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Vol 20, No 1 (2021)

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Original studies

Assessment of hemodynamics in patients with hypertension using dry carbon dioxide baths and ozone therapy

Yashkov A.V., Statskaya S.Y., Popolitov A.B.


BACKGROUND: Despite the wide prevalence of arterial hypertension in modern society, including in the Russian population, patients sometimes do not suspect the presence of the disease, and among patients with an established diagnosis, drug therapy has low effectiveness.

AIMS: Of the study was to study the effect of dry carbon dioxide baths and ozone therapy on heart rate variability and reocardiography in patients with hypertension.

MATERIALS AND METHODS: We observed 71 patients with stage I hypertension and grade 1–2 arterial hypertension. Patients were randomly selected into three groups: in the control group (n=18), patients received complex spa treatment, including diet, physical therapy, massage of the collar area and aromatherapy; in the comparison group (n=20) — basic spa therapy and dry carbon dioxide baths; in the main group (n=33) — basic spa therapy, ozone therapy and dry carbon dioxide baths.

RESULTS: The combined use of dry carbon dioxide baths and ozone therapy in the complex treatment of patients with hypertension in sanatorium conditions is accompanied by a significant improvement in heart rate variability and central hemodynamics.

CONCLUSION: Complex spa treatment of patients with hypertension with the additional appointment of dry carbon dioxide baths and ozone therapy helps to reduce the tension of the central mechanisms of regulation of the cardiovascular system, restore vegetative balance and vascular tone.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):5-12
pages 5-12 views

Novel non-pharmacological treatment for degenerative joint and disc disease

Gerasimenko M.Y., Badalov N.G., Borodulina I.V., Mukhina A.A.


BACKGROUND: The most common pathologies in the structure of musculoskeletal disorders are osteoarthritis and non-specific back pain caused by degenerative disc disease, proportion is 20% and 46%, respectively. According to the new WHO initiative "Rehabilitation-2030: call for action", the implementation of non-pharmacological methods in the treatment programs for patients with degenerative joint and disc disease is of great importance.

AIMS: A clinical study was conducted to evaluate the effectiveness of a new method of balneo-thalassotherapy — seaweed in the form of local applications and general baths in patients with osteoarthritis and back pain.

MATERIALS AND METHODS: A randomized controlled clinical trial included 40 patients (mean age 51.67±0.65 years). Patients were divided into 3 groups: 1group (n=15) — patients received local applications of seaweed on the joints and affected segments of the spine, and basic medical treatment; 2 group (n=15) — patients received procedures of seaweed general baths, and basic medical treatment; 3 group (control, n=10) — patients received only basic medical therapy. The treatment course was 20 days (15 procedures with a break for the weekend).

RESULTS: A significant positive effect of the method of seaweed therapy on the clinical symptoms of degenerative pathology of the joints and spine was demonstrated: decreasing of pain, improving of the level of motor activity and daily functioning, and an increase in the quality of life was noted. The effectiveness of the treatment was 73.3–80%.

CONCLUSION: The obtained results prove the effectiveness of using seaweed in patients with degenerative pathology of the joints and spine with pain syndrome. This treatment method can be included in rehabilitation programs for these patients as local applications or general bath procedure.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):13-21
pages 13-21 views

The use of heated oxygen-helium mixture in patients with chronic obstructive lung disease

Bobkina N.V., Lyadov M.V., Gerasimenko M.Y., Zhitareva I.V.


BACKGROUND: In recent years, along with the development of new pharmacological approaches and treatment COLD (chronic obstructive lung disease), a significant attention is paid to the study of non-medical methods of treatment and correction of the system inflammation occurring.

AIMS: To assess the effectiveness of the use of heated oxygen-helium mixture (OHM) in the rehabilitation of patients with chronic obstructive bronchitis on an outpatient polyclinic stage.

