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Vol 21, No 5 (2022)

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Original studies

Personalized physiotherapy of patients with late complications after the introduction of lip fillers

Aksenenko I.P., Gerasimenko M.Y.


BACKGROUND: Lip contouring with preparations based on synthetic hyaluronic acid is one of the most popular cosmetic procedures. But in recent years, there has been an explosive increase in the number of complications. There are many physiotherapeutic methods for the treatment of late complications of lip contouring. However, currently there are no differentiated approaches to the choice of physiotherapy techniques and their combination with each other, depending on the nature of the filler and the clinical and functional picture of the complication.

AIM: to develop and evaluate the use of personalized physiotherapy in patients with complications after the introduction of lip fillers, taking into account their genetic predisposition.

MATERIAL AND METHODS: The study involved 52 patients aged 30–42 years with a diagnosis of "L57.4 Senile atrophy (lethargy) of the skin", who received late complications (local swelling, dry and pale lip skin, filler contouring, soreness, sensitivity change) at the filler injection site. All patients underwent genetic testing on the Cosmetology panel before the start of treatment. There were 3 groups that received physico-pharmacological methods: laserophoresis of longidase, diadinamophoresis of collagenase or a combination of them in the lip area at the filler injection site.

RESULTS: When analyzing the data after the course of treatment, patients with the combined protocol showed a significant improvement in the quality of life, both in the near and long-term research period. This was expressed in a statistically significant decrease in intradermal edema, rapid regression of pain syndrome and more accelerated biodegradation of the superficially injected filler in the main group compared to other study groups/

CONCLUSION: In patients with late local complications after the introduction of hyaluronic acid fillers, the combined protocol with the inclusion of laser-phoresis of longidase and collagenase diadinamophoresis significantly shortens the recovery period, contributes to a faster reduction of local edema, pain, neuropathy phenomena, accelerated biodegradation of the superficially injected filler, and also allows for a stable clinical result. Personalized physiotherapy is an effective factor in relieving complications after lip contouring.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):313-320
pages 313-320 views

The impact of early medical rehabilitation on improving the quality of life of patients after surgical treatment of breast cancer

Evstigneeva I.S.


BACKGROUND: Various methods of physical therapy are widely used in the rehabilitation of patients with oncological diseases. It is known about the successful use of magnetotherapy, various types of electrotherapy, laser therapy, as a result of which the pain, edematous anti-inflammatory syndrome decreases after radical treatment. There are a large number of studies in the literature devoted to the study of the quality of life and the psycho-emotional state of a patient in the process of antitumor treatment, however, there are few studies on the effect of early onset of medical rehabilitation on the quality of life of women after surgical treatment of breast cancer.

AIM: тo compare the effectiveness of prescribing medical rehabilitation in breast cancer patients at different times after surgical treatment of breast cancer 2–4 days and 1–1.5 months after surgery.

MATERIAL AND METODS: A randomized placebo-controlled study was conducted in 70 patients at different times after surgical treatment of breast cancer. All patients underwent medical rehabilitation: individual physical therapy classes, balance therapy, classes with a medical psychologist, general magnetotherapy and intermittent pneumocompression. The main group included 35 patients who were rehabilitated on the 2nd-4th day after surgical treatment of breast cancer, the comparison group included 35 women who were rehabilitated after 1–1.5 months on the background of radiation therapy.

RESULTS: It was proved that the early start of medical rehabilitation in patients after surgical treatment of breast cancer (on the 2nd–4th day), contributed to the rapid restoration of the quality of life, namely, a rapid reduction in pain and postoperative edema, an increase in the volume of movements in the shoulder joint, prevention of severe lymphostasis, rapid restoration of electrical excitability of the shoulder girdle muscles.

CONCLUSION: In the groups, a long-term clinical effect was obtained after the appointment of physiotherapy procedures, which emphasizes the expediency of exposure to physical factors at the first stage of rehabilitation to restore the motor function of the operated upper limb in patients with a history of breast cancer.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):321-330
pages 321-330 views

Application of non-drug methods in rehabilitation programs to improve the quality of life of patients after lower limb joint endoprosthetics

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


BACKGROUND: All over the world, osteoarthritis is a common disease and accounts for 10% of all diseases in the population, and therefore, the frequency of large joint arthroplasty continues to increase, which determines the need to develop new methods of complex treatment in the rehabilitation of patients after arthroplasty operations.

AIM: Scientific substantiation of the expediency of the complex use of a stabilometric multifunctional platform with biofeedback and light therapy in patients after arthroplasty of the joints of the lower extremities to improve the quality of life in the late recovery period.

MATERIAL AND METHODS: 60 patients were examined three months after total joint replacement of the lower limb at the age of 55 to 75 years. All patients were randomly divided into three groups of 20 people comparable in terms of clinical and functional characteristics. Patients of the main group were exposed to monochromatic polarized incoherent light and underwent physical training using a stabilometric complex with biofeedback COBS (mtd-Systems, Germany), in the comparison group, patients received therapeutic exercises on a stabilometric simulator with biofeedback, patients the control group received only a standard rehabilitation complex and drug therapy, which served as a background in the main group and the comparison group.

