Bulletin of Rehabilitation Medicine

INTRODUCTION. Health preservation and active longevity are key priorities of modern medicine and public healthcare policy. The effectiveness of their implementation strongly depends on the development of sustainable healthy lifestyle (HLS) skills among the population. Health-resort organizations (HRO) existing In Russia have unique potential for implementing comprehensive preventive and educational programs. Existing programs have low population coverage and insufficient effectiveness due to organizational difficulties, limited accessibility, a formal approach, and a lack of motivation.

AIM. To conduct a systematic review of domestic and international scientific data on approaches to disease prevention and the development of healthy lifestyle skills in HRO settings, as well as to analyse the effectiveness of these approaches.

MATERIALS AND METHODS. A systematic review of the literature in domestic and international databases PubMed, Web of Science, Google Scholar, eLIBRARY.RU with no restrictions on the publication date was conducted on October 15, 2025.

RESULTS. A total of 11 publications, 7 foreign researchers, and 4 domestic studies, were finally included in the descriptive analysis. Domestic and international experience demonstrates that integration of educational modules into spa treatment programs significantly increases medical awareness and commitment to a healthy lifestyle — in both healthy individuals and patients with various chronic diseases, which is true in both paediatric and adult settings.

DISCUSSION. This approach has been shown to be effective in quality-of-life improvement, reduction of clinical symptom severity, and prevention of disease relapse. A structured program "School of Health in Health-Resort Organisations" that combines educational, interactive, preventive, and rehabilitation components and focused on improving health literacy, can be an effective tool for fostering a healthy lifestyle and preventing chronic noncommunicable diseases at the population level.

CONCLUSION. The implementation of the "School of Health Health-Resort Organisations" in the work of the HRO allows us to utilize the potential of the resort environment as a platform where patients receive not only treatment but also practical knowledge about a healthy lifestyle, as well as develop skills in self-management, balanced nutrition, physical activity, and stress management.

INTRODUCTION. In the comprehensive rehabilitation of patients with coronary heart disease (CHD), spa treatment plays a key role, consolidating the results of inpatient treatment and enhancing the body's adaptive reserves without excessive medication. This article examines the impact of the temperate continental climate of the Krinitsa Sanatorium (Sanatorium) on patients with functional class (FC) 1 and 2 CHD undergoing spa treatment and recuperation.

AIM. Assessment of the impact of climatic conditions at Sanatorium Krinitsa on the psychofunctional state and quality of life in patients with ischemic heart disease.

MATERIALS AND METHODS. The assessment of the climate conditions in the sanatorium-resort area was based on official data from a representative meteorological station located in the vicinity of the health resort. The research instruments included validated questionnaires: a method for assessing the body's functional reserves; the WAM (well-being, activity, mood) differential self-assessment test; the Hospital Anxiety and Depression Scale (HADS); and the EQ-5D-5L quality of life questionnaire. The sample representativeness consisted of 50 patients with Functional Class I and II ischemic heart disease.

RESULTS. Analysis of the psycho-functional state and quality of life in patient with coronary heart disease showed highly significant improvement in functional reserve dynamics (p < 0,001 according to the Wilcoxon test), with the average value decreasing by 29,4 %. Positive dynamics were observed in the WAM test results (significance level p < 0,01 according to the Wilcoxon test: well-being 4,36 ± 1,13; activity 4,14 ± 0,75; mood 5,41 ± 0,71). Depressive manifestations and anxiety symptoms demonstrated a statistically significant decrease in mean scores from 3,48 ± 3,03 to 1,96 ± 2,20 and from 4,06 ± 3,19 to 1,86 ± 2,12, respectively.

DISCUSSION. Evaluation of the climatic conditions of the health resort area allowed for the identification of favorable periods for climatotherapy. The data obtained indicate a pronounced positive impact of comprehensive health resort treatment in a temperate continental climate on the physical and psychological state of patients with functional class I and II coronary heart disease.

CONCLUSION. The sanatorium-resort area of the Sanatorium Krinitsa possesses favorable medical and climatic conditions for climate-based health procedures (aerotherapy, heliotherapy, and dasotherapy). An assessment of the winter climate severity indices indicates that most of the resort area (60–65 %) is classified as moderate. The study showed that the potential for climate therapy is not fully utilized due to a lack of real-time meteorological data, which hinders the proper planning of climate-based health procedures. The evaluation of the psychofunctional status and quality of life of patients with FC I and II ischemic heart disease at the health resort established high treatment efficacy. This contributed to the harmonization of the patients' emotional state, significantly reducing levels of situational anxiety and depression, which is a key factor in the prevention of cardiovascular complications.