MATERIALS AND METHODS: The supervision was 102 patients aged from 32 to 56 (43.7±4.1) years. All patients entered into research signed voluntary informed consent. Patients were divided into three groups: the first group (n=32) is the control; the second group (n=35) is the main one. Patients of these groups had a verified diagnosis: chronic obstructive bronchitis, moderate and moderate degree of obstruction, the duration of the disease amounted to 2 years to 16 (5.4±1.4) years. The third group (n=35) is practically healthy patients. The patients of the second and third group passed the respiratory course of heated OHM (the temperature of the mixture in the mask 50º). Breathing was carried out in cyclical-fractionated mode: the breath of the mixture — 5 minutes then breathing with atmospheric air — 5 minutes (one cycle), 3 cycles for the 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 reducing treatment was assessed before the start of therapy, after the 10th procedure in the following indicators: Harvard step test index, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (heart rate), blood pressure recovery time, maximum oxygen consumption (MOC); diagnosis of psycho-emotional state using WBAM Questionnaire (well-being–activity–mood).

RESULTS: In the group of practically healthy patients, a positive dynamics was noted in the speed of adaptive processes for the restoration of the cardiovascular system after physical exertion of the form of a decrease in blood pressure reduction time, a decrease in systolic blood pressure, the indicators of the Harvard step test index and maximum oxygen consumption increased. Patients with chronic obstructive bronchitis, who passed the breathing rate of heated oxygen-helium mixture, had an increase in points on WBAM Questionnaire, which indicates the improvement of the psycho-emotional state of patients.

CONCLUSION: The use of the course of breathing heated oxygen-helium mixture in patients with chronic obstructive bronchitis does not affect the increase in physical performance. The use of heated oxygen-helium mixture has a positive effect on the functional state of practically healthy patients, which is manifested in the form of slowing the connection of the anaerobic mechanisms of energy supply in the process of performing physical exertion, leading to an increase in oxygen consumption, improving physical performance.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):23-29
pages 23-29 views

Study of body mass index in physically active young people

Korolev D.S., Pustovalov D.A., Karazhelyaskov O.P., Arkhangelskaya A.N., Zaborova V.A., Gurevich K.G.


BACKGROUND: One of the indicators for assessing the state of human health is the body mass index. But this indicator does not give an objective picture, for example, it does not reflect the features of a person's physique. To assess the type of obesity, the ratio of waist circumference to hip circumference is used. This can lead to an incorrect assessment of the nutritional status, and, accordingly, incorrect recommendations for the prevention of non-communicable human diseases.

АIMS: To evaluate the indicators: body mass index and the ratio of waist circumference to hips, the results were compared with the data of a bioimpedance study.

MATERIALS AND METHODS: 154 people of different physical fitness were examined (105 people are athletes, 49 are not engaged in sports). All the surveyed are men, from 15 to 25 years old. The results were obtained for the following indicators: body mass index, waist-to-hip ratio, bioimpedance study (assessment of fat mass, lean mass, active cell mass, dry muscle mass, total, extracellular and intracellular water).

RESULTS: Тhe body mass index significantly correlates with such indicators as fat mass, lean mass, dry muscle mass, as well as the water content in the body. The correlation relationship with fat mass is positive, with other indicators ― negative. There is no reliable correlation with the active cell mass. The ratio of waist circumference to hips had a reliable relationship with all the indicators we evaluated. A negative correlation was noted with the fat mass, and a positive correlation was observed for the rest of the indicators.

In people who are actively engaged in sports, the relationship between the body mass index and the content of adipose tissue in the body is more pronounced.

The body mass index and the ratio of waist circumference to hip circumference in athletes are more correlated with the data of the bioimpedance study.

A reliable relationship between the body mass index and the ratio of the waist circumference to the hips has not been established. Thus, it is necessary to conclude that when assessing the state of the body, it is necessary to take into account both indicators. None of these parameters can be used to determine the risks of developing non-communicable diseases.

