Bulletin of Rehabilitation Medicine

INTRODUCTION. Arterial hypertension (AH) is a socially significant disease. A significant proportion of patients with AH are weather-sensitive, which significantly aggravates the course of the underlying disease.

AIM. To develop programs for restoring the functional state and adaptive capabilities of patients with arterial hypertension and increased weather sensitivity in order to optimize the duration of their spa treatment.

MATERIALS AND METHODS. An observational prospective clinical comparative study of 129 patients aged 62 [56; 68] years was conducted for 12 days. The patients were divided into 3 groups. All patients received general sodium chloride baths, gas-air carbon dioxide baths, parafango applications, hyperbaric oxygenation, therapeutic exercises, cognitive-behavioral therapy, and continuous hypotensive drug therapy. Additionally, the first group of patients received dosed aerotherapy together with therapeutic exercises, and the second group received paradoxical breathing exercises using the Strelnikova method. Before and after the course of treatment, anthropometry, peripheral hemodynamics, heart rate variability, and the psychophysiological state of the patients were assessed.

RESULTS AND DISCUSSION. After completion of treatment, statistically significant differences were obtained in all groups of patients in terms of a decrease in systolic blood pressure (SBP) and an increase in the Well-Being scale scores of the SAN test (according to the Wilcoxon test, p < 0.05). In the first group of patients, after treatment, a statistically significant decrease in elevated pulse pressure, heart rate (HR), integral and frequency indices of heart rate variability (RMSSD, SDNN, LW, IN, PARS) was observed (according to the Wilcoxon test, p < 0.05). Statistically significant differences were revealed between the first and third groups in the level of reduction of initially elevated systolic (U = 54.0, p = 0.02) and pulse BP (U = 55.5, p = 0.023), HR (U = 56.0, p = 0.037), RMSSD, SDNN, LW, IN, PARS (U = 13.0, p = 0.048; U = 34.2, p = 0.033; U = 13.0, p = 0.048; U = 0.0, p = 0.02; U = 48.0, p = 0.033, respectively), and the Well-Being scale of the SAN questionnaire (U = 50.0, p = 0.043).

CONCLUSION. The study has shown the effectiveness of non-drug treatment programme for AH with increased meteosensitivity, including procedures of aerotherapy and exercise therapy, allowing to optimize the terms of health-resort treatment.

INTRODUCTION. Development and improvement of methods and materials used in regenerative medicine for non-drug stimulation of tissue repair will solve a number of clinical problems associated with diseases that impede the normal process of reparative regeneration, such as diabetes, cardiovascular diseases and metabolic disorders. Collagen and its derivatives are already used as components of biomaterials for medical purposes. However, low mechanical strength, rapid biodegradation in physiological environments and weak resistance to enzymes limit the scope and effectiveness of their medical and biological applications.

AIM. The aim of the study is to evaluate the effect of carboxylic acids on the strength, biodegradability and biocompatibility of collagen xerogel, in vitro.

MATERIALS AND METHODS. The mechanical characteristics of the materials were assessed using a TA.XTplus texture analyzer. The biocompatibility of the materials was assessed by light and fluorescence microscopy using fluorescent dyes (DAPI, Rhodamine) and a Calcein AM (CCK-F) cell viability kit.

RESULTS AND DISCUSSION. A xerogel based on denatured collagen with high strength characteristics was created. The parameters of heat treatment and concentrations of carboxylic acids were selected to stabilize the mechanical properties of the hydrogel. It was found that the introduction of citric acid into the hydrogel from denatured collagen and subsequent high-temperature treatment allows to increase the mechanical strength of the xerogel from 59 ± 3 to 82 ± 13 kPa. In addition, the introduction of citric acid into the composition of the xerogel increases its resistance to biodegradation by more than three times. The microenvironment created by the xerogel containing citric acid does not have a cytotoxic effect, but it does inhibit proliferation of fibroblasts.

CONCLUSION. The results of the in vitro study showed that the obtained material can become a promising platform for use both as an extracellular scaffold and as an independent biomaterial for filling the volume of tissue lost as a result of surgery or injury.

INTRODUCTION. Team sports are an important part of adapting activities for athletes with hearing impairment. However, it is necessary to take into account the focus and intensity of physical activity in athletes with hearing impairment, since sports activities can have a modulating effect on the functioning of the