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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Bulletin of Rehabilitation Medicine</journal-id><journal-title-group><journal-title xml:lang="en">Bulletin of Rehabilitation Medicine</journal-title><trans-title-group xml:lang="ru"><trans-title>Вестник восстановительной медицины</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2078-1962</issn><issn publication-format="electronic">2713-2625</issn><publisher><publisher-name xml:lang="en">National Medical Research Center for Rehabilitation and Balneology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">595739</article-id><article-id pub-id-type="doi">10.38025/2078-1962-2023-22-2-136-145</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Dissertation Orbit</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Диссертационная орбита</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The Effect of Mechanotherapy and Virtual Reality on Cardiovascular Activity and the Severity of Shortness of Breath in Patients with Post COVID-19 Syndrome: A Prospective Randomized Study</article-title><trans-title-group xml:lang="ru"><trans-title>Эффект механотерапии и виртуальной реальности на показатели сердечно-сосудистой деятельности и выраженность одышки у пациентов, перенесших COVID-19: проспективное рандомизированное исследование</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8888-6149</contrib-id><name-alternatives><name xml:lang="en"><surname>Ansokova</surname><given-names>Maryana A.</given-names></name><name xml:lang="ru"><surname>Ансокова</surname><given-names>Марьяна Аркадьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Junior Researcher of the Department of Somatic Rehabilitation, Reproductive Health and Active Longevity</p></bio><bio xml:lang="ru"><p>младший научный сотрудник отдела соматической реабилитации репродуктивного здоровья и активного долголетия</p></bio><email>ansokovama@nmicrk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1886-124X</contrib-id><name-alternatives><name xml:lang="en"><surname>Marchenkova</surname><given-names>Larisa A.</given-names></name><name xml:lang="ru"><surname>Марченкова</surname><given-names>Лариса Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci (Med.), Head of Somatic Rehabilitation, Active Longevity and Reproductive Health department, Chief Researcher</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, заведующая отделом соматической реабилитации, репродуктивного здоровья и активного долголетия, главный научный сотрудник</p></bio><email>marchenkovala@nmicrk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7626-5521</contrib-id><name-alternatives><name xml:lang="en"><surname>Yurova</surname><given-names>Olga V.</given-names></name><name xml:lang="ru"><surname>Юрова</surname><given-names>Ольга Валентиновна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor, Deputy Director for Science and Professional Education</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заместитель директора по образовательной и научной деятельности</p></bio><email>yurovaov@nmicrk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3097-8889</contrib-id><name-alternatives><name xml:lang="en"><surname>Fesyun</surname><given-names>Anatoliy D.</given-names></name><name xml:lang="ru"><surname>Фесюн</surname><given-names>Анатолий Дмитриевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor of Department of Healthcare Planning and Health Resort Management, Acting Director</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор кафедры организации здравоохранения и санаторно-курортного дела, и. о. директора</p></bio><email>fesyunad@nmicrk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3384-5205</contrib-id><name-alternatives><name xml:lang="en"><surname>Knyazeva</surname><given-names>Tatyana A.</given-names></name><name xml:lang="ru"><surname>Князева</surname><given-names>Татьяна Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor, Chief Researcher</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор, главный научный сотрудник</p></bio><email>knyazevata@nmicrk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5734-9903</contrib-id><name-alternatives><name xml:lang="en"><surname>Vershinin</surname><given-names>Alexey A.</given-names></name><name xml:lang="ru"><surname>Вершинин</surname><given-names>Алексей Анатольевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Сardiologist, Doctor of Functional Diagnostics</p></bio><bio xml:lang="ru"><p>врач кардиолог, врач функциональной диагностики</p></bio><email>vershininaa@nmicrk.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">National Medical Research Center for Rehabilitation and Balneology</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр реабилитации и курортологии» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2023-08-22" publication-format="electronic"><day>22</day><month>08</month><year>2023</year></pub-date><volume>22</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>136</fpage><lpage>145</lpage><history><date date-type="received" iso-8601-date="2023-09-24"><day>24</day><month>09</month><year>2023</year></date><date date-type="accepted" iso-8601-date="2023-09-24"><day>24</day><month>09</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2023, Ansokova M.A., Marchenkova L.A., Yurova O.V., Fesyun A.D., Knyazeva T.A., Vershinin A.A.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2023, Ансокова М.А., Марченкова Л.А., Юрова О.В., Фесюн А.Д., Князева Т.А., Вершинин А.А.</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="en">Ansokova M.A., Marchenkova L.A., Yurova O.V., Fesyun A.D., Knyazeva T.A., Vershinin A.A.</copyright-holder><copyright-holder xml:lang="ru">Ансокова М.А., Марченкова Л.А., Юрова О.В., Фесюн А.Д., Князева Т.А., Вершинин А.А.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://journals.eco-vector.com/2078-1962/article/view/595739">https://journals.eco-vector.com/2078-1962/article/view/595739</self-uri><abstract xml:lang="en"><p><bold>INTRODUCTION.</bold> At present, there is an urgent need to develop modern rehabilitation programs for COVID-19 patients with long-lasting residual symptoms of the disease, primarily from the cardiopulmonary system.