CONCLUSION: Body mass index indicators, as well as the ratio of waist circumference to hips, significantly correlate with the results of bioimpedance examination, with the exception of active cell mass.

It is advisable to use the body mass index and the ratio of waist circumference to hips as one of the simplest ways to determine risk groups for the development of non-communicable diseases during a mass screening study.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):31-36
pages 31-36 views

Possibilities of physiotherapy in Mayer–Rokitansky–Kuester–Hauser syndrome

Kruglyak D.A., Buralkina N.A., Ipatova M.V., Uvarovа E.V., Malanova T.B., Batyrova Z.K., Kumykova Z.K.


BACKGROUND: Mayer–Rokitansky–Kuester–Hauser syndrome occurs in 1 of 4000–5000 newborn girls. The first-line treatment of aplasia of the vagina is considered a vaginal dilation. The use of physiotherapy capabilities in the practice of obstetricians and gynecologists is quite widespread and has firmly established itself in clinical practice.

AIMS: To evaluate the effectiveness and tolerability of dilation in combination and without physical effects in the formation of vagina in adolescent girls.

MATERIALS AND METHODS: A prospective cohort study of 64 adolescent girls 15 to 18 y with a first-time diagnosis of vaginal and uterine aplasia was conducted. Their psychophysiological features were analyzed with testing according to the questionnaire well-being, activity, mood (SAN), physical and sexual development, a gynecological examination was performed to determine the depth of the vaginal fossa. Teenage girls were randomized into 2 groups: 1 (n=36) — to create an artificial vagina, with the method of dilation. The second group of patients (n=28) underwent preformed physiotherapy with subsequent dilation. All the girls daily made a graph of the increase in the length of the vagina and determined the intensity of pain using a visual-analog scale (VAS). After the treatment was completed, the patients were re-tested according to the SAN method.

RESULTS: A significant increase in the length of the neovagal space was noted in the group of complex treatment with physiotherapy already at the 8th procedure, with an increase after the completion of 20 procedures. In group 2, the dynamics of pain intensity significantly decreased in comparison with the 1st group. The psychological status of the patients according to the SAN before the start of treatment was characterized by an unfavorable state.

CONCLUSION: Conducting course procedures of complex dilation with the use of heat-magneto-vibration in girls with vaginal aplasia has a significant reduction in pain and allowed to achieve the required anatomical length in a shorter time compared to monomethodics.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):37-43
pages 37-43 views

The results of the use of preformed physical factors in the rehabilitation treatment of corneal ulcers

Yurova O.V., Solovyov Y.A., Konchugova T.V.


BACKGROUND: Currently, an infectious corneal ulcer, a defect in the corneal epithelium, remains one of the main causes of monocular blindness, which necessitates the development of new effective methods of treatment.

AIMS: The aim of the study is to develop and evaluate the effectiveness of a methodology for the complex application of preformed physical factors of local and segmental action in patients with corneal ulcers.

MATERIALS AND METHODS: The study involved 85 patients with corneal ulcer defect aged 18 to 60 years, who were divided into three groups. Patients of the control group (29 people) received standard drug therapy, the comparison group (29 people) underwent a course of magnetophoresis with solcoseryl on closed eyelids against the background of standard drug therapy, patients of the main group (27 people) received standard drug therapy. magnetophoresis and low-frequency electrostatic fields on the collar area. All patients were assessed for visual acuity, the size of the ulcer and the area of stromal infiltration. The subjective severity of pain syndrome (VAS scale), psychoemotional state (SAN test) were assessed.

RESULTS: Immediately after treatment, visual acuity in the main group was significantly higher than in the comparison group and the control group, and averaged 0.14±0.14. The size of the ulcerative defect in the main group was significantly smaller than in the control group and the comparison group (p <0.05). The assessment of the psychoemotional state of patients after treatment revealed significant differences in the main group in relation to the control group on the Well-Being scale (p <0.05).

