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Vol 21, No 4 (2022)

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Original studies

Recovery of anti-gravity muscles in patients with consequences of limb injury

Somov D.A., Makarova M.R., Maiorov E.A.

Abstract

BACKGROUND: Over the past years, injuries have been consistently included in the first seven leading classes in the structure of general morbidity, and in the distribution of the number of people aged 18 years and over who were first recognized as disabled, they are included in the first six causes of disability.

AIM: to study the clinical efficacy and safety of the author's technique, in patients after injuries of the lower and upper extremities at the second stage of medical rehabilitation.

MATERIALS AND METHODS: The study included 105 patients who had suffered injuries. 37 (35.2%) men, 68 (64.8%) women. The patients were randomly divided into 2 observation groups: the main group (n=53), whose patients, in addition to the standard rehabilitation program, were trained on the biofeedback simulator Tergumed Pegasus 3D (Germany), a course of 7–10 procedures, and the control group (n=52), whose patients underwent a course of medical rehabilitation only according to the standard program of the 2nd stage, lasting 10–14 days. The complex rehabilitation treatment of patients included standard drug therapy, massage courses, physiotherapy, group exercise therapy. Treatment outcomes were assessed using the VAS (Visual Analog Scale), HAQ (Health Assessment Questionnaire), Lequesne index, and 20-m walking time scales. Data analysis included comparison of dependent series of variables and descriptive statistics methods. The type of data distribution (parametric or nonparametric) was assessed using the Shapiro–Wilk and Kolmogorov–Smirnov tests. The statistical significance of differences between dependent groups was assessed using the Wilcoxon and Mann–Whitney tests. The value of p=0.05 was taken as the level of statistical significance.

RESULTS: All measured indicators improved significantly (p <0.001). In the main group, compared with the control group, there was a statistically significant increase in walking speed, and there was a tendency to a more pronounced positive change in the Lequesne and HAQ indices, the level of pain according to VAS, compared with the control group.

CONCLUSION: Our proposed method of training with the participation of antigravity muscles trunk is effective for patients after limb injuries at the 2nd stage of medical rehabilitation.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):237-244
pages 237-244 views

Clinical efficacy of the combined use of a pulsed dye laser and enzyme preparation phonophoresis in patients with immature hypertrophic skin scars

Ismailyan K.V., Kruglova L.S., Nagornev S.N., Frolkov V.K.

Abstract

BACKGROUND: Taking into account the role of angiogenesis processes in the zone of development of immature scar tissue, it seems pathogenetically justified to use a vascular laser for the correction of hypertrophic skin scars that are at the maturation stage. In this regard, we used a pulsed dye laser, the effect of which is perceived by the patient without pronounced pain, and the technology itself is quite safe and leads to a rapid recovery of the skin after the procedure. Fermencol phonophoresis supplementation of laser therapy with pulsed dye laser has the potential to enhance the therapeutic efficacy of a vascular laser, since Fermenkol is a preparation of collagenases of hydrobiont origin that can destroy the components of the extracellular matrix, the formation of which exceeds in intensity its degradation by matrix metalloproteinases at the stage of formation scar. The use of ultrasound in this case not only accelerates the delivery of proteolytic enzymes, but also exhibits independent fibromodulatory activity.

AIM: comparative evaluation of the effectiveness of the use of physiotherapeutic factors (Fermenkol phonophoresis, pulsed dye laser therapy and their combination) in patients with immature hypertrophic skin scars, taking into account clinical research methods.

MATERIAL AND METHODS: The study was performed on 125 patients aged 19 to 50 years with immature (less than 6 months) hypertrophic skin scars. All patients were divided into 4 groups according to the simple fixed randomization procedure. The first group (control, 32 patients) received course local compression therapy using silicone plates for two months. The second group (31 patients) was treated with phonophoresis of 0.01% Fermencol gel. The third group (31 patients) was treated with pulsed dye laser. The fourth group (31 patients) received complex treatment, including a combination of two pulsed dye laser procedures and two cycles of Fermencol phonophoresis. Patients were examined twice: before the start of treatment and 2 weeks after the end of the course of treatment. The assessment of the clinical condition of patients was carried out according to the modified Vancouver scale for assessing the signs of cicatricial deformity.

