapted Spielberger–Hanin questionnaire, the SAN test, and the assessment of vegetative status using the “vegetative questionnaire” by A.M. Wein. Neuroimaging research: CT, MRI of the brain and spine for diagnostic purposes. The neurophysiological study consisted of EEG, TCD, duplex scanning of the craniocervical junction vessels. For a more detailed assessment, a neural network analyzer of lumbar pain was used, which allows predicting its course.

Results. A clinical and neurophysiological study of patients with back pain revealed that, along with other disorders of cerebral neurodynamics, a large role is played by lateralization of cerebral neurodynamics (asymmetry), which is manifested by more pronounced changes in the EEG in the contralateral hemisphere. When studying the subjective state of patients, two main types of disorders were distinguished: the type of associated and the type of non-associated mental disorders.

As a result of the analysis of mathematical (neural network) algorithms of pain syndromes, clinical and neurophysiological studies, new principles of chronization of the pathological process with the transformation of the pain syndrome into an independent psychological disease were formulated. ALGIC DISEASE is characterized by a pronounced clinical polymorphism due to complex information-structural interactions of dominant and subdominant zones and characterized by: 1) heterogeneity and chaotic spatial parameters of pain in relation to the zones of innervation of nociogenic structures; 2) non-topological time parameters of peripheral and Central sensitization with increased pain − from instant to prolonged; 3) mutual suppression, displacement, migration of pain centers; 4) changing the monocausal dependence of the polycausal pain syndrome with the possibility of a reverse process in the process of regional integrative measures with a multidisciplinary approach; 5) the relationship of chronic pain with pronounced cognitive, emotional and vegetative reactions.

Conclusions. Based on the information and structural theory of pain, the results of research and the proposed psychoalgological approach, the principles of building a rehabilitation program for patients with chronic pain are formulated, which consists in a complex effect on nociogenic structures of types 1, 2 and 3 in combination with the modification of patient behavior through individually selected psychotherapeutic techniques.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):95-100
pages 95-100 views

Evaluation of the effectiveness of the use of osteоpathic methods of treatment of patients with chronic stone-free cholecystitis

Pankov O.A., Matvienko V.V., Frolkov V.K., Zhernov V.A., Zubarkina M.M.


Background. Osteopathic methods are used in practical medicine, but there is little scientific research in this area, especially in the treatment of somatic diseases.

The purpose of the research is to evaluate the effectiveness of osteopathy in the complex therapy of patients with chronic stone-free cholecystitis from the point of view of evidence-based medicine.

Methods. The study involved 114 patients who were divided into two groups, the control group and the main group, in which osteopathic procedures were applied. The functions of the gallbladder, bile and blood biochemistry, and cholecystokinin secretion were analyzed.

Results. It was found that osteopathic methods significantly increased the effectiveness of standard therapy both in terms of regression of clinical symptoms of the disease and in the functioning of the gallbladder. It is proved that the main group of patients significantly increases the secretion of cholecystokinin, which correlates with an improvement in the biochemistry of bile and its allocation. It was found that the effectiveness of osteopathic treatment methods does not depend on the gender of patients.

Conclusion. The results of the study indicate a fairly pronounced therapeutic effect of osteopathic procedures in the complex therapy of patients with chronic stone-free cholecystitis. The increase in the secretion of cholecystokinin is difficult to explain from the point of view of correction of functional blocks, and this problem remains the subject of further research.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):101-106
pages 101-106 views

Application of modern non-drug technologies for the full formation of postoperative scar in patients after plastic surgery for rectocele

Zhumanova E.N.


Background. In recent decades, various physiotherapeutic methods have been widely used in surgical practice in order to obtain an anti-inflammatory and bactericidal effects, accelerate reparative and regenerative processes, and improve microcirculation in the postoperative area.

Aim: to develop and scientifically substantiate optimized complex programs, including general magnetotherapy, fractional microablative therapy with a CO2 laser, electrical myostimulation with the biological connection of the pelvic floor muscles and a special complex of physiotherapy exercises (exercise therapy) in patients of different age groups after reconstructive plastic surgery for rectocele.

Methods. The article presents data on treatment of 160 women of childbearing, peri- and menopausal age with rectocele of II–III degree. Patients after surgical treatment of rectocele, in the late postoperative period for the full formation used rehabilitation programs, including in various combinations of General magnetotherapy, electromyostimulation with biological connection of the pelvic floor muscles, procedures of intra-vascular fractional microablative therapy with CO2 laser and a special complex of therapeutic physical education.

Results. As a result of the research, it was found that when combined with General magnetotherapy, fractional microablative CO2 laser therapy, electromyostimulation with biological connection of the pelvic floor muscles, and a special complex of physical therapy in patients after plastic surgery for rectocele, a pronounced trophostimulating effect is formed, to a greater extent in patients with peri- and of menopausal age, which is particularly important, as they have in the background of the age hypoestrogenia perimenopausal and postmenopausal women marked atrophy.