CONCLUSION: The use of preformed physical factors in the form of a course application of a low-frequency electrostatic field and magnetophoresis with the drug Solcoseryl made it possible to shorten the time of epithelialization of the ulcer and suppression of the inflammatory reaction in the cornea, which made it possible to significantly improve the clinical and functional parameters of the eye, as well as reduce the severity of pain syndrome against the background of an improvement in the psycho-emotional state patients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):45-51
pages 45-51 views

Information-predictive approach to evaluation of the efficiency of treatment of chronic generalized periodontitis using non-drug technologies ABSTRACT

Ryabtsun O.I., Nagornev S.N., Frolkov V.K., Gusakova E.V.


BACKGROUND: The information-predictive approach can be used for determining biomarkers as predictors that allow predicting the effectiveness of the treatment of chronic generalized periodontitis using the combined use of ozone and transcranial magnetotherapy.

AIMS: Determination of the set of initial morphometric parameters that have predictive significance, as well as the development of a method for the integral assessment of the clinical effectiveness of the combined use of ozone and transcranial magnetotherapy in patients with chronic generalized periodontitis.

MATERIALS AND METHODS: A multiple regression model was built, which establishes the relationship between the dependent variable (effective sign — treatment effectiveness) and the value of independent variables (factors characterizing the initial state of patients).

RESULTS: It has been established that the technology of combined use of ozone and transcranial magnetotherapy is most effective in the initial clinical manifestations of chronic generalized periodontitis and minimal values of other pathogenetically significant parameters (microcirculation, oxygen metabolism, lipid peroxidation disorders) in the initial state.

CONCLUSION: The clinical and laboratory cluster identified as a result of mathematical analysis — the index of bleeding of the gingival sulcus, the volume of nutritive blood flow, the fluorescent indicator of oxygen consumption, the quality of life according to the Daily Life domain generalized periodontitis, determining the indications and contraindications for the use of this treatment regimen for inflammatory periodontal diseases.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):53-60
pages 53-60 views

Hardware and software method preclinical detection of pathological conditions in persons arriving for medical and psychological rehabilitation in the sanatorium conditions

Syuris N.A., Razinkin S.M., Komlev A.M.


BACKGROUND: It is important to identify the risks of developing somatic disorders, for further clarification by laboratory and instrumental diagnostic methods. An objective assessment of the effectiveness of the medical and psychological rehabilitation (MPR) of a serviceman is important.

AIMS: The aim of the study is to determine the informative value of the Diamed-MBS hardware and software complex as a method of preclinical detection of pathological conditions by assessing heart rate variability (HRV), electrosomatography, bioelectrography (BEG), as well as the psychosomatic context of complaints and identified deviations.

MATERIALS AND METHODS: Along with the methods of the Diamed-MBS agro-industrial complex, the MPR program of military personnel included a regulated scope of measures: examination for UPFT-1/30 "Psychophysiologist" (simple visual-motor reaction and variational cardiointervalometry); registration of the levels of "energy potential" and stress background by gas-discharge visualization on the pulse analyzer "GRV-Express", determination of the compositional composition of the body by bioimpedance measurement on the analyzer "Tanita BC-532".

The automated system of assessment in points (APC) allows for differentiated diagnostics of the somatic and psychoemotional profile of military personnel who arrived at the MPR; to personalize the rehabilitation program; to evaluate the effectiveness of the MPR program. The data of a group of 85 military personnel undergoing MPR were processed in the Statistica 10 (StatSoft Inc., USA).

RESULTS: In the branches of the Federal State Budgetary Institution SKK "Privolzhsky" of the Ministry of Defense of the Russian Federation ("Volga Clinical Sanatorium", "Chebarkulsky Sanatorium", "Yeltsovka Sanatorium") within the framework of the psychotherapy office (psychologist's office) with the category of MPR, work was carried out on the Diamed-MBS hardware and software complexes for 9 months. This allowed for a short examination time (up to 20 minutes) to conduct an objective assessment of the psychosomatic state of a person: respiratory, digestive, immune, genitourinary, musculoskeletal, cardiovascular, endocrine systems, as well as the general state of the body and psychological status.