RESULTS: Conducting a course of treatment of patients with immature hypertrophic skin scars made it possible to establish a good tolerability of the effects of physiotherapeutic factors. At the same time, the positive dynamics of clinical manifestations of cicatricial changes in the skin, assessed by Vancouver scar scale, in the control and main groups was not the same and increased in the following order: Control < Fermencol phonophoresis < pulsed dye laser < pulsed dye laser + Fermencol phonophoresis. The use of the correlation adaptometry technique, which makes it possible to objectify the obtained clinical data, evaluating them using the category of functional reserves of the body, confirmed that the best clinical result was achieved in the group recieved combined use of pulsed dye laser and Fermencol phonophoresis.

CONCLUSION: The conclusion was made about the maximum therapeutic effect in the group of complex use of pulsed dye laser and ultrasound administration of an enzyme preparation, which manifested itself due to the synergistic type of interaction between two physiotherapeutic factors that have different modalities, points of application and mechanisms for implementing their therapeutic activity.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):245-254
pages 245-254 views

Reduction of glycemic risks in patients with diabetes mellitus and chronic periodontitis after physiotherapy

Chkheidze T., Zhilokov Z.G., Tkachenko A.S., Kulikova N.G.

Abstract

BACKGROUND: The article is devoted to the actual task of reducing inflammatory complications after dental manipulations in patients with diabetes mellitus. It is noted that worldwide there is a steady trend of increasing the incidence of diabetes mellitus and predicting an increase in the number of patients to 250 million people by 2025. The prevalence, severity of dental complications and inflammatory diseases of periodontal tissues in patients with diabetes is extremely high, which determines the relevance and scientific and practical significance of the study.

AIM: to evaluate the score, index dental indicators, cytokine plasma indicators before/after the use of physiotherapy methods in complex dental treatment.

MATERIAL AND METHODS: The study included 121 patients (58 men and 63 women) with diabetes mellitus with an underlying disease duration of up to 5 years who were diagnosed with diabetes periodontal-periodontal inflammatory diseases. Starting and ending points: point, index dental indicators, glycemic profile and immunological cytokine plasma indicators before/after the application of physiotherapy methods before/after the application of physiotherapy methods in complex dental treatment, including a transcanal method of drug electrophoresis with a copper-calcium preparation and laser exposure to NILI (low-intensity laser radiation; l=810 nm). Analysis of statistical data was carried out in Microsoft Office Excel (2017) programs. The differences were considered significant at р <0.05.

RESULTS: It has been established that the use of complex physiotherapy in patients with diabetes reduces glycemic risks and increases antioxidant reserves.

CONCLUSION: The use of complex physiotherapy in patients with type 2 diabetes mellitus reduces the risks of inflammatory complications in periodontal-periodontal tissues, which is confirmed by clinical efficacy in relation to cellular immunity and hygiene index.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):255-261
pages 255-261 views

Retrospective study of inpatient patient records of the Center for comprehensive rehabilitation of disabled people "Butovo"

Zaytseva T.N., Gerasimenko M.Y., Prityko D.A., Kozyreva V.O.

Abstract

BACKGROUND: The problem of medical rehabilitation/habilitation of patients with diseases of the nervous system, mental disorders, congenital anomalies and developmental delays is extremely relevant. The article analyzes the comprehensive care for this category of patients on the basis of the State Budgetary Institution Center for Comprehensive Rehabilitation of the Disabled "Butovo".

AIM: analysis of the volume and methodology of prescribing physical factors in the provision of medical and social services to patients at the State Budgetary Institution Center for Comprehensive Rehabilitation of the Disabled "Butovo".

MATERIALS AND METHODS: In 2021, based on archival data for 2019–2020 an assessment was made of the conduct of socio-medical rehabilitation at the State Budgetary Institution Center for Comprehensive Rehabilitation of the Disabled "Butovo". The observation unit is represented by stationary patient charts.

