Vol 20, No 4 (2021)

BACKGROUND: In the arsenal of a physiotherapist, there are many methods of non-drug rehabilitation. As contraindications to their use, spinal neoplasms, benign formations with a tendency to growth are indicated, among other things. At the same time, there is no data in the literature on contraindications to physiotherapy in the presence of non-aggressive vertebral hemangioma. As well as there are no scientific studies with a proven absence of a negative effect on the course of this tumor.

AIMS: scientific substantiation of the use of physical methods of treatment of patients with degenerative-dystrophic diseases of the spine in the presence of non-aggressive vertebral hemangioma.

MATERIAL AND METHODS: The study involved 154 patients with degenerative-dystrophic diseases of the spine and non-aggressive vertebral hemangioma. 94 patients were analyzed retrospectively, 60 took part in a prospective study. The following methods of physical therapy were used in the treatment of all patients: magnetotherapy, electrotherapy, physical therapy and massage. All patients underwent computer or magnetic resonance imaging of the spine before the start of treatment and 1 year after the end of treatment with an assessment of the presence or absence of hemangioma growth in dynamics.

RESULTS: In 94 patients with degenerative-dystrophic diseases of the spine in combination with non-aggressive vertebral hemangioma, who received various methods of physiotherapy, a different proportion of cases of increase in the size of vertebral hemangioma was noted upon repeated examination after 1 year. At the same time, in no case did the vertebral hemangioma acquire signs of aggressiveness. The minimum frequency of increasing the size of vertebral hemangioma was noted in patients after magnetic therapy, therapeutic gymnastics and massage. As a result of the use of magnetotherapy, electrotherapy, therapeutic gymnastics and massage in 60 patients, the growth of vertebral hemangioma was detected only in 1 case.

CONCLUSION: In patients with degenerative-dystrophic diseases of the spine, local low-frequency electrotherapy, magnetic therapy, physical therapy and therapeutic back massage did not significantly affect the frequency of cases of increase in the size of vertebral hemangioma. The possibility of using other methods of physiotherapy in the treatment of patients with degenerative-dystrophic processes of the spine in the presence of non-aggressive vertebral hemangioma requires further research.

BACKGROUND: Long-term experience of clinical use of isotretinoin for acne indicates that it has a good safety and efficacy profile; however, against the background of taking standard doses of isotretinoin, pronounced adverse events that are dose-dependent are noted. Therefore, the search for new combined treatment regimens that reduce the dose of isotretinoin is an urgent task.

AIMS: The aim of our work was to evaluate the effectiveness of a combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin (0.1–0.3 mg/kg of body weight per day) compared with monotherapy with standard doses of isotretinoin (0.5–1 mg/kg of body weight per day) in patients with acne.

MATERIAL AND METHODS: During the study, the dermatological status of patients was assessed taking into account the dermatological index GSS (Global Severity Scog), dermatological acne index (DIA), IGA scale (Investigator's Global Assessment). For a comparative analysis of the impact of various techniques on the quality of life, a high-valid quality of life index (HQIQ) was used. Dermatological status and quality of life were assessed in patients before and after 6 months of therapy. 12 months after the end of therapy, patients were invited to the clinic to identify delayed relapses.

RESULTS: Evaluating the overall results of treatment of patients with moderate severity of acne by isotretinone monotherapy and combination therapy with low doses of isotretinoin and broadband incoherent light, the effectiveness of both methods can be noted, however, according to the global severity scale (GSS), clinical remission was significantly more often observed in the combination therapy group compared with the motor therapy group (88 and 74%, respectively, p <0.05). In addition, no relapses were detected after 12 months in the combination therapy group, and adverse events caused by the use of isotretionine were also less frequent.

CONCLUSION: Thus, the combination therapy of acne with low doses of isotretinoin and broadband incoherent light is more effective.

BACKGROUND: Various methods of physical therapy have been proposed for the rehabilitation of patients with breast cancer. However, a staged approach to prescribing physiotherapeutic factors in the early period after surgical treatment of breast cancer has not been developed enough.

AIMS: to develop a staged approach to the appointment of physiotherapeutic factors at different times after surgical treatment of breast cancer.

MATERIALS AND METHODS: Examination and treatment of 64 patients aged 30 to 70 years after surgical treatment for breast cancer were carried out. All patients underwent medical rehabilitation: individual exercise therapy, balanstherapy, sessions with a medical psychologist, course exposure to an alternating low-frequency electrostatic field and general magnetotherapy. The main group consisted of 33 patients who underwent a 2-stage course of medical rehabilitation: the 1st course on days 2–4 after the operation and the 2nd course after 1–1.5 months against the background of adjuvant radiation therapy. The control group — 31 women, underwent physiotherapy placebo procedures.

RESULTS: I was found that two-stage physical rehabilitation improves the quality of life, reduces swelling, increases the range of motion, decreases pain, decreases the number of postoperative complications, and shortens the duration of lymphorrhea.

