


Vol 23, No 6 (2024)
Original studies
Application of combined pharmaco-physiotherapy to relief clinical symptomatics and improve quality of life in patients with dry eye syndrome
Abstract
Aim: To evaluate the effects of a therapeutic regimen incorporating magnetophoresis with Argensept and tear replacement therapy on patient complaints, clinical symptoms, and quality of life in individuals with mild to moderate dry eye syndrome (DES).
Materials and methods: The study included 50 individuals (100 eyes) diagnosed with mild to moderate DES (H04.1 according to the International Classification of Diseases, 10th revision). The average patient age was 43.3 years. Participants were divided into two groups. The first group (comparison group) comprised 25 patients (50 eyes) who received a therapeutic regimen consisting of magnetophoresis with Argensept and tear replacement therapy. The second group (control group) included 25 patients (50 eyes) who received only tear replacement therapy. Additionally, data from 20 healthy individuals (40 eyes) were used as a reference for normal values. All participants underwent Schirmer’s test and completed the OSDI (Ocular Surface Disease Index) questionnaire before and after treatment.
Results: Following treatment, the group receiving the combined therapy of magnetophoresis with Argensept and tear replacement therapy demonstrated a significant reduction in the frequency of complaints and clinical symptoms. Additionally, highly significant improvements were observed in Schirmer’s test scores and OSDI questionnaire results in patients with both mild and moderate DES.
Conclusion: The application of a therapeutic regimen that includes magnetophoresis with Argensept and tear replacement therapy significantly reduces complaints, improves subjective well-being, and enhances the quality of life in patients with mild to moderate DES. These findings are supported by improvements in Schirmer’s test scores and OSDI questionnaire responses.



Application of therapeutic physical factors in the therapy of psoriatic onychodystrophy
Abstract
Background: One of the common clinical manifestations of psoriasis is nail plate damage, leading to psoriatic onychodystrophy (PОD). PОD is often accompanied by severe pain syndrome, causing difficulties in wearing shoes or socks and performing daily household tasks, which leads to a decrease in quality of life and contributes to the development of anxiety and depression. Studies on PОD treatment have demonstrated the effectiveness of non-pharmacological approaches, particularly pulsed dye laser (PDL) therapy and medium-frequency pulsed currents (Darsonval therapy), which promote regression of clinical symptoms.
Aim: To assess the clinical efficacy of a comprehensive treatment approach incorporating PDL and Darsonval therapy in patients with psoriatic onychodystrophy.
Materials and methods: A prospective, controlled, randomized study was conducted, including 110 patients with PОD, who were randomly assigned to four groups using simple fixed randomization. Group 1 (Control, n=27): received only basic therapy (BT) consisting of topical application of calcipotriol ointment. Group 2 (Comparison Group 1, n=28): received three courses of Darsonval therapy in addition to BT Group 3 (Comparison Group 2, n=28): received 5–6 sessions of PDL therapy, performed at one-month intervals, in addition to BT. Group 4 (Main Study Group, n=27): received both Darsonval therapy and PDL therapy in combination with BT. The clinical assessment included the frequency of nail matrix and nail bed lesions, as well as the Nail Psoriasis Severity Index (NAPSI) and the Dermatology Life Quality Index (DLQI)scores.
Results: NAPSI assessment revealed widespread involvement of the nail bed and matrix among patients. The initial DLQI score was 23.6 points, indicating a significant negative impact of nail disease on patients’ daily lives. All treatment groups demonstrated clinical improvement, but the extent of symptom regression depended on the treatment regimen. Additional therapeutic physical factors further enhanced effectiveness, with the combined use of Darsonval therapy and PDL therapy producing the best clinical outcomes.
Conclusion: Incorporating physical therapy modalities into the standard treatment regimen for psoriatic onychodystrophy significantly improves clinical effectiveness. The combined application of pulsed dye laser and Darsonval therapy achieves the greatest regression of clinical manifestations and substantial improvements in patients’ quality of life.



Rehabilitation treatment of female patients after uterine endoscopic surgery for infertility using complex physio- and hydrogen sulfide balneotherapy
Abstract
Aim: To evaluate the effectiveness of combined physiotherapy and hydrogen sulfide balneotherapy in patients who underwent endoscopic surgery on the fallopian tubes for tubal and uterine infertility.
Materials and methods: A total of 104 patients who had undergone endoscopic surgery on the fallopian tubes for tubal and uterine infertility were observed. Using simple randomization, the study population was divided into three groups. The control group (34 patients) received standard postoperative therapy, including conventional antibiotic treatment. The second group (32 patients) received a combination of pharmacotherapy, electro-magnetolaser therapy, and an anti-adhesion resorbable gel Mesogel (Russia). The main group (38 patients) underwent delayed rehabilitative treatment with hydrogen sulfide water therapy following combined pharmacological and electro-magnetolaser therapy. Patients were evaluated using standard clinical assessment methods, including clinical and immunological parameters, hysterosalpingography, pelvic ultrasound, and quality-of-life assessment.
Results: The study assessed the restoration of reproductive function in women through physiotherapeutic and natural local treatments. The main group demonstrated significant alleviation of clinical symptoms (p <0.01), improvement in immune status parameters (p <0.05), restoration of fallopian tube patency (p < 0.05), and improved pelvic organs condition. A clinically significant difference in final outcomes was observed between the main and control groups (p <0.05). The high therapeutic efficacy of the proposed rehabilitative treatment was confirmed, with pregnancy achieved in 48% of cases.
Conclusion: The obtained results suggest that the proposed rehabilitation method for patients after endoscopic surgery on the fallopian tubes for tubal and uterine infertility significantly enhances the effectiveness of standard therapy and leads to a substantial improvement in reproductive function.