RESULTS: The study revealed a sufficient volume and correct methodology for prescribing physical factors to patients with diseases of the nervous system, mental disorders, congenital anomalies and developmental delays. At the same time, the absence of an adequate goal of rehabilitation/habilitation was noted. The goals that were set for patients were often unrealizable, non-specific, not defined in time, or not related to the needs of the patient himself.

CONCLUSION: A unified comprehensive approach is needed to assess the condition, identify needs and implement rehabilitation measures for patients with diseases of the nervous system, mental disorders, congenital anomalies and developmental delays. It has been determined that in this category of patients it is advisable to apply the International Classification of Functioning, which will allow one to concentrate on the necessary areas of diagnostics, select the necessary diagnostic tools, identify and link functional disorders and disability to each other, determine the areas of intervention of different specialists, unite specialists into one team with overall goal of rehabilitation/habilitation.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):263-272
pages 263-272 views

The effectiveness of ultrasound therapy and phonophoresis in the treatment of ankylosing spondylitis

Al-Zamil M.K., Stepanovich M.А., Kulikova N.G., Vasilieva E.S.

Abstract

BACKGROUND: In Bekhterev's disease, an autoimmune inflammatory process develops in the intervertebral joints and paravetebral muscles and leads to severe pain syndrome and progressive fusion of articular surfaces. Anti-inflammatory and analgesic therapy should be carried out daily with the use of large doses of nonsteroidal anti-inflammatory drugs. With the progression of the disease, drug therapy is not effective enough to relieve pain and to restore the volume of movement in the joints. In this regard, the use of non-drug treatment is a necessary measure for the treatment of such patients.

AIM: comparison of the effectiveness of phonophoresis and ultrasound in the treatment of pain syndrome in patients with ankylosing spondylitis.

MATERIALS AND METHODS: 30 patients with Bekhterev's disease were included in our study. All patients were found to carry the HLA antigen and high value of C-reactive protein with an increase in the rate of erythrocyte sedimentation. Radiographs revealed signs of arthrosis of the sacroiliac joint and signs of arthritis and arthrosis of the intervertebral joints of the spine in one or several departments. The severity of the pain syndrome was 9.4 points on the visual analog scale (VAS) and 31.1 points on the McGill Pain Questionnaire (MPQ). 10 patients underwent ultrasound therapy, 10 patients underwent phonophoresis with karepain and 10 patients underwent placebo (Simulation of ultrasound exposure).

RESULTS: The analgesic effect of ultrasound therapy was 57.9% at rest, 55.3% with spinal movement. The overall reduction in pain syndrome determined by MPQ was 50%, 49.54% in the sensory class and 51.8% in the affective class. Regression of pain syndrome against the background of the use of phonophoresis with karipain was 60.4% at rest, 54.5% with spinal movement. According to MPQ, the pain syndrome decreased by 46.7% in the sensory class and 52.8% in the affective class and by 49.5% in general. In patients who underwent a placebo course, the pain syndrome according to VAS and MPQ remained without significant dynamics.

CONCLUSION: The significant effectiveness of ultrasound therapy and phonophoresis in the treatment of severe pain syndrome in of patients with ankylosing spondylitis has been proven, but it was not possible, to identify significant differences in the analgesic effect between ultrasound therapy and phonophoresis.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):273-280
pages 273-280 views

The use of electrotherapy in complex treatment programs for patients after total arthroplasty

Kolbakhova S.N., Kulchitskaya D.B., Khaptagaev T.B., Strukov R.N., Koneva E.S.

Abstract

BACKGROUND: Total knee arthroplasty is one of the most common surgical interventions in the world and the Russian Federation. Endoprosthetics of the knee joint occupies a leading place in the structure of surgical methods for the treatment osteoarthritis.

AIM: of the study was to scientifically substantiate the feasibility of the complex use of electrical stimulation and therapeutic exercises in patients after total knee arthroplasty.