After the course of MPR, the improvement of the indicators of the condition of military personnel was noted to a greater extent due to the indicators according to the survey data (Questionnaire 1, 2) (p <0.000) (the subjective component of the study), which ultimately reflected the improvement of the integral indicator (Integral 1, 2) (p <0.007). Changes in the psychoemotional (Psychoemotional 1, 2) and somatic state (Soma 1, 2) were not statistically significant (p >0.05).

CONCLUSION: The restoration of the psychoemotional background and the necessary training in stress resistance skills requires a revision of the duration of the MPR by military personnel. The advantage of the Diamed agro-industrial complex is the arrangement of three diagnostic complexes in one device: for determining the parameters of heart rate variability, electro-tomography, bioelectrography; in the mode of express diagnostics, the determination of the state of the body in the range "healthy-practically-healthy-weakened-premorbid state-sick-critical condition".

The possibility of creating a single information and analytical center for processing the final protocols of the examination of military personnel under the MPR program in the CCM sanatoriums.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):61-68
pages 61-68 views


Nutritional nutrition in rehabilitation of cancer patients

Kumisbekova R.K., Shanazarov N.A., Bimbetov B.R., Gilmutdinova L.T., Tuleutaev M.E.


The article provides a brief overview of the issues of nutritional therapy in the rehabilitation of cancer patients. Excess sugar in food and drink, fatty and high-calorie foods, processed meat, trans fatty acids, preservatives and dyes are risk factors for the formation of malignant tumors. Patients should be informed about adherence to a healthy lifestyle and exclusion from the diet of foods containing carcinogens to reduce the recurrence of the disease. Chemotherapy courses and radiation sessions are accompanied by a number of side effects that lead to a decrease in the body's defense systems. For the recovery of cancer patients, protein, vitamins and minerals must be present in the diet. All nutrients are better obtained from the natural foods. To maintain a healthy diet, the World Cancer Research Foundation (WCRF) and the American Institute for Cancer Research (AICR) recommends you toinclude vegetables, fruits, whole grains and legumes in your daily diet. The article focuses on mare's milk, its multicomponent composition, which has immunomodulatory, antiviral, antibacterial properties. To increase the effectiveness of rehabilitation measures in patients after antitumor treatment, it is advisable to include mare's milk in medical nutrition, which has therapeutic and health-improving properties, and it is also possible to use it in patients undergoing antitumor cytostatic therapy. Further comprehensive study of the therapeutic and rehabilitation potential of mare's milk would make it possible to use this product more widely as an important component of nutritional support for cancer patients during specific therapy courses, which will have a positive effect on their survival rates and quality of life. In the treatment of malignant tumors, the main emphasis is on the development of strategies, new treatment options, and medical nutrition and a healthy lifestyle are an integral part of their complex rehabilitation.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):69-77
pages 69-77 views

The role and place of preformed physical factors in the complex treatment of patients with corneal ulcer

Yurova O.V., Solovyov Y.A., Konchugova T.V.


Corneal ulcer is a severe pathology of the anterior segment of the eye, the outcome of which can be the loss of the eye as an organ, the formation of gross corneal opacity and irreversible vision loss. Currently, there is evidence of the successful use of preformed physical factors in the treatment of patients with corneal ulcers. The article presents information about the effectiveness of magnetic therapy, pulsed electrotherapy, ultrasound and laser therapy, hyperbaric oxygenation and a number of other physiotherapy methods in this pathology. Standard pathogenetic therapy is an integral part of the treatment process of corneal ulcers, but the use of physiotherapy techniques in addition to standard therapy allows you to achieve a better clinical effect, which makes it possible to consider the actual problem of medical rehabilitation of patients with corneal ulcers.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(1):79-84
pages 79-84 views

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