Vol 19, No 3 (2020)

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Full Issue

Original studies
Photodynamic therapy for correction of involutive facial skin changes
Surkichin S.I., Bochkova N.V., Kholupova L.S.

Background. The appearance of the skin is of high social importance, largely determining the behavior and self-confidence of a person. The relevance of methods for the correction of involutive skin changes is growing every year. One modern treatment for photodamaged skin is photodynamic therapy.

Objective: the study evaluated the effectiveness of photodynamic therapy using chlorin E6 as a photosensitizer for the correction of involutive changes in the skin of the face compared to using only light exposure.

Methods. The study involved patients aged 40−60 years with signs of involutive changes in the skin of the face. In group 1 (n = 36), patients underwent therapy using only light coherent radiation. In group 2 (n = 35), patients underwent PDT using light coherent radiation.

Results. According to the results of elastometry, corneometry, assessment of transepidermal water loss, ultrasound examination of the skin in group 2, more positive indicators were obtained than in group 1. When assessing safety, the results in groups 1 and 2 are comparable.

Conclusions. The method of photodynamic therapy using chlorin E6 can be recommended for course use in wide clinical practice.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):140-144
A method of treating complications after contour plasty with preparations based on stabilized hyaluronic acid in the nasolacrimal sulcus region
Aksenenko I.P., Gerasimenko M.Y.

Background. In order to correct involutive changes in the skin or aesthetic defects, fillers based on stabilized hyaluronic acid, which are used to fill in various wrinkles and creases, have recently become most popular. It is the procedure of contouring that is one of the three most popular cosmetic procedures.

Objective: to study the effectiveness of a combined method that includes a course of longidase diadinamophoresis and injectable carboxytherapy in correcting complications of contouring the nasolacrimal sulcus area with fillers based on stabilized hyaluronic acid.

Methods. There were 29 women under observation, average age 36.4 ± 4.4 years with complications after the introduction of a filler based on stabilized hyaluronic acid with localization in the nasolacrimal sulcus. There were 3 groups of patients who received a course of longidase diadinamophoresis (3000 IU), a course of carboxytherapy, or a combination of them.

Results. The use of a combined course of longidase diadinamophoresis (3000 IU) and carboxytherapy has a significant effect, reducing the clinical manifestations in the form of contouring and compaction, local edema and neuropathy, and stabilizing the psychoemotional state of patients. In addition, the treatment complex significantly accelerates the biodegradation of the filler and has a restructuring effect on the skin of the nasolacrimal furrow-reduces the thickness of the dermis and increases the dermis density coefficient, which is probably due to the regression of intra-dermal edema that occurs as a reaction to a superficially introduced filler based on stabilized hyaluronic acid.

Conclusion. The combined use of the method, which includes a course of longidase diadinamophoresis and injectable carboxytherapy for the correction of complications of nasolacrimal sulcus contouring with fillers based on stabilized hyaluronic acid in the form of local edema, neuropathy and filler contouring, is a highly effective treatment method, which is confirmed by the relief of clinical symptoms, acceleration of drug biodegradation and improvement of the quality of life of patients.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):145-151
The evaluation of functional abilities of patients with osteoporotic vertebral fractures as a basis for rehabilitation programs developing
Marchenkova L.A., Makarova E.V., Eryomushkin M.A., Герасименко M.Y., Styazkina E.M., Chesnikova E.I.

Background. Due to the demand for special rehabilitation programs for patients with osteoporotic vertebral fractures (VFs), it is of interest to study the functional abilities of those patients. The scientific hypothesis suggests that osteoporotic VFs would cause muscle weakness, muscle dysfunction and conditional (basic motor) disturbances.

Objective: to estimate muscle strength, motor function and coordination disorders in patients with VFs in the setting of systemic osteoporosis as a basis for rehabilitation programs developing.

Methods. 120 patients aged 43−80 with primary osteoporosis were enrolled. Study group comprised of 60 subjects (56 women, 4 men) with at least 1 VF confirmed by X-ray. Control group included 60 subjects (56 women, 4 men) with osteoporosis but without any osteoporotic fracture. The examination program consist of back muscles tenzodynamometry, balance tests and stabilometry.

Results. Muscle strength deficiency was estimated in study group in trunk flexors (TF) — 40.9% and in trunk extensors (TE) — 18.1% with an adequate function of the left lateral flexors (LLF) and in right lateral flexors (RLF). Patients with VFs had the lower muscle strength vs controls of TE (15.64 ± 9.8 vs 27.73 ± 9.9 kg, p = 0.00002), TF (14.61 ± 8.98 vs 21.28 ± 8.38 kg, p = 0.0006), LLF (13.10 ± 7.2 vs 24.06 ± 8.9 kg, p = 0.005) and RLF 13.44 ± 7.43 vs 24.26 ± 7.65 kg, p = 0.0003). Patients with VFs lose their balance faster during one-leg-standing test with open eyes (5.0 [1.0; 10.0] vs 7.5 [5.0; 10.5] sec in control group, p = 0.03) and with closed eyes (2.0 [0; 3.0] vs 3.5 [3.0; 5.0] sec, p = 0.04). Fukuda-Unterberger test showed greater side dislocation in study group — 40º [25; 45] vs controls 30º [10; 45], (p = 0.02). According to stabilometry study group was characterized vs control group by lower balance coefficient with open eyes (77.2 ± 7.6 vs 85.7 ± 9.4%, p = 0.002) and with closed eyes (67.1 ± 9.8 vs 73.4 ± 9.9%, p = 0.03), greater sagittal displacement (6.8 [2.1; 37.7] vs 4.8 [1.8; 10.7] mm, p = 0.025) and deviation in the saggital plane (1.2 [-1.07; 1.5] vs -1.2 [-1.5; 1.2] mm, p = 0.01), and also less pressure center velocity (9.51 ± 4.4 vs 7.1 ± 2.7 mm/sec, р = 0.009).