The role of pulsed electromagnetic therapy after knee arthroplasty
Abstract
Background: Pulsed electromagnetic field therapy (PEMF) is included in current clinical guidelines for postoperative rehabilitation after knee arthroplasty. However, its indications remain limited, primarily for managing pain during the early mobilization of the operated joint.
Aim: To evaluate pain relief and clinical outcomes — including knee function, general health status, objective and subjective knee swelling assessment, nonsteroidal anti-inflammatory drug (NSAID) consumption, persistent pain, daily activity limitations, and complications — in patients undergoing unicompartmental knee arthroplasty (UKA) followed by PEMF therapy, compared with a control group receiving sham PEMF.
Materials and methods: This prospective, randomized, placebo-controlled study included 72 patients who underwent medial UKA. Participants were randomized into either a control group (sham PEMF) or a treatment group receiving PEMF therapy. Patients in the treatment group were advised to use PEMF for 20 minutes, four times daily, for 60 days. Evaluations were conducted preoperatively and at 1, 2, 6, 12, and 36 months postoperatively. The control group followed the same schedule using sham PEMF. Clinical assessments included the Visual Analog Scale (VAS) for pain, the Oxford Knee Score (OKS), the Short Form-36 (SF-36) health survey, a questionnaire on subjective knee swelling, and an objective measurement of knee circumference. NSAID consumption was recorded at each follow-up visit.
Results: VAS scores decreased in both groups over time, but statistically significant differences favoring the PEMF group were observed at 6 months (p=0.0143), 12 months (p=0.0004), and 36 months (p=0.0213). One month postoperatively, 73% of patients in the PEMF group and 91% in the control group used NSAIDs (p=0.0341). At 2 months, 14% of the PEMF group continued NSAID use, compared to 38% in the control group (p=0.0326). Objective knee circumference measurements showed statistically significant differences at 6 (p=0.0232), 12 (p=0.0016), and 36 months (p=0.0004), with better outcomes in the PEMF group. Subjective swelling assessment demonstrated statistically significant differences at 2 (p=0.0064), 6 (p=0.0005), 12 (p=0.00022), and 36 months (p=0.00031), again favoring the PEMF group. Finally, OKS scores were significantly higher in the PEMF group across all time points (1 month: p=0.0258; 2 months: p=0.0014; 6 months: p=0.0003; 12 months: p=0.0002; 36 months: p=0.0144).
Conclusion: PEMF therapy significantly reduced pain, improved clinical outcomes, and decreased NSAID consumption following medial UKA compared with the control group.



Modern trends in the organization of rehabilitation care for patients with dorsopathy in the form of telemedicine services
Abstract
Background: Vertebrogenic disorders are among the most common chronic diseases in humans, with degenerative-dystrophic changes in the spine being the most prevalent. Severe clinical manifestations of vertebrogenic diseases typically occur during active working years and are a frequent cause of temporary disability. A particularly important issue is the need for regular rehabilitation courses for patients with chronic dorsopathy to prolong remission. However, due to the working-age status of many patients, logistical and paramedical challenges — particularly in implementing therapeutic exercises — often hinder access to rehabilitation procedures. The development of remote rehabilitation using information and communication technologies, such as smartphones and computers, presents a viable alternative to in-person rehabilitation.
Aim: To assess the effectiveness and safety of motor rehabilitation using telemedicine in patients with dorsopathy of various localizations in remission.
Materials and methods: This retrospective study included 32 patients aged 35 to 70 years with dorsopathy of various localizations in remission who underwent rehabilitation via telemedicine. Upon completing an in-person comprehensive treatment course which included pharmacotherapy and medical rehabilitation, all patients were provided with a link to access a structured motor rehabilitation program. The effectiveness of rehabilitation was assessed using standardized questionnaires and mobility assessment tests.
Results: Telemedicine-based rehabilitation for patients with dorsopathy of various localizations in remission demonstrated positive clinical outcomes.
Conclusion: Specialized therapeutic exercise programs and a structured model for remote rehabilitation may serve as an effective alternative to in-person rehabilitation, particularly in cases where paramedical challenges hinder direct participation.