INTRODUCTION. Traumatic impregnation (tattoo) of the face is an artificial blue-black spot formed as a result of foreign particles entering the dermis. Rehabilitation of patients with this psychotraumatic condition consists of eliminating the cosmetic defect, namely, removing foreign particles from the skin, which is a difficult task and, until recently, was only possible in the early stages (before the epithelialization of wounds).

AIM. To evaluate the dynamics of indicators of limitation of vital activity in patients with traumatic impregnation during the implementation of the developed rehabilitation program, including the sequential use of two types of laser radiation.

MATERIALS AND METHODS. The study was conducted at the Military Medical Academy (St. Petersburg, Russia) in the period from January 2024 to March 2025. The study included 70 patients with traumatic impregnation of facial skin, who were randomly divided into two groups. The first was the study group (35 people), where the developed rehabilitation program using laser technologies was used. The second was the control group (35 people), where the standard approach was used (rinsing of wounds and mechanical removal of foreign particles from the skin within 72 hours after the injury and application of methyluracil ointment to the lesions for a month). The duration of observation of patients was 3 months. Control examinations were carried out before the start of rehabilitation (visit 1) and after 3 months (visit 2). The indicators of disability were assessed in accordance with the International Classification of Functioning of the World Health Organization, 2001 (ICF-WHO): psychomotor functions (PF), emotional functions (EF), pain sensation (PS), protective functions of the skin (PFS), reparative functions of the skin (RFS), stress coping (SC), basic interpersonal interactions (BII), work and employment (WE).

RESULTS. In the study group, the effectiveness of rehabilitation was significantly higher than in the control group, which was reflected in a significant difference between the groups in the main recorded indicators at visit 2: PF_1group = 0.64 arb. unit, PF_2group = 1.52 arb. unit, p = 0.011; EF_1group = 1.03 arb. unit, EF_2group = 1.67 arb. unit, p < 0.001; PS_1group = 1.73 arb. unit, PS_2group = 2.0 arb. unit, p = 0.033; PFS_1group = 0.73 arb. unit, PFS_2group = 1.39 arb. unit, p < 0.001; RFS_1group = 0.61 arb. unit, RFS_2group = 2.30 arb. unit, p < 0.001; SC_1group = 0.85 arb. unit, SC_2group = 1.21 arb. unit, p = 0.028; WE_1group = 0.61 arb. unit, WE_2group = 1.03 arb. unit, p = 0.039. No differences were registered in terms of basic interpersonal interactions (BII_1group = 1.0 arb. unit, BII_2group = 1.15 arb. unit, p = 0.091).

DISCUSSION. The proposed correction technique makes it possible to fully restore the functional characteristics of the skin to a normal level, thereby eliminating the traumatic situation in the form of a persistent facial skin defect.

CONCLUSION. The developed method of rehabilitation of patients with traumatic impregnation, including the sequential use of two variants of high-intensity laser irradiation within one procedure, is highly effective and allows for significantly improved results in comparison with the standard protocol.

INTRODUCTION. The rapid digitalization of society and the widespread adoption of virtual reality (VR) technologies are opening new prospects for rehabilitation. Despite the proven potential of immersive environments, their practical application is hindered by a lack of research into individual physiological responses to physical exertion under conditions of artificial sensory stimulation.

AIM. To identify the features of physical load tolerance in an immersive environment depending on the type of higher nervous activity (HNA) and the type of autonomic regulation of heart rate.

MATERIALS AND METHODS. 10 practically healthy volunteers participated in the study. Between October and December 2024, sessions using an experimental methodology involving VR headsets were conducted twice a week for 45 minutes each at the Institute of Natural Sciences and Sports Technologies of Moscow City University. The intensity of the exercise was progressively increased every two weeks by making the game scenario more complicated. Before and after the intervention, the functional state was measured: assessment of the mobility and strength of neural processes and analysis of autonomic heart rate regulation. Statistical data processing was performed using the Wilcoxon-W-test.

RESULTS. It was found that regular VR sessions significantly improve simple visual-motor reaction times (decreases in average reaction time and standard deviation, p < 0.05), while simultaneously increasing the stress index (SI by 154 %, p < 0.05), the proportion of VLF and LF waves, and a decrease in parasympathetic activity (HF by 24.7 %, p < 0.05).

DISCUSSION. Analysis of individual-typological features revealed the multidirectional nature of adaptive responses. In individuals with an inert type of HNA and a sympathetic (central) type of autonomic regulation, an improvement in accuracy (a 22.5 % reduction in errors) and normalization of the stress index (a 26 % reduction) were observed. In individuals with a mobile type of HNA, against a background of high learning ability (error reduction by 37.5 %), a critical increase in the stress index (by 549 %) and an increase in delayed reactions were recorded, indicating psycho-emotional overstrain and sensory conflict.

