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Vol 19, No 4 (2020)

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Original studies
Laser therapy in the correction of systolic left ventricle myocardial dysfunction in children and adolescents
Kotovsky A.V., Gerasimenko M.Y., Strukov V.I.
Abstract

Background. Due to the need to develop a complex therapy for children and adolescents with functional heart disorders, rhythm disorders against the background of the restructuring of the autonomic regulation of heart activity, a very important section is to study the possibility of using laser therapy in the correction of left ventricular (LV) systolic function disorders in patients. One of these methods is laser therapy. The research hypothesis suggests that using laser stimulation of active points, it is possible to restore the synchronicity of contractile activity of the contralateral segments of the LV myocardium.

Aims: To study the effect of laser correction on the functional state of the LV myocardium in children and adolescents and the vegetative status, which leads to the formation of functional changes in the heart in children and adolescents, necessary for the development of complex therapy for systolic dysfunction.

Material and methods. The study involved 60 children and adolescents aged 12–16 years. Patients were divided into two groups: group 1 (n = 30) – children aged 12–14 years; 15 girls and 15 boys. Group 2 (n = 30) — teenagers 14–16 years old. The sample also includes 15 girls and 15 boys. Evaluation of contractile activity disorders was performed with ECHO-KG in the parasternal position along the long axis. The thickness of the interventricular septum (LVM) and the posterior wall of the left ventricle (LVL) in systole and diastole was evaluated. Assessment of the vegetative status was performed by cardiointervalography in the study of daily ECG recording. Treatment was performed by laser correction according to the standard method: 10 daily sessions with laser stimulation of trigger zones in the shoulder and forearm – extraceptive (1000 Hz, 2 min) and proprioceptive (50 Hz, 2 min), as well as in the direct projection of the heart (5 Hz, 2 min). Аctivation рoints: 4th intercostal space at the left edge of the sternum (5 Hz, 5 min), carotid sinus (left carotid artery pulsation zone — 50 Hz, 2 min), to the left of the spine at the level of the left corner of the scapula (5 Hz, 2 min). After laser therapy, repeated ECHO-cardiography was performed to assess the dynamics of LV systolic function in children and adolescents.

Results. Of the 60 children examined, 24% of children aged 12 to 14 years had symmetrical thickening of the myocardium of the LV and LVL, compared to 67% in the group aged 15 to 16 years. In the group from 12 to 14 years, 43% of children had asynchronous systolic dysfunction of the anterior-septal type. The remaining children (33%) had asynchronous posterobasal systolic dysfunction. In the group of children aged 14 to 16 years, asynchronous systolic dysfunction in the anterior-septal type was detected in 23%, and in the posterior-basal type — in 1%. According to the results of cardiointervalography, hypersympathicotonia was detected in 72% of children aged 14–16 years. Mixed type of vegetative dystonia was observed in 25% of cases in this age group. Hyperparasympathicotonia was detected in 3% of the examined patients. In children aged 12–14 years, a mixed type of hyperactivity was detected in 79% of cases. Hyperparasympathicotonia was observed in 15% of the examined patients, against 6% of patients with hypersympathicotonia. All children identified moderate stress tension autonomic regulation, and baroreflexes regulation was not violated. After laser therapy using a standardized method, the following results were obtained: in the group of children aged 12–14 years, symmetrical thickening of the contralateral segments of the myocardium was detected in 72% of children. In children aged 15–16, resynchronization was achieved in 85% of patients.

Conclusions. Laser therapy in children and adolescents with functional disorders of the contractile activity of the LV myocardium in the group of children 12–14 years old led to resynchronization of contraction of contralateral segments and a change in autonomic reactivity mainly to parasympathicotonic.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):204-209
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Scientometric analysis of evidence-based studies of rehabilitation physical factors for head and neck cancer patients
Kasparov B.S., Semiglazova T.Y., Kovlen D.V., Ponomarenko G.N., Kluge V.A., Radzhabova Z.A., Orlova R.V., Kutukova S.I., Tynkasova M.A., Kondrateva K.O., Adkhamov B.M., Semiglazov V.V., Belyaev A.M.
Abstract

Background. The article presents the results of scientometric analysis of studies from 1996 till 2019 which were devoted to using of medical physical factors in rehabilitation of patients with head and neck cancer at different stages of treatment.

Aims. To make guidelines, which would be based on scientometric analysis of evidences, based on the analysis of evidence-based studies containing reasonable data on the use of physical factors in rehabilitation of patients with head and neck cancer.

The most studied factors in rehabilitation of patients with head and neck cancer with authentically proven effect are general physical activity and physical exercises with the tongue, acupuncture, kinesotherapy, low-intensity ultrasound therapy and low-frequency laser therapy.

