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Vol 22, No 1 (2023)
Original studies
Informativity of the method of correlation adaptometry for assessing the severity of the corrective effect of combined use therapeutic physical factors on the example of metabolic syndrome
Abstract
BACKGROUND: Evaluation of the effectiveness of the use of therapeutic physical factors using the method of correlation adaptometry is based on the effect of increasing the number of severity of correlation dependencies between the parameters characterizing the functional state of the body under the action of a stressor.
AIM: Evaluation of the effectiveness of the combined use of transcranial magnetotherapy and a pulsed low-frequency electrostatic field in patients with metabolic syndrome using the method of correlation adaptometry.
MATERIALS AND METHODS: The study involved 100 patients with a diagnosis of metabolic syndrome established in accordance with clinical guidelines. All patients were divided into four groups of 25 by simple fixed randomization. Patients in the control group received a placebo effect (imitation of physiotherapeutic effects with the device turned off) for 10 days of observation, in comparison group 1 ― exposure to a low-frequency electrostatic field, in comparison group 2 ― transcranial magnetotherapy with a traveling magnetic field, in the main group ― exposure to a pulsed electrostatic field in combination with transcranial magnetotherapy. The objectification of the effects of physiotherapy (evaluation of functional, biochemical and hormonal parameters) was based on a two-stage examination (before and after a course of treatment).
RESULTS: Correlation adaptometry was based on the results of correlation analysis using a correlation matrix of variables characterizing the condition of patients after course correction. For each of the four groups of patients, 28 correlation coefficients were determined. For each group, 378 correlation coefficients were calculated, presented as the weight of the correlation graph. Additionally, the indicator of the average adaptive correlation was calculated. It is shown that the use of therapeutic physical factors is accompanied by a decrease in the weight of the correlation graph, which indicates the severity of the clinical effect due to the sanogenetic action of physiofactors. The most pronounced decrease was noted in the group of combined physiotherapy. Correlation analysis between the parameters of the average adaptive correlation and the integral coefficient of therapy efficiency showed that there is a strong, negative significant relationship between the HOMA insulin resistance index and the Quetelet index, chosen as the most informative variables.
CONCLUSION: It is concluded that the method of correlation adaptometry is highly informative in assessing the effectiveness of using a pulsed low-frequency electrostatic field, transcranial magnetotherapy and their combined effects in patients with metabolic syndrome. A decrease in the indicator of the average adaptive correlation indicates an increase in the functional reserves of the system, the patterns of which are changes in certain estimated parameters that are not related to each other.
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Influence of pulsed electromagnetic field on the course of intervertebral hernia of the cervical spine
Abstract
BACKGROUND: A herniated disc of the cervical spine is a common cause of neck pain that results from leakage of the nucleus pulposus from the annulus fibrosus and creating pressure on the spinal cord and nerve roots.
AIM: to study the effect of therapy with a pulsed electromagnetic field on pain, disability, psychological state and quality of life in intervertebral hernia of the cervical spine.
MATERIALS AND METHODS: Patients were randomly divided into two groups, including group 1, who received therapy consisting of transcutaneous electrical nerve stimulation, thermal procedures, and pulsed electromagnetic field, and group 2, who received a false magnetic field in addition to transcutaneous electrical nerve stimulation and thermal procedures. Pain was assessed using a visual analogue scale (VAS). Other outcome measures were pain and disability (Neck Pain and Disability Scale), anxiety-depression (Hospital Anxiety and Depression Scale), and quality of life (Nottingham Health Profile). All evaluations were performed before treatment, at week 3, and at week 12 post-treatment.
RESULTS: Significant improvements were found in scores for neck pain, disability, depression, anxiety, and quality of life in both groups after treatment compared with scores before treatment. However, when comparing changes within groups, significant improvements were only identified in VAS and Nottingham Health Profile sleep subparameters at week 12 post-treatment compared to pre-treatment.
CONCLUSION: Pulsed electromagnetic field therapy in intervertebral hernia of the cervical spine can be safely used in conservative treatment as part of combined physiotherapy.
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Ultraphonophoresis of an enzyme gel with direct proteolytic activity in patients with hypertrophic skin scars
Abstract
BACKGROUND: Correction and prevention of severe cicatricial deformities is a labor-intensive task for doctors of aesthetic and rehabilitation medicine. Often, as a result of skin scarring, the psychological status of the patient changes due to the presence of persistent subjective sensations or the location of defects in open, functionally active areas of the skin. The steady annual growth in trauma, the number of surgical interventions and invasive procedures actualizes the question of finding an optimal, effective and widely available method for preventing severe skin scarring or correcting fibrous deformities.