CONCLUSION. VR technologies have varying effects on participants. Immersive environments are most effective for individuals with an inert type of higher nervous activity and a central type of regulation. For individuals with a mobile type of higher nervous activity, programs must be strictly tailored to prevent stress reactions and overexertion. A personalized approach, based on preliminary diagnosis of typological characteristics, is a key prerequisite for the successful implementation of VR in medical rehabilitation practice.

INTRODUCTION. Artificial intelligence (AI) and machine learning represent a promising approach in the rehabilitation of trauma and orthopedic patients. The integration of predictive models and adaptive algorithms into rehabilitation practices enables personalized rehabilitation treatment and improves functional outcomes.

AIM. To systematize and assess the evidence base for the use of AI technologies in the rehabilitation of patients following orthopedic and trauma interventions, including joint replacement, fracture fixation, and spinal surgery.

МATERIALS AND METHODS. A narrative review of publications devoted to the use of machine learning algorithms, deep learning, convolutional and recurrent neural networks in the rehabilitation of traumatological and orthopedic patients was carried out. The search for sources was carried out between June 2025 and January 2026 in the international databases PubMed/MEDLINE, Scopus and Web of Science Core Collection for the period from January 2014 to February 2024. Studies were analyzed that included predictive models of functional outcomes, motion monitoring systems, and the prediction of complications and hospital stay. A primary search yielded 1247 publications, after removing duplicates and sequentially selecting by inclusion and exclusion criteria, 43 sources were selected for the final analysis, which formed the basis of this review.

МAIN CONTENT OF THE REVIEW. Machine learning algorithms demonstrated high predictive accuracy in predicting functional outcomes after hip and knee arthroplasty (AUC 0.852–0.98), assessing fracture union (accuracy up to 0.98), predicting postoperative complications (AUC 0.810–0.835), and length of hospital stay (AUC 0.82–0.98). Hybrid CNN-RNN architectures outperformed traditional machine learning methods in predicting rehabilitation success: the weighted F1 score increased from 65 % to 74 %, and the mean absolute error decreased by 12 %. Random forest models achieved 90 % accuracy in predicting patient discharge. Wearable sensors with AI platforms provide personalized monitoring of motor patterns in real time.

СONCLUSION. Artificial intelligence technologies in the rehabilitation of trauma and orthopedic patients have moved beyond experimental development and demonstrated real clinical value. The most significant predictors of functional recovery are age, functional status, range of motion, and cognitive status of the patient. Large-scale prospective studies with a high level of methodological rigor are needed for widespread clinical implementation.

INTRODUCTION. Dysfunction of the calf muscle-venous pump (MVP) associated with venous obstruction contributes to ineffective venous blood emptying from the distal lower extremities and can be considered a therapeutic target in the treatment of chronic venous diseases. Physical exercise (PE) can be an effective method for increasing the hemodynamic efficiency of the MVP.

AIM. A search and analytical review of research findings published in international databases, focusing on the role of MVP dysfunction in the pathogenesis of chronic venous insufficiency (CVI), as well as the effectiveness of various types of physical exercise.

MATERIAL AND METHODS. Fifty-one sources were identified from databases eLibrary.RU, Scopus, PubMed, Web of Science from 1998 to 2025, of which 19 were systematic reviews, including two Cochrane reviews, five practice guidelines, and 27 randomized controlled trials.

RESULTS. In patients with mild CVI, PE was found to improve venous reflux, muscle strength, ankle range of motion (AROM), and quality of life. In patients with severe CVI, PE increased ejection fraction, decreased residual volume, and improved muscle strength and AROM. Isotonic exercise was shown to improve muscle endurance, efficiency, and strength of the calf muscles, improving their contractility and overall hemodynamics in limbs with venous trophic ulcers (VTU). It was established that the effectiveness of MVP also depends on the mobility of the ankle joint and the calf muscles contractile strength.

DISCUSSION. Despite the compelling evidence base for prescribing progressive strength training and aerobic activity to patients with VTU, there are no studies examining the effectiveness of isokinetic training in the comprehensive rehabilitation of patients with post-thrombotic syndrome (PTS). This underscores the need to develop modern isokinetic training protocols for patients with PTS, as they achieve improved performance through maximal muscle loading, which enhances motor learning through real-time feedback.

CONCLUSION. Studying the effects of isokinetic exercise training on calf pump function, muscle strength, AROM, and quality of life in patients with PTS is a promising area of medical rehabilitation.