RESULTS: Prior to the start of treatment, when analyzing the indicators of static and dynamic stabilometric studies, an uneven distribution of the load was established during tests with a preponderance towards the healthy leg. After a course of treatment, patients of all groups showed statistically significant positive results, however, a more pronounced improvement in indicators was observed in patients of the main group, less pronounced, but statistically significant results were obtained in the comparison group, and insignificant positive dynamics was noted in patients of the control group. When studying the quality of life and the effectiveness of treatment according to the EQ-5D questionnaire in the examined patients in the initial state, the indicator averaged 6.6±0.8 points. After the course of treatment, patients of the main group showed a statistically significant decrease in the scores of the EQ-5D questionnaire from 6.7±0.9 points in the initial state to 4.2±0.9 (p <0.001), which lasted up to 6 months. In patients of the comparison group, in all periods of observation, a decrease in the indicator was also noted, but less pronounced, in patients of the control group ― only a positive trend. The findings were supported by the results of the Hospital Anxiety and Depression Scale (HADS).

CONCLUSION: The use of a comprehensive rehabilitation program with the inclusion of a stabilometric platform with biofeedback and polarized light "Bioptron" contributes to a marked improvement in the state of balance, balance and coordination abilities of patients, normalization of muscle tone, a significant reduction in anxiety and depression and can significantly improve the quality of life of patients with endoprostheses in the late recovery period.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):331-337
pages 331-337 views


Medical rehabilitation of complications after injections of lipolytics

Ikonnikova E.V., Manturova N.E., Kruglova L.S.


Lipolytic injections are widely used in cosmetology practice. In most cases, they are used to correct the contours of the body, as well as to reduce the amount of fat deposits in the submental area. Side effects after their use are rare and, as a rule, resolve themselves. However, in the case of the use of non-certified medications, the frequency and severity of complications increase sharply, which requires timely and highly qualified therapy.

The article presents overview data concerning the mechanism of action of the main types of lipolytics and their classification, indications and contraindications to lipolytic therapy, reveals the problems of complications that have developed as a result of their use. A description of a clinical case of the development of an inflammatory reaction after injection of a low-quality lipolytic in the area of paint fat bags is presented. The tactics of her therapy are described. This clinical case demonstrates the importance of using certified products, compliance with injection techniques and the correct choice of the patient for this method of cosmetic therapy.

The article is of interest to a wide range of specialists (cosmetologists, dermatovenerologists, plastic surgeons, physiotherapists).

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):339-348
pages 339-348 views

Laser and phototherapy of rosacea

Matushevskaya Y.I.


Rosacea is a non-infectious dermatological disease of middle age, requiring long-term and often lifelong treatment. The onset of the disease begins with minor clinical manifestations such as centrofacial transient erythema or conjunctivitis, which patients often do not consider as a need to consult a doctor.

Early therapy prevents the chronization of the process and the development of severe forms, which include papulo-pustular rosacea, ophthalmosacea and phymes.

One of the methods of rosacea treatment is physiotherapy, which includes laser light, cryotherapy, darsonvalization, electrophoresis, electrocoagulation, pulse therapy, inductothermy, phototherapy of vascular pathology, and others.

This review presents the main mechanisms of laser light action on human skin and systematizes recent data on its use in various forms of rosacea.

Despite the moderate success of laser therapy, further research will help to choose more effective treatment protocols for rosacea. The appearance of the first signs of vasodilation in the facial area, especially in people with a family history of rosacea, frequent eye diseases or the presence of fim, requires contacting a dermatologist.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):349-358
pages 349-358 views

Plasma medicine: Prospects and experience of application of low-temperature argon plasma in medical rehabilitation

Kozyreva V.O.


Plasma medicine is a dynamically developing field of science based on the physical and chemical properties of air-plasma flows.

Low-temperature plasma is a partially ionized gas with a temperature of about 40ºC, the synergistic interaction of its active substances is a successful method of sterilization, decontamination of wound surfaces, treatment of surgical and burn wounds. Due to the combined action, over the past decades, low-temperature plasma has proven itself in purulent surgery, dermatology, and dentistry, but in addition, it has opened up great prospects in oncology. Possessing the effects of inhibiting inflammatory processes, stimulating regeneration processes, improving microcirculation and tissue metabolism, plasma flows are also used in medical rehabilitation.

The review considers the possibilities of using low-temperature plasma in various fields of medicine, as well as the effect of plasma flows on basic cellular processes and various forms of cell death. The experience of using low-temperature argon plasma in the complex rehabilitation of patients with malignant neoplasms is presented.

Literature sources from Russian and foreign databases (Elibrary, PubMed) on the topic of low-temperature plasma application in medical practice were analyzed. The analysis showed that plasma medicine is a rapidly developing modern direction, opening up new opportunities in healthcare.

Further studies of plasma streams are needed to unlock their full therapeutic potential and fully understand the mechanisms of action.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):359-367
pages 359-367 views

Variable electromagnetic fields in physiotherapy of diseases of the musculoskeletal system

Byalovsky Y.Y., Ivanov A.V., Rakitina I.S.


Increasing evidence suggests that the exogenous electromagnetic field may be involved in many biological processes of great importance for therapeutic interventions.

It is known that variable electromagnetic fields are a non-invasive, safe and effective therapeutic tool without obvious side effects. Numerous studies have shown that variable electromagnetic fields can become an independent or additional method of treating diseases of the musculoskeletal system. However, several questions remain unresolved. Prior to their widespread clinical application, further research is needed based on well-designed, high-quality studies to standardize treatment parameters and develop an optimal protocol for healthcare decision making.

In this review, we aimed to provide up-to-date data on the mechanism of action, clinical application, and controversy regarding variable electromagnetic fields in the physiotherapy of musculoskeletal disorders.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2022;21(5):369-388
pages 369-388 views

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