Bulletin of Rehabilitation Medicine

INTRODUCTION. Disorders affecting the nervous system rank among the top causes of illness and disability within the population. Military health resort facilities possess a unique potential for rehabilitating patients with central and peripheral nervous system disorders. Some prospects have been mapped out for developing the potential of military health resorts in the field of neurological rehabilitation.

AIM. To evaluate the capacity of military health resorts to provide treatment for patients with disorders of the central and peripheral nervous systems, and the effectiveness of natural and physical therapies.

MATERIALS AND METHODS. Medical records from the Podmoskovye and Dalnevostochny health resorts, managed by the Russian Ministry of Defence in 2024, were analyzed. The study focused on various patient categories, the distribution of diagnoses based on ICD-10 classifications.

RESULTS. Among patients with neurological conditions, the majority are reservists and their family members (aged 51–88), as well as contract servicemen (aged 21–57) who were admitted following the completion of special missions. In the breakdown of conditions among patients with neurological disorders resulting from wounds, injuries, concussions and other external causes (Class XIX of the International Classification of Diseases, 10th Revision), the following predominate: T93 — sequelae of injuries to the lower limb (including sequelae of open wounds to the lower limb) (33.1 per cent); T92 — sequelae of injuries to the upper limb (19.6 per cent); T94 — sequelae of injuries involving multiple body regions and injuries of unspecified localization (32.4 per cent); T90 — sequelae of head injuries (6.0 %); T91 — sequelae of neck and trunk injuries (6.6 %); T95 — sequelae of thermal and chemical burns, frostbite (1.2 %), and other unspecified external causes (1.1 %). The overwhelming majority of this group are contract service personnel, aged between 21 and 57, who have been transferred from hospitals for medical rehabilitation following the completion of special missions (88.5 % of the total number of individuals in this group). In 92.2 % of cases of treatment in the settings of a military sanatorium, a significant improvement in the patient's condition is achieved. The use of modern physiotherapy methods and VR enabled a significant reduction or complete cessation of pharmacological treatment for pain syndrome in 45–50 % of cases.

DISCUSSION. A comprehensive health resort treatment programme involving natural therapeutic agents (mineral waters, muds), hardware physiotherapy, kinesitherapy, psychotherapy and modern techniques (transcranial magnetic stimulation, ozone therapy, pharmacopuncture) enables intervention at various stages of the pathogenesis of neurological disorders. The greatest effectiveness was achieved in patients with post-traumatic neuropathies when the rehabilitation commenced early (2–6 months after the injury). There is a high demand for methods aimed at restoring motor, sensory and psycho-emotional functions.

CONCLUSION. Utilizing natural and physical treatment methods in a military sanatorium plays a crucial role in improving the quality of life for patients dealing with neurological disorders. This strategy effectively diminishes both temporary disabilities and long-term impairments resulting from nervous system diseases and injuries. It highlights the importance of ensuring patients' physical, psychological, and social adaptation to new living conditions.

INTRODUCTION. Motor development is intricately connected to cortical processes in the brain, and these processes show distinct features in children with intellectual disabilities. Evaluating motor function, creating effective physical rehabilitation programs, and assessing changes in performance indicators relative to neurotypical peers are crucial tasks.

AIM. To evaluate the musculoskeletal system and develop a programme of exercise therapy tailored to the specific nature of the disorder, and analyze its effectiveness.

MATERIALS AND METHODS. The study was conducted in special education and mainstream schools in Yekaterinburg between 2021 and 2023. It involved 160 children aged 12–14, who were divided into four groups of 40: groups 1 and 2 (control and experimental) comprised individuals with mild intellectual disability, whilst groups 3 and 4 (control and experimental) comprised individuals with neurotypical development. Intellectual development was measured using the Wechsler test, and the condition of the musculoskeletal system was assessed using the Humac Norm biomechanical therapeutic and diagnostic system. Statistical analysis was carried out using SPSS software. For a comparative analysis of the significance of differences between the groups, the non-parametric one-way Kruskal — Wallis ANOVA was used. Correlation analysis was carried out using Spearman's rank correlation test. Quantitative data are described with the median, the 1st and 3rd quartiles.

RESULTS. A statistically significant reduction in muscle deficit indicators (ΔD) was observed after 4 courses of exercise therapy using the developed methodology among participants in the experimental groups (ranging from 2 to 15 %). For those muscles where no positive changes were observed, the percentage of negative progress in terms of asymmetry was only 0.5 %. In the control groups, particularly among individuals with intellectual disabilities (IWID), an increase in deficit was diagnosed across all muscle groups studied (ranging from 3.5 to 18.5 %). The changes in strength indicators ranged from 16.73 to 50.7 % in the control group of IWID, and from 23.46 to 63.85 % in the experimental group of IWID; in the control group of individuals with neurotypical development, the range was from 14.22 to 44.35 %, and in the experimental group of individuals with neurotypical development, the range was from 15.1 to 47.85 %.