CONCLUSION: The inclusion of exposure to an alternating low-frequency electrostatic field and general magnetotherapy in the early stages (2–4 days) and 1–1.5 months after surgical treatment has broad functionality and allows you to obtain a pronounced functional and stable clinical result.

BACKGROUND: In recent decades, a steady increase in the prevalence of autism spectrum disorders around the world has been reported. It is known that autism spectrum disorders requires early diagnosis and medical intervention. By identifying the risks of autism spectrum disorders, doctors can help the child and family get qualified help as soon as possible. Given the variety of functional disorders in autism spectrum disorders, these patients require special rehabilitation programs and therefore physicians planning work in the field of physical therapy and medical rehabilitation should be oriented in this problem.

AIMS: To determine the level of awareness of the problem of autism spectrum disorders among doctors of different specialties planning to work in the field of physical and rehabilitation medicine.

MATERIAL AND METHODS: A survey was conducted on the KCAHW questionnaire of 105 doctors of 8 medical specialties who underwent primary retraining in the cycle "Physical and Rehabilitation Medicine" at the Department of Physical Therapy, Sports Medicine and Medical Rehabilitation of the Russian Medical Academy of Continuous Professional Education.

RESULTS: According to the results of filling out the KCAHW questionnaire, the median of correct answers was 14 [7; 19] out of 19 possible, which is the average value of the level of knowledge about autism spectrum disorders. Our research shows that there is a lack of knowledge in the relationship between autism and epilepsy and mental retardation, as well as the relationship between the disease and poor nutrition. Among the respondents, there was also a misunderstanding about the age of the child at which the first signs of autism spectrum disorders can be suspected: 60 (57.1%) of the survey participants correctly determined that autism begins in childhood, 35 (33.3%) of the surveyed doctors believed that autism occurs in infancy, and 10 (9.5%) people indicated the neonatal period.

CONCLUSION: The KCAHW questionnaire is a reliable tool for assessing health care providers' knowledge of childhood autism. The conducted research allows us to conclude that doctors are not sufficiently knowledgeable in the field of knowledge about autism spectrum disorders. The totality of all the respondents' answers indicates the importance of additional information about modern research on the problem of autism spectrum disorders for all doctors planning further work in the field of physical and rehabilitation medicine.

Spinal muscular atrophy is a significant medical and social problem and is one of the most common causes of child mortality caused by inherited neuromuscular diseases. The scientific review focuses on etiology, clinical features, as well as approaches in the rehabilitation and orthopedic treatment of patients with spinal muscular atrophy.

AIM: analysis of world literature on aspects of etiology, pathogenesis, clinical manifestations, approaches in rehabilitation and orthopedic treatment of patients with spinal muscular atrophy.

Search for literary sources in open electronic databases PubMed and eLIBRARY for the entire period available in these databases.

Spinal muscular atrophy is a heterogeneous group of hereditary diseases occurring with damage to the motor neurons of the anterior horns of the spinal cord. With predominant clinical signs in the form of muscle weakness, mainly in the lower extremities. Rehabilitation and orthopedic treatment should be carried out with a focus on the musculoskeletal system and related functional disorders

Analysis of various literary sources shows a rapid increase in the number of publications on spinal muscular atrophy, but a large layer of aspects remains that require clarification and more detailed study. A more detailed study of etiological factors, pathogenesis and clinical features of spinal muscular atrophy will allow a more extensive look at the problems of this disease in order to better understand the possible methods of diagnosis and treatment of patients with this pathology.

A sharp increase in life expectancy over the past century has led to a significant increase in demand for long-term medical and social care.

With aging, the reactivity of the body to the effects of the external environment changes, in particular, a decrease in resistance to pathogenic factors. Older people have chronic diseases (cardiovascular system, respiratory and digestive organs, central nervous system, joints, organs of vision and hearing, as well as diabetes, oncological diseases, etc.) that reduce physical and social activity.

Vascular diseases of the brain remain one of the most acute medical and social problems that cause enormous damage to society. A special place among them is occupied by cerebral stroke due to the high mortality rate, significant disability and social maladaptation of elderly patients. According to modern data, at least 1/3 of stroke patients develop motor function disorders on average. These disorders significantly worsen the daily functioning of the quality of life.

The aim of rehabilitation of elderly patients who have suffered a stroke is to return the patient to active social and household activities, create optimal conditions for his active participation in society and, ultimately, improve the quality of life of both the patient and his relatives. The task of psychological and physical recovery, social and labor adaptation of post-stroke patients is most successfully solved in the system of complex multidisciplinary rehabilitation. The lack of timely restorative treatment leads to irreversible anatomical and functional changes and a violation of the psychoemotional status of a person.

Evidence has been provided that physical rehabilitation measures for elderly patients can significantly improve the indicators of physical, mental and social functioning without increasing the risk of undesirable effects. Successful and safe interventions have made it possible to achieve the goal of rehabilitation, increasing the functional status of elderly patients and independence in everyday life, as well as reducing the burden of the disease for both the individual and his family and society as a whole.