Vol 24, No 1 (2025)

BACKGROUND: Instrumental gait analysis (IGA) provides an objective and quantitative assessment of characteristic human movement patterns.

AIM: To analyze quantitative IGA parameters using inertial sensors in children with psoriatic arthritis (PsA) to identify early diagnostic markers and assess their potential application in evaluating the effectiveness of medical rehabilitation methods.

MATERIALS AND METHODS: The study included 34 children aged 11 to 17 years. The study group consisted of 17 children diagnosed with psoriasis and PsA (n=17). The control group included 17 children with conditions unrelated to significant neurological disorders or musculoskeletal abnormalities that could affect gait biomechanics (n=17). Gait parameters were recorded using the Stedis trainer, which utilizes eight biometric sensors placed on the lower extremities — on the feet, lower third of the shins, upper third of the thighs, sacrum, and at the level of the 12^th thoracic vertebra. Spatiotemporal and kinematic gait parameters were analyzed.

RESULTS: A comparative analysis was conducted between the two groups: the control group (children without significant neurological or musculoskeletal abnormalities affecting gait biomechanics) and the PsA group. Children with PsA demonstrated an increased stance phase duration and single-limb support time on the affected lower limb compared to the control group. The swing phase duration of the affected limb was reduced by approximately 1.5% compared to the healthy limb. The foot-lift height of the affected limb was found to be 5 cm higher than that of the healthy limb. Compared with the control group, single-limb support time for the healthy leg in control group children was nearly 4% higher than in children with PsA. The differences were statistically significant (р=0.009). The swing phase duration for the affected lower limb in children with PsA was 2.3% higher than in the control group. The differences were statistically significant (р=0.019). The overall swing phase duration was nearly 4% higher in the control group (р=0.019), with statistically significant differences. The differences were statistically significant (р=0.019).

CONCLUSION: The development of a gait pattern characteristic of PsA is determined by own mechanisms distinct from those in other types of arthritis.

BACKGROUND: Chronic subluxation of the first cervical vertebra (atlas) is a condition that remains insufficiently studied both in terms of diagnostic criteria and clinical outcomes of therapeutic interventions.

AIM: To evaluate the radiological and clinical outcomes of indirect instrumental correction of the C1 vertebra position using the Atlas-Standard protocol in patients with chronic pain syndrome.

Materials and METHODS: A single-center prospective study, AtlaStandard (ClinicalTrials.gov ID: NCT05986656), was conducted. Patients with chronic subluxation of the first cervical vertebra and lateral atlanto-dental interval asymmetry of ≥1 mm in at least one radiographic projection were consecutively enrolled. Indirect instrumental correction of the atlas position was performed using the Atlas-Standard technique with the ATLASPROF device. Follow-up radiography was scheduled one month after the intervention. Additionally, at six months, patients underwent a follow-up examination, physical assessment, survey, questionnaire-based evaluation, and spinal inclinometry.

RESULTS: The study included 46 participants — 14 men (30.4%) and 32 women (69.6%) — with a median age of 42 years (33; 49.8). After the intervention, a statistically significant reduction in lateral atlanto-dental interval asymmetry was observed in the anterior open-mouth projection and the posterior Fuchs projection, along with a decrease in the atlas tilt angle (p <٠.٠٥). Additionally, there was a significant reduction in the median tension headache intensity (measured by a numerical rating scale) and median pain levels across all spinal regions — cervical, thoracic, lumbar, and sacral (p <0.05). The use of analgesics decreased (p <0.001), functional disability scores on the Oswestry Disability Index 2.1a improved (p <0.05), and the vertical spinal axis deviation angle normalized in both the sagittal and frontal planes (p <0.05). No serious adverse events were recorded.

CONCLUSION: The Atlas-Standard technique using the ATLASPROF device enables indirect correction of the first cervical vertebra position in cases of chronic subluxation, as confirmed by radiographic data, with effects observed for at least one month post-procedure. Moreover, six months after treatment, this method demonstrates positive clinical outcomes, including reduced tension headache intensity, decreased pain in all spinal regions, reduced analgesic use, improved functional disability score, and normalization of spinal axis deviation angles.

AIM: To analyze the mechanisms and effectiveness of a rehabilitation program combining psychocorrection and transcutaneous electrical stimulation in individuals with post-stress disorders engaged in high-risk professions.

MATERIALS AND METHODS: The study included 120 men with repeated participation in combat operations, demonstrating high levels of stress. Within this group, two categories were identified (each comprising 60 individuals): active-duty personnel and veterans, further subdivided by age into those under 40 and those over 50 years old. The majority of men, particularly those in the older age group, exhibited the development of neuropsychiatric and somatic disorders of varying severity, with cardiovascular conditions being the most prevalent. Psychological and electrophysiological assessments supplemented the overall evaluation of participants’ health status. The practical aspect of the study initially compared the effectiveness of two types of psychorelaxation—autogenic training and breathing exercises—followed by an additional phase incorporating transcutaneous electrical stimulation.

RESULTS: The assessment of psychocorrection therapy demonstrated its greater effectiveness in middle-aged individuals. The achieved results were largely independent of the chosen psychological intervention method; however, in the older age group, breathing training proved to be more effective. Additionally, while psychorelaxation had a positive impact on the somatic health of middle-aged individuals, it was insufficiently effective for the older group. Given this, breathing training was supplemented with transcutaneous electrical stimulation, which significantly enhanced treatment outcomes.

CONCLUSION: This study confirms the effectiveness of the proposed rehabilitation program and underscores the potential for implementing new health restoration programs for socially significant populations.