DISCUSSION. Individuals with intellectual disabilities typically exhibit lower baseline muscle strength than their neurotypical peers. However, our study results demonstrated signifi cant strength gains across various muscle groups for all participants, regardless of the severity of their condition. Notably, the experimental group of individuals with intellectual disabilities achieved the greatest improvement in overall performance.

CONCLUSION. Methods of exercise therapy, which focused on correcting movement disorders through strength training and the stimulation of interhemispheric interaction using the TRX (Total Body Resistance Exercise) and elastic bands with varying degrees of resistance, has proven effective in promoting physical development and reducing muscular asymmetries.

INTRODUCTION. Postmenopausal osteoporosis (PMO) is a common metabolic bone disease leading to fractures, reduced quality of life, and disability. Medical rehabilitation improves functional outcomes, but the effect is often unsustainable. Ibandronic acid is an effective antiresorptive agent; however, its role in maintaining rehabilitation benefits remains understudied.

AIM. To evaluate the effect of treatment with oral form of ibandronic acid 150 mg on the duration of maintaining the effect of medical rehabilitation in patients with established postmenopausal osteoporosis undergoing the 2nd stage of medical rehabilitation.

MATERIALS AND METHODS. The work included 70 women aged 45 years and older in the postmenopausal period of more than 1 year, admitted to hospital for the 2nd stage of medical rehabilitation for diseases of the musculoskeletal system and diagnosed with postmenopausal osteoporosis. Women were randomized into 2 groups: the main group (n = 35), where ibandronic acid, 150 mg tablets for administration once a month, was prescribed, and the comparison group (n = 35). All patients in the main and comparison groups received cholecalciferol (vitamin D₃) at an average dose of 1500 IU per day. Evaluation of the effectiveness of treatment after 12 months was carried out using a “battery” of functional tests to assess the function of movement, strength of the muscles of the spine and abdomen, static and dynamic balance indicators, as well as by assessing pain on a 5-point visual analogue scale and quality of life using the SF-36 questionnaire.

RESULTS. At 12 months, the main group showed significant improvements in static and dynamic endurance of back and abdominal muscles, walking speed, Timed Up and Go test, postural control (stabilometry), reduction in fall rate (from 34.3 % to 14.3 %; p < 0.05), increase in spine BMD (3.5 %) and hip bone mineral density (2.5 %), a 46.6 % decrease in the resorption marker CTx, improvement in SF-36 domains, and pain reduction on VAS (from 4.0 points to 1.5 points; p < 0.05). In the comparison group, positive changes were lost by 12 months. Adverse events in the main group occurred in 11.4 % (transient flu-like symptoms).

DISCUSSION. Oral bisphosphonate therapy combined with rehabilitation reduces the risk of falls in postmenopausal osteoporosis.

CONCLUSION. Twelve-month therapy with oral ibandronic acid (Rezoviva 150 mg once monthly) combined with medical rehabilitation and vitamin D effectively sustains and enhances functional outcomes, increases BMD, reduces pain and falls, and has a favorable safety profile. It is recommended for long-term management of PMO patients after rehabilitation.

INTRODUCTION. Dysfunction of the lower leg muscle-venous pump (MVP) in post-thrombotic syndrome (PTS) can be considered a therapeutic target in the treatment of chronic venous insufficiency. Correction of muscle dysfunction and reduction of functional deficit (arthritic muscle inhibition / AMI) can be achieved by improving neuromuscular control and proprioception during robotic isokinetic MVP training, which will improve the effectiveness of comprehensive rehabilitation for PTS.

AIM. To study the effectiveness of a comprehensive rehabilitation program using robotic isokinetic lower limb muscle training with biofeedback (BFB) on lower leg MVP performance and ankle range of motion in patients with PTS.

MATERIALS AND METHODS. The study included 30 patients with lower extremity PTS (C3–C5 according to the CEAP classification), with an average age of 57.24 ± 10.17 years, a disease duration of 8.67 ± 1.14 years, and a BMI of 32.61 ± 5.81 kg/m². All patients had a documented history of DVT of varying duration. The dynamics of the ankle joint range of motion (AROM) (dorsiflexion, plantar flexion) indicators were studied in degrees according to goniometry data. The performance indicators of the lower leg MVP were investigated according to isokinetic dynamometry of the lower limb muscles, including peak torque, work of the extensor and flexor muscles of the foot and the fatigue coefficient characterizing proprioception. Each patient underwent measurements before and after a rehabilitation course, including intermittent pneumatic compression of the legs No. 12, intravenous laser irradiation of blood using Low-level laser radiation in the infrared range (wavelength 890 nm) No. 12, as well as 12 isokinetic training sessions on a robotic Isokinetic Extremity System "Leg press" with biofeedback. The study was conducted at the National Medical Research Center for Rehabilitation and Balneology from February 2024 to August 2025.