Conclusions. The use of certain physical factors in the rehabilitation of patients with head and neck cancer should be justified by the results of randomized controlled clinical trials, which serve as the basis for the subsequent development of guidelines.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):210-219
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Modern approach to neurorehabilitation of children with hiv-encephalopathy
Saidkhodjaeva S.N., Madjidova Y.N., Yuldashev К.H.
Abstract

Background. Currently, there is no standardized and evidence-based medicine specific therapy for HIV-associated neurocognitive disorders.

The aim of the study was to evaluate the effectiveness of various neurorehabilitation programs, including the use of memantine hydrochloride and the virtual reality feedback method (NIRVANA) in children with HIV encephalopathy (HIVE) in the aspect of neurocognitive status.

Material and methods. The study included 260 children with HIV-positive status and receiving highly active antiretroviral therapy (НAART) according to an individually selected scheme for at least 6 months. All the children included in the study showed signs of HIVE. After the initial examination, all patients were divided into 4 groups: only НAART, НAART + memantine, НAART + NIRVANA and НAART + memantine + NIRVANA. The follow-up period was 3 months. The neurological study included a standard neurological examination, as well as various psychometric scales and questionnaires.

Results. In the groups of active neurorehabilitation, there were significant positive changes in the neurocognitive status: the score of all components of neurocognitive disorders decreased in all three groups with comparable relative dynamics. As a result, by the end of the 3rd month of follow-up in children taking memantine (НAART group + M and НAART + M + H) achieved a significantly lower IQ score compared to children who were only on НAART (p <0.001 for both comparisons). Also in children who received complex neurorehabilitation (НAART + M + H) by the end of the 3rd month of observation, a significantly lower integral score of neurocognitive status assessment was achieved compared to children of the НAART group (p <0.05).

Conclusion. Thus, in the course of this study, it was found that children with HIVE, despite the ongoing НAART, have a tendency to progress HIVE. Children with HIV-associated dementia are most susceptible to progression. The use of active neurorehabilitation, especially a combination of memantine and virtual reality techniques, can significantly improve the indicators of neurocognitive status.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):220-226
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Application of combined enzyme therapy for complications of lip contouring in cosmetology
Aksenenko I.P.
Abstract

Purpose: to study the effectiveness of a combined method that includes a course of magnetolaserophoresis of longidase and diadinamophoresis of collalizin 1000 KE (collagenase units) in correcting complications of lip contouring that occurred when a large volume of filler or surface injection of a drug based on stabilized hyaluronic acid into the skin.

Material and methods. We observed 31 women aged 25 to 32 years with complications after the introduction of a filler based on stabilized hyaluronic acid with localization in the lip area. Were allocated to three groups who received a course of magnetolaserotherapy of longidaza, the rate of diadynamophoresis of collalizin, or a combination.

Results. The use of a combined course of longidase magnetolaserophoresis with collazine diadinamophoresis has a significant clinical effect, reducing edema, gel contouring phenomena and stabilizing the psychoemotional state of patients. In addition, the treatment complex significantly accelerates the biodegradation of the filler and has a restructuring effect on the lip tissue, gives a pronounced effect of reducing the thickness of the dermis and increasing the density coefficient of the dermis, which is probably due to a decrease in intra-dermal edema that occurs as a reaction to a surface-injected filler.

Conclusions. Combined use of magnetolaserotherapy of longidaza and diadynamophoresis of collalizin to the lip when complications in the form of a surface of introduction of the filler or injecting too much of the drug based on stabilized hyaluronic acid is a highly effective method of treatment, which is confirmed by relief of clinical symptoms and improvement in quality of life of patients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):227-233
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Application of comprehensive rehabilitation programs after radical treatment of prostate cancer
Yashkov A.V., Sivokhina T.A., Burmistrova S.A., Rybakova N.G.
Abstract

Background. The main side effect of most of the methods of treating prostate cancer is incontinence of urine in varying degrees of severity. Although in most cases incontinence is a temporary phenomenon, this problem occurs in 39–63% of patients during the first two years after treatment, and about 24–56% of patients have to use urological pads or condoms. Incontinence of urine is also a serious psychological traumatic factor, which has аn extremely negative effect on patients quality of life.

Aim: to substantiate the effectiveness of the use of complex rehabilitation programs in the correction of urinary incontinence in men who have undergone radical treatment for prostate cancer.

Materials and methods. The study included patients with stage I–III prostate cancer, mean age 55 ± 6 years, with complications after radical prostatectomy for at least 2 months without a tendency to improve in the form of moderate and severe urinary incontinence.

Results. The combined technique of correction of urinary incontinence, modified by us, using neuromuscular stimulation, physiotherapy exercises and psychocorrectional exercises, has demonstrated its effectiveness in improving the quality of life in this group of patients.