</p> <p><bold>AIM. </bold>To assess the impact of a comprehensive medical rehabilitation program using virtual reality technologies, robotic mechanotherapy with biofeedback and interactive balance therapy on the severity of hypoxic syndrome, shortness of breath and cardiovascular activity in patients who have undergone COVID-19 and have manifestations of post-COVID syndrome (long COVID).</p> <p><bold>MATERIAL AND METHODS. </bold>The study sample consisted of 120 patients aged 40 to 70 years who had suffered COVID-19 within 1–6 months prior to inclusion in the study and had manifestations of SPCN, who were randomized into 2 groups. In the main group (n = 60), a new complex of medical rehabilitation was prescribed against the background of basic treatment: 1) sessions on the robotic biofeedback simulator for lower limb muscle training Con-Trex, #10; 2) balance therapy (sensorimotor training) using the biofeedback simulator «Stabilan 01–2», #10; 3) training on the rehabilitation interactive markerless system with virtual reality technology Nirvana, #10. In the control group (n = 60) patients received only basic treatment: 1) a special complex of therapeutic gymnastics performed in the hall with a physical therapy instructor, № 10; 2) low-intensity laser radiation, № 10; 3) speleo-exposure, № 10; 4) medical massage on the chest area, № 10. Research methods included clinical examination, anamnesis collection and cardiopulmonary testing and assessment of dyspnea severity before the beginning of rehabilitation and immediately after its completion.</p> <p><bold>RESULTS AND DISCUSSION. </bold>In the period from 1 to 6 months after COVID-19, 90.0 % of patients had dyspnea, as well as a decrease in peak oxygen consumption and high values of heart rate (HR), systolic and diastolic blood pressure (BP) at peak exercise. The application of a new complex of medical rehabilitation in patients with post-COVID disorder syndrome contributed to a more significant, than in the standard method of rehabilitation, increase in cardiorespiratory endurance, which is manifested in the increase in the maximum work performed by 12.9 % and oxygen consumption of the first ventilation threshold by 6.3 % and in the decrease in diastolic BP at peak load by an average of 7 mm Hg. hg according to cardiopulmonary testing, as well as an increase in the proportion of patients with mild (up to 60.0 %) or no dyspnoea (up to 26 %) and a decrease in the number of patients with moderate dyspnoea (up to 13.3 %), severe and very severe dyspnoea (up to 0 %). Most of the authors in their studies also note a high frequency of shortness of breath, along with such manifestations of post- COVID-19 syndrome as general weakness, poor exercise tolerance.</p> <p><bold>CONCLUSION. </bold>A new comprehensive medical rehabilitation program using virtual reality technologies, robotic mechanotherapy with biofeedback and interactive balance therapy are recommended to reduce the severity of hypoxic syndrome and dyspnea and improve cardiovascular performance in patients with post-COVID syndrome.</p></abstract><trans-abstract xml:lang="ru"><p><bold>ВВЕДЕНИЕ.</bold> Потребность в разработке программы реабилитации пациентов с постковидным синдромом с сохраняющимися симптомами, в т.ч. со стороны кардиопульмональной системы, сохраняется.</p> <p><bold>МАТЕРИАЛЫ И МЕТОДЫ. </bold>Исследуемую выборку составили 120 пациентов от 40 до 70 лет с постковидным синдромом в период от 1 до 6 месяцев после перенесенной COVID-19, которые были рандомизированы на 2 группы. Основная группа (n = 60) получала новый комплекс медицинской реабилитации: занятия на роботизированном тренажере с биологической обратной связью (БОС) для тренировки мышц нижних конечностей Con-Trex, № 10; интерактивная балансотерапия «Стабилан 01-2», № 10; тренировки на реабилитационной интерактивной безмаркерной системе с технологией виртуальной реальности Nirvana, № 10. Группа контроля (n = 60) получала базовое лечение: специальный комплекс лечебной гимнастики, № 10; низкоинтенсивное лазерное излучение, № 10; спелеовоздействие, № 10; медицинский массаж на область грудной клетки, № 10. Перед началом и в конце курса реабилитации проводился клинический осмотр, сбор анамнеза, проведение кардиопульмонального тестирования и оценка выраженности одышки.</p> <p><bold>РЕЗУЛЬТАТЫ И ОБСУЖДЕНИЕ.</bold> В начале курса реабилитации у 90 % пациентов присутствовала одышка, наблюдались снижение пикового потребления кислорода и высокие значения частоты сердечных сокращений (ЧСС), систолического и диастолического артериального давления (АД) на пике нагрузки. Применение нового комплекса медицинской реабилитации у данных пациентов способствовало более значимому, чем при стандартном методе реабилитации, повышению кардиореспираторной выносливости, по данным кардиопульмонального тестирования: возросли максимально выполненная работа на 12,9 % и потребление кислорода первого вентиляционного порога — на 6,3 %, снизилось диастолическое АД на пике нагрузки в среднем на 7 мм рт. ст.; увеличилась доля пациентов с легкой степенью до 60 % и с отсутствием одышки до 26 %, уменьшилось число пациентов с одышкой средней степени до 13,3 %, тяжелой и очень тяжелой одышкой до 0 %.</p> <p><bold>ЗАКЛЮЧЕНИЕ.</bold> Новый комплекс с применением технологий виртуальной реальности, роботизированной механотерапии с БОС и интерактивной балансотерапии может быть рекомендован в реабилитации пациентов с постковидным синдромом.</p></trans-abstract><kwd-group xml:lang="en"><kwd>post-COVID syndrome</kwd><kwd>rehabilitation</kwd><kwd>mechanotherapy virtual reality</kwd><kwd>cardiopulmonary testing</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>постковидный синдром</kwd><kwd>медицинская реабилитация</kwd><kwd>механотерапия</kwd><kwd>виртуальная реальность</kwd><kwd>кардиопульмональное тестирование</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Moreno-Pérez O., Merino E., Leon-Ramirez J.M., Andres M., Ramos J.M., Arenas-Jiménez J., Asensio S., Sanchez R., Ruiz-Torregrosa P., Galan I., Scholz A., Amo A., González-delaAleja P., Boix V., Gil J. 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