Conclusions. VFs in osteoporotic patients are associated with reduction of trunk muscles strength and negatively affect static and dynamic balance function. The obtained data should be taken into account when developing rehabilitation programs for patients with osteoporosis who have suffered compression VFs.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):152-159
Influence of pulse magnitotepapy on capillary blood flow indicators in complex treatment of patients with gonarthrosis
Byalovsky Y.Y., Ivanov A.V., Zaytseva T.N., Evstigneeva I.S.

Background. Today, osteoarthritis, in particular its clinical form of gonarthrosis, is the most common degenerative-dystrophic diseases of the joints in practice in all countries.

The objective: of the present study was to estimate the efficacy of local pulsed magnetotherapy on capillary blood flow in patients with osteoarthritis of the knee joint.

Methods. A total of 50 patients aged from 36 to 65 years with I−III stage gonarthrosis. All patients of the main group (n = 25) received treatment with a pulsed magnetic field and NSAID therapy (diclofenac 25 mg 3 times a day, course 15 days). Patients in the comparison group (n = 25) received only NSAIDs. The functional state of the capillary bed was assessed by biomicroscopy of the vessels of the outer corner of the eye using a fiber optic ophthalmoscope with a Riester Ri-Scope L diode lamp (Germany). The state of the vessels of the angle of the eye was assessed by capillary (KI1) intravascular (KI2), extravascular (KI3) and general (KIgen) indices.

Results. After a course of local pulsed magnetotherapy, normalization of the ateriol-venular ratio, restoration of blood flow through the capillaries and the disappearance of a cloudy background were noted in all patients of the main group. After 6 months, the found changes were preserved in the patients of the main group, while in patients receiving NSAID mototherapy, all positive changes from the capillary blood flow disappeared.

Conclusions. In recent years, magnetotherapy, both general and local, has been successfully used to treat patients with gonarthrosis. One of the mechanisms of action of magnetic fields is to improve microcirculation in tissues. The therapeutic effect of magnetic fields in gonarthrosis has been studied, and its high efficiency has been proven.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):160-170
Vibrotherapy in medical practice
Kir'yanova V.V., Gerasimenko M.Y., Shorokhova M.N., Gorbacheva K.V.

A review of literature sources on the use of vibrotherapy in physiotherapy is presented. In the mechanism of action of vibrotherapy, the leading role belongs to vibration sensitivity — the main link between the human body and the impact on it of the environment. The patient's tissues are affected using devices for vibrotherapy, using mechanical vibrations with a frequency of 10 to 250 Hz in continuous or pulsed modes. Vibrotherapy has trophic, reflex, neuroprotective, myorelaxing, anti-inflammatory, analgesic, oxygenating, antioxidant effects and is recommended for prevention, treatment and rehabilitation in various nosologies and conditions of the human body. In addition to the above, vibrotherapeutic effects contribute to the formation of protective and adaptive mechanisms.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):171-177
The rationale for the use of selective pulsed electrotherapy in rehabilitation programs after surgery on the pelvic organs
Lyadov K.V., Muravlev A.I., Kovalev S.A.

The article presents the results of clinical and experimental research of Russian and foreign scientists on the use of modern non-drug technology-selective pulse electrotherapy for various diseases and justification of its use in rehabilitation programs after pelvic surgery.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):178-183
Clinical Guidelines
Application of therapeutic mud «tomed» in clinical practice: textbook
Kulikov A.G., Zaitseva T.N., Voronina D.D.

Authors on the basis of available scientific data and their own clinical observations summarized information concerning the use of peloidotherapy. The historical aspects of mud treatment are described, the classification of the main types of mud is given, indications and contraindications to peloidotherapy are presented. The principles of the purpose and application of resource-saving mud treatment technologies are described in detail. The characteristic of mud preparations of the "TOMED" series is given.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):184-194
Clinical notes and case reports
Experience in using low-temperature plasma after surgical treatment of breast cancer
Gerasimenko M.Y., Evstigneeva I.S., Salchak C.T., Zaitseva T.N., Lutoshkina M.G.

Background. Plasma medicine is a new direction in science at the intersection of plasma physics and chemistry with biology and medicine low-temperature plasma (LTP) has a number of fundamental advantages, which include high non-specific bactericidal activity, low probability of the appearance of stable forms, the absence of ionizing radiation and highly toxic substances. In addition, LTP stimulates healing of infected wounds at the early stages of exposure, which makes LTP a promising method of treating various pathological conditions.

Clinical case description. Low-temperature argon plasma treatment was performed for a patient with a diagnosis of: cancer of the right breast cancer T2N1M0, IIB stage. Condition after non-adjuvant PCT and radical resection of the right breast. Complication: Abscess in the area of the postoperative scar. After the 3rd treatment with plasma flow, the wound was sutured and while continuing treatment with low-temperature argon plasma, the patient began radiation therapy of the right breast and regional lymph flow zones in the mode of classical dose fractionation. During the follow-up period, the patient showed positive dynamics in the area of the postoperative scar, which did not lead to a long period of rehabilitation in the postoperative period and radiation therapy was started in a timely manner.

Conclusion. Thus, the use of this technique in clinical practice has proven that the period of rehabilitation in the postoperative period is shortened for continuous comprehensive treatment of severe cancer patients with breast cancer.

Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;19(3):195-200

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