RESULTS. At baseline, patients with PTS showed a significant decrease in muscle strength in both limbs (affected and intact). In the affected limb with edema, the extensor strength deficit reached 55–64% of the lower limit of normal, and an even more pronounced deficit of 75–83 % was recorded for the flexors. Moreover, the muscles of the back of the leg (m. gastrocnemius, m. soleus) were weakened to a greater extent than the anterior tibialis and other dorsiflexors. After the rehabilitation course, an increase in AROM (dorsiflexion) goniometry values was noted from 9.88 ± 2.92° to 12.44 ± 4.35° (p < 0.001); AROM (plantar flexion) from 26.90 ± 10.06° to 31.27 ± 9.08° (p < 0.001). After the rehabilitation course, a significantly more pronounced improvement in the maximum extension torque on the affected limb was noted by 36 % (p = 0.019), compared with an increase of 16.1 % (p = 0.04) in the intact limb; an improvement in the relative extension torque on the intact limb was 45.5% (p = 0.006), compared with the affected limb, where the increase was 16.7 % (p = 0.028), indicating the effectiveness of MVP training in an isokinetic mode and with biofeedback, due to the correction of proprioceptive sensitivity, muscle strength, and, possibly, due to improved coordination abilities. A decrease in the malleolar circumference by 10.4 % (p < 0.05) was also noted after treatment.

DISCUSSION. In previous studies it has been proven that supravenous Low-level laser therapy provides an anti-inflammatory effect, reducing the severity of perivascular venous inflammation, while pressotherapy promotes lymphatic drainage in PTS. Isokinetic training is an effective method for increasing the hemodynamic efficiency of the muscle pump, overcoming the mechanisms of AMI by activating proprioceptors, as well as muscle strength, as evidenced by an increase in AROM, peak torque, overall work of the extensor and flexor muscles of the foot, and the fatigue coefficient.

CONCLUSION. Incorporating isokinetic training of the lower extremity muscles into a rehabilitation program (with intermittent pneumatic compression and Low-level laser therapy) improves the function of the muscles involved in the MVP by reducing the identified functional deficit (AMI).

INTRODUCTION. This review presents an in-depth analysis of the use of medical xenon as a universal agent in modern anesthesiology and therapeutic practice. Particular attention is paid to the use of xenon for the management of chronic pain syndrome in osteoarthritis, where adverse effects and insufficient analgesic efficacy often limit traditional pharmacotherapy. A high safety profile, the absence of systemic toxicity, and the ability to modulate central sensitization make this inert gas a promising component of multimodal analgesia.

AIM. To analyze the clinical application of medical xenon and substantiate its efficacy and safety in the treatment of pain syndrome in patients with osteoarthritis based on a systematic review of the literature.

MAIN CONTENT OF THE REVIEW. This review was prepared through a systematic search and critical analysis of international literature focusing on the physicochemical properties, pharmacodynamics of medical xenon, and its clinical application in anesthesiology and the management of pain syndromes in osteoarthritis. Relevant publications were identified in Russian and international databases, including eLIBRARY.RU, PubMed, Scopus, and Google Scholar. The search period covered studies from the earliest fundamental research on inert gases (1898) to contemporary clinical guidelines and multicenter trials (2025). The paper examines the physicochemical determinants and molecular mechanisms of action of this inert gas, including its effects on NMDA receptors and metabotropic complexes. The stages of xenon anesthesia are described in detail, and its high safety profile in geriatric and pediatric populations is substantiated. Particular attention is given to an innovative method for managing pain syndromes in patients with osteoarthritis through local para-articular injections of highly purified xenon. The presented clinical experience demonstrates a significant reduction in pain intensity according to the Visual Analog Scale (VAS), along with prolonged analgesic effects in the absence of systemic toxicity. The use of specialized equipment enables optimization of dosing regimens and minimization of adverse effects, thereby opening broad prospects for the use of xenon therapy in the rehabilitation of patients with degenerative joint diseases and in reducing disability rates.

CONCLUSION. Available data suggest that xenon can be considered a promising component of multimodal analgesia in patients with osteoarthritis. However, further randomized controlled trials specifically focused on this patient population are required, particularly to assess long-term efficacy and the impact on the neuropathic component of pain.