MATERIALS AND METHODS: We examined 60 patients who were admitted 3 months after TCS and were randomized into 2 groups. In the first group, 30 subjects received electrical stimulation of the quadriceps muscles and underwent therapeutic exercises, for a course of 10 procedures. The subjects of the second group, 30 people, had only physiotherapy exercises.

RESULTS: The use of electrotherapy and physiotherapy exercises, in the complex treatment of patients after total knee arthroplasty, improves the function of joint mobility. This is confirmed by the improvement in the functional activity of the operated joint according to the KSS scale (Кnee Society Scores), the improvement in the state of microcirculation and the positive dynamics of the pain syndrome according to the VAS (Visual Analog Scale). The obtained data of the HAQ (Health Assessment Questionnaire) questionnaire testify to the expansion of the possibilities for performing most of the activities in everyday life. However, more statistically significant results were obtained in patients after a course of quadriceps electrical stimulation and therapeutic exercises compared with the use of therapeutic exercises alone.

CONCLUSION: The complex of rehabilitation of patients after total knee arthroplasty presented by us, including electrostimulation and therapeutic gymnastics, is scientifically sound, effective and can be implemented into the basic scheme of outpatient and sanatorium treatment of this category of patients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):281-287
pages 281-287 views

Review

Correction of age-related changes of the face skin using radiofrequency micro needling. Brief literature review

Agapova M.A., Sharova A.А.

Abstract

The problem of choosing a method for skin rejuvenation remains relevant despite a wide selection of conservative and surgical methods for eliminating age-related changes. In recent years, treatment methods for voluminous and traumatic ones have been striving for minimally invasive, quickly feasible with an optimal result that should meet both the needs of patients and doctors. For this reason, injection and hardware methods of rejuvenation began to come to the fore, especially when correcting changes on the face. Cosmetic devices based on radiofrequency can compete in efficiency with laser technology, having their own specific advantages.

The aim of the work was to evaluate the available literature sources related to the use of radiofrequency in dermatology and dermatocosmetology, especially for leveling age-related changes in the skin of the face.

The available literature sources from Russian and foreign databases (Elibrary, PubMed, Google Academia) were analyzed on the use of radiofrequency and radiofrequency micro needling in dermatocosmetology for facial skin rejuvenation.

The analysis showed the widespread use of radio frequency in dermatocosmetology, its high efficiency and safety, however, there are very few full-fledged studies devoted to radio frequency microneedling.

In our opinion, radiofrequency microneedling is a significant step forward compared to traditional radiofrequency devices, especially for facial skin rejuvenation by increasing the safety and effectiveness of the procedure. The use of radiofrequency microneedling can be effective for correcting age-related skin changes, especially in the face area, both as monotherapy and in combination with other methods of rejuvenation.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):289-299
pages 289-299 views

The use of suspended systems in the rehabilitation of people with mental retardation: A review and substantiation of the method

Fedulova D.V., Berdyugin K.A.

Abstract

Suspension systems occupy a special place in the rehabilitation of people with a neurological and orthopedic profile, forming a stable basis for safe movement exercises at various stages of recovery.

Mental retardation as a nosological group has its own secondary disorders of physical development, which require separate corrective and preventive work, without which stable compensatory mechanisms that have a defective basis can form.

In view of the peculiarities of the perception of information, a special approach is required to the choice of tools and means of work for correctional and preventive and correctional rehabilitation classes. When analyzing the content component of the TRX-system (Total Body Resistance Exercises) method, it was determined that it can include the implementation of all necessary areas of work for children with mental retardation and be available for adaptation. The main provisions of the TRX-training methodology for children with mental retardation are aimed at: developing static and dynamic postural control; correction of violations of the walking pattern; correction of major secondary disorders of the musculoskeletal system, such as impaired posture, flat feet, valgus position of the ankle and knee joints.

And, given that one of the main violations of this nosological category is a violation of the coordination of both the coordination of movements and the coordination of the neuromuscular interaction, this feature forms additional advantages of the method, due to its profile.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(4):301-308
pages 301-308 views


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