Conclusions. Complex treatment that promotes proper formation of postoperative scar by improving microcirculation and thickening of the dermis and mucosa, endometrium, submucosa and connective tissue, as confirmed by the ultrasound scan.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):107-115
pages 107-115 views

Vasocorrigating effect of general magnetotherapy and electromyostimulation with biofeedback in combination with fractional microablative co2 laser therapy in patients with posterior vaginal wall prolapse after surgery

Lyadov K.V., Kotenko K.V., Zhumanova E.N.


Background. The high recurrence rate after surgical treatment of pelvic organ prolapse makes it necessary to improve therapeutic methods.

Objective: to develop and scientifically substantiate the use of a rehabilitation complex, including general magnetotherapy, electromyostimulation with biofeedback in combination with fractional microablative therapy with a CO2 laser, in patients of different age groups with rectocele after surgery.

Methods. The article presents the treatment data for 100 women of childbearing, peri- and menopausal age with rectocele II–III degree, which were divided into 2 groups comparable in terms of clinical and functional characteristics (main and control), within each group they were divided by 2 subgroups: subgroup A included women of childbearing age, subgroup B included women of peri- and menopausal age. The patients of the main group in the early postoperative period after plastic surgery for rectocella (from 1 day) underwent a course of general magnetotherapy and in the late postoperative period (one month after the operation) they performed a set of measures consisting of a course of electromyostimulation with biological connection of the pelvic floor muscles and a special complex physiotherapy exercises and 2 intravaginal procedures of fractional microablative CO2 laser therapy with an interval of 4–5 weeks. Patients in the control group after surgical treatment of rectocele in the late postoperative period received symptomatic therapy, including painkillers and antispasmodics, which served as a backdrop for patients of the main group.

Results. As a result of the studies, it was found that regardless of the age and severity of uterine blood flow disorders in the uterine arteries in patients with rectocele, the most pronounced dynamics was observed in patients of the main group, which, in our opinion, is associated primarily with the vasoactive effects of general magnetotherapy, manifested in the removal of spasm from arteries and arterioles, improving the contractility of the veins and increasing venous outflow, which in combination with electrical stimulation, exercises to strengthen the muscles of the pelvis bottom and fractional microablative therapy allowed to obtain such a pronounced vasocorrigating effect.

Conclusions. Due to the pathogenetic effect of the developed complex (electrical stimulation, exercises to strengthen the pelvic floor muscles and fractional microablative therapy) on one of the main mechanisms of the development of the disease, a pronounced vasocorrecting effect was obtained.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):116-122
pages 116-122 views


General principles of diagnostic and conservative treatment of idiopathic scoliosis

Zaytseva T.N.


Scoliosis is an orthopedic disease characterized by complex multi-plane deformation of the spinal column and chest, accompanied by a violation of the functions of organs and systems of the body, which is the cause of severe physical and psychological suffering in children. It is very important to carry out effective conservative treatment of scoliosis in I and II severity to prevent further progression of spinal deformity. It is proved that physical treatment methods are required in the complex treatment of patients with scoliosis. The purpose of physiotherapy is to eliminate dystrophy, improve contractile function of the muscles of the back and abdomen, eliminate instability of the spine and reduce pain.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):123-131
pages 123-131 views

Guidelines for practitioners

Methods of physiotherapy in the treatment of obesity

Skotnikova Y.V., Arkhangel’skaya A.N., Gurevich K.G., Pustovalov D.A., Ivkina M.V.


Currently, there is a significant increase in the prevalence of obesity among children and adolescents of the world population. Overweight and obesity are a “global epidemic” of humanity. In economically developed countries, including Russia, on average, every third inhabitant has a weight that exceeds the maximum allowed. Russia ranks 15th in the world in the prevalence of overweight and obesity among children and adolescents. Obesity is now considered as a chronic, relapsing disease associated with the development of a number of diseases that reduce life expectancy and reduce its quality. An important factor in demonstrating the urgency of the problem of child and adolescent obesity is its prognostically adverse effect on obesity in adulthood. The lack of targeted detection of overweight and obesity in children and adolescents in Russia accounts for its late diagnosis specialists. Complications of obesity affect the cardio − vascular, reproductive, respiratory, nervous system, digestive organs, musculoskeletal system. In connection with the rise of obesity than the early detection of issues and preventive measures to prevent its further progression. Obesity in the early diagnosis and early treatment is a reversible condition. Important role in the treatment of obesity play a non-drug methods - diet, exercise stress, a variety of physical therapy, taking into account individual tolerance and comorbidity. Physiotherapy treatments have not only symptomatic but also the pathogenic effects, eliminating the primary metabolic and neuroendocrine disorders.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(2):132-136
pages 132-136 views

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