Conclusions. The combined technique of correction of an incontience of urine with use of neuromuscular stimulation, physiotherapy exercises and the psychocorrection of occupations is presented in this article, the assessment of efficiency of this comprehensive program of rehabilitation, and also improvement of quality of life of patients is carried out.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):234-238
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Clinical effectiveness of combined phototherapy in the treatment of patients with atopic dermatitis
Kruglova L.S., Novikova L.A., Borzunova L.N., Dontsova E.V., Voron'kova N.A.
Abstract

Background. Due to the insufficient effectiveness of currently known methods of treating patients with atopic dermatitis (ATD), there is a need to find new approaches to solve this problem.

Aims: The study was conducted in order to study the possibility of improving the effectiveness of basic therapy for patients with ATD using combined phototherapy (FT) of narrow-band medium-wave and wide-band long-wave ultraviolet (UV) radiation.

Materials and methods. In a group of 62 patients (average age 24.1 ± 6.1 years), a comparative assessment of the effectiveness of ATD basic drug therapy (BT) and complex treatment using combined FT of narrow-band medium-wave (311 nm) and wide-band long-wave radiation in the range of 320–400 nm was performed.

Results. When using BT and combined FT (CFT) together, there is a potentiation of the clinical effects of the used therapeutic methods. The reduction in the relative risk of the disease recurrence in the СFT + BT group (compared to the BT group) during the year of follow-up was 42%.

Conclusion. The developed method of treatment using combined phototherapy provides a more effective reduction in the severity of skin manifestations of ATD according to the SCORAD index by 34.2% and an improvement in the quality of life by 43.5%, as well as a reduction in the relative risk of the disease recurrence by 42% compared to the results of basic drug therapy.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):239-243
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Review
Justification of the use of the method of deep oscillation by pulsed low-frequency electrostatic field in the early rehabilitation period after surgical interventions
Korchazhkina N.B., Mikhailova A.A., Kovalyov S.A., Rzhevsky V.S., Portnov V.V.
Abstract

The article presents the data of scientific research on the features of the application of the method of deep oscillation by pulsed low-frequency electrostatic field (low-frequency electrostatic massage) in the early rehabilitation period after surgical interventions and in various diseases.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):244-248
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Physical methods of post-acne scar correction: scientometric alysis of evidence-based research (literature review)
Kurganskaya I.G., Kovlen D.V.
Abstract

Background. The arsenal of physical methods for correcting pathological skin scars is quickly replenished, but the results of their use are often unsatisfactory. An inadequate approach to therapy, without taking into account the evaluation of their effectiveness, leads to relapses and increased growth of scar tissue or the absence of a clinically significant effect of many of them and requires strict scientific evidence in the course of benign scientific studies.

Aims: Comprehensive (qualitative, quantitative, structural) analysis of evidence-based research in electronic evidence-based research databases (PEDro, PubMed, e-Library) and systematic review databases (Cochrane Library) for the period from 2000 to 2020.

The clinical effects and suggested mechanisms of action of currently proven therapeutic physical factors in the treatment of patients with coronary heart disease are considered in detail. The most studied of the physical methods with proven effects are high-intensity laser technologies of high-intensity laser therapy (47%), fractional radiofrequency therapy (14%), microneedling (9%) and microdermabrasion (8%), which cause the most pronounced remodeling of the extracellular matrix of the skin in the area of scars.

Conclusion. It is necessary to regularly generalize and analyze existing evidence-based studies, as well as perform new high-quality randomized controlled clinical trials to study the impact of physical correction methods on post-acne scars, which serve as the basis for developing clinical recommendations.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):249-256
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Radicular pain associated with chronic neuropathic pain syndrome. Modern approaches to non-drug treatment
Mit'kovskii S.V., Kiparisova E.S., Kochetkov A.V., Mit'kovskii V.G.
Abstract

The review presents modern data on epidemiology, mechanisms of pathogenesis, clinical presentation, diagnosis of radicular pain. The indications for surgical treatment, the causes of failures in the treatment of radicular pain syndrome and the issues of its chronicity, as well as the prevention of the development of chronic pain of lumbosacral localization are considered. A generalized list of predictors of outcomes of surgical treatment of radicular pain is presented. Criteria for stage-by-stage diagnostics, physical and instrumental examination of patients with radicular pain in the lower back are presented. Conditions aimed at expanding the range of diagnostic studies, the feasibility of a multidisciplinary approach to the treatment of patients with pain in lumbosacral localization are discussed.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):257-265
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Guidlines for practitioners
Physical rehabilitation of patients with the new coronavirus infection covid-19 in a military hospital using telecommunication technologies
Frolov D.V., Kruykov E.V., Svetlitskaya M.V., Kostuychenko O.M., Zaitsev A.A., Chernov S.A., Chernetsov V.A.
Abstract

The guidelines are devoted to the practical application of the method of remote physical rehabilitation of patients with the new coronavirus infection COVID-19 through telecommunication technologies. The purpose of the document is the need to develop a unified approach in organizing assistance for physical rehabilitation for patients with the new coronavirus infection COVID-19 in military hospitals. The advantage of using telecommunication technologies is associated with a decrease in the risk of personnel infection.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):266-274
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