AIM: scientific and practical substantiation of the use of enzyme gel ultraphonophoresis with direct proteolytic activity in patients with hypertrophic skin scars.
MATERIALS AND METHODS: A prospective interventional cohort comparative study of the efficacy and safety of enzyme gel ultraphonophoresis with direct proteolytic activity in patients with hypertrophic skin scars was performed. The study included 42 patients with a diagnosis of "Hypertrophic scars" (ICD-10, L91) of postoperative or post-traumatic genesis, divided into observation and comparison groups with emerging (n=20) and mature (n=22) scars. In the course of the study, clinical, instrumental and medical and sociological research methods were used.
RESULTS: A pronounced positive dynamic of indicators of clinical and instrumental parameters of scar tissue was established, improvement of quality-of-life indicators was the most significant in patients of the observation group with developing scars. The expediency of using the enzyme gel ultraphonophoresis technique with direct proteolytic activity in patients with hypertrophic skin scars is confirmed by a combination of parameters: positive dynamics of the clinical status, functional properties of scar tissue and quality of life indicators, a high safety profile and patient satisfaction with treatment. The effectiveness of correction in patients with developing and mature hypertrophic scars was 83–87%.
CONCLUSION: The therapeutic and preventive technology of enzyme gel ultraphonophoresis with direct proteolytic activity is an effective and promising method for the correction and prevention of postoperative and post-traumatic cicatricial skin defects.
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Resource-saving peloidotherapy techniques in the rehabilitation of patients after microdiscectomy
Abstract
BACKGROUND: Intervertebral disc herniations are a common neurosurgical problem. However, there is practically no information about the effectiveness of using non-thermal gentle methods of peloid therapy using peat mud in patients after spinal surgery for disc herniations, about the indications for their use depending on the existing clinical and functional characteristics.
AIM: to develop and scientifically substantiate the use of resource-saving non-thermal peloidotherapy techniques in the rehabilitation of patients after spinal surgery for herniated discs.
MATERIALS AND METHODS: 74 patients aged 20 to 65 years were examined 4–9 weeks after microdiscectomy. Patients underwent clinical and functional examination before and after the rehabilitation course, pain intensity was determined using a visual analog scale (VAS). Functional activity was assessed using the "Get up and go" test (3 and 6 meters). Infrared thermography of the back and lower extremities was performed. The study used the Oswestry questionnaire, as well as the HADS Anxiety and Depression Scale. By simple randomization, all patients were divided into 2 main groups (25 people each) and a control group (24 people). The control group received basic treatment ― therapeutic gymnastics and massage of the lower limb on the affected side. In the I main group, 10 procedures of thin-layer mud applications were additionally prescribed. In the II main group, 10 procedures of fluctuophoresis of peat mud solution were prescribed for basic treatment. The rehabilitation course lasted 14–15 days.
RESULTS: Repeated examination after the course of treatment showed a significant decrease in the VAS index in both main groups, more significant in group II, whereas in the control group the changes were not significant. In all the studied groups, there was a reduction in the execution time of the "Get up and Go" test, but it was most significant in both main groups. Positive shifts on the Oswestry scale were also observed in all groups, including the control group, but some advantage was determined in the main groups receiving peloid therapy. Analysis of repeated results of remote infrared thermography revealed a decrease in local hyperthermia in the area of surgical intervention in persons receiving non-thermal peloid therapy techniques, the most significant in the II main group. Indicators of anxiety on the HADS scale decreased by the end of rehabilitation in all the studied groups, and subclinical manifestations of depression ― only in the I and II main groups.
CONCLUSION: The inclusion of non-thermal resource-saving peloidotherapy techniques in the rehabilitation complex of patients after microdiscectomy makes it possible to more effectively relieve pain syndrome, eliminate microhemodynamic disorders and increase the motor activity of patients, which contributes to the normalization of their psychoemotional state and the quality of their life. These methods are not load-bearing, have a minimum number of contraindications to the appointment, does not require significant material costs and can be applied in various medical organizations.
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Long-term results of complex medical rehabilitation of patients after reconstruction of the anterior cruciate ligament performed at different times after injury
Abstract
BACKGROUND: Despite the overall success of arthroscopic anterior cruciate ligament reconstruction, the scientific literature contains studies reporting high recurrence rates (up to 30%), often accompanied by other lesions such as meniscal tears and cartilage damage. The main reasons for this development of events are considered: repeated injury of the anterior cruciate ligament, possible technical errors during surgery, as well as the timing of reconstructive operations after injury.
AIM: Assessment of long-term (after 1 year) results of complex medical rehabilitation of patients after reconstruction of the anterior cruciate ligament, performed at different times after injury.
MATERIALS AND METHODS: The study involved 175 patients aged 18–55 years with an isolated rupture of the anterior cruciate ligament of the knee joint, who underwent rehabilitation measures after arthroscopic reconstruction of the anterior cruciate ligament. Using the stratification method, all patients were divided into two groups depending on the time of arthroscopic reconstruction of the anterior cruciate ligament. In the group with early reconstruction (88 patients), anterior cruciate ligament reconstruction was performed early after the injury, from the 2nd to the 6th week inclusive. Patients of the second group (delayed reconstruction of the anterior cruciate ligament, 87 patients) were operated on late after the injury from the 7th week to 1 year. Each of these stratification groups was divided into two groups using a simple fixed randomization method: control (with a basic rehabilitation complex) and main (with the additional inclusion of high-frequency magnetic therapy and hydrocortisone ultraphonophoresis). The basis of the follow-up study was the results of questionnaires for subjective assessment of the functional state of joints, as well as an assessment of the level of quality of life of patients obtained using MOS SF-36.
RESULTS: A comparative comparison of long-term results obtained in groups where arthroscopic reconstruction of the anterior cruciate ligament was performed early after injury made it possible to establish the advantage of the proposed complex of medical rehabilitation based on high-frequency magnetic therapy and hydrocortisone ultraphonophoresis. This was manifested by a significantly low level of pain according to visual analog scale and a statistically significant excess on scales of subjective assessment of the functional state of the knee joint.
CONCLUSION: The obtained results of positive dynamics of the condition of the knee joint of patients 1 year after reconstruction of the anterior cruciate ligament and rehabilitation indicate the restoration of stability and kinematics of the knee joint. However, comparison of the results obtained between the main groups with different periods of reconstruction of the anterior cruciate ligament made it possible to establish that the assessed parameters differed favorably in patients with early reconstruction of the anterior cruciate ligament.
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Review
Treatment of patients with erectile dysfunction by physiotherapy. Literature review
Abstract
Erectile dysfunction is one of the most frequent sexual disorders in men and is found in 10-52% of men in the general population.
The disease is polyetiological, involving psychogenic, vascular, neurological, urological, and endocrine mechanisms.
The relevance of this problem lies in the high damage to the mental health of the patient, leading to a deterioration in his quality of life. In addition, drug therapy with the use of type 5 phosphodiesterase inhibitors is accompanied by headaches, skin flushing, heartburn, nasal congestion and dizziness, visual impairment, and muscle pain. In this regard, it became necessary to use physiotherapeutic methods of treatment to restore erectile function with minimal side effects.
This review also presents pathogenetic substantiated basic physiotherapeutic methods for treating patients with erectile dysfunction using pelvic floor muscle training, aerobic sports exercises, transcutaneous electrical nerve stimulation, manual therapy and mechanical vibration therapy.
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The use of aromatherapy in pediatric practice
Abstract
Aromatherapy is a method of treatment using natural essential oils injected into the body through the respiratory tract, skin and (or) mucous membranes. Currently, about 3,000 essential oil plants have been studied, from which over 500 organic compounds have been isolated and identified, the number of which in the composition of one essential oil can vary from 120 to 500, and no essential oil has yet been fully investigated.
Essential oils are multicomponent organic compounds of terpenes, alcohols, aldehydes, ketones and other hydrocarbons produced by essential oil plants. Biologically active substances of essential oils have a low molecular weight and therefore easily penetrate the skin through the bloodstream. The effect exerted on a person by essential oils is determined in two ways ― neuro-reflex and humoral. Each essential oil is multifunctional. The composition of essential oils can include up to 300 components, so they can have several medicinal properties at the same time, but there is a general trend in the action of essential oils. All of them have immunomodulatory, pronounced bactericidal and antiseptic effects, antiviral and anti-inflammatory properties.
In medical practice, the method of hardware aromatherapy is used, the active factor of which is a therapeutic respiratory environment that simulates the natural air background over plants. The study of the effect of essential oils in children's institutions showed their positive effect on the general condition of children, emotional tone, immunological reactivity and nonspecific protection factors, the frequency and severity of respiratory pathology, the course of the adaptation period. The beneficial effect of the complex effect of aromatherapy in the sensory room is shown.
Thus, the high efficiency of hardware aromatherapy, good tolerability, the availability of domestic equipment allows us to recommend the method for wide use in therapeutic and preventive and sanatorium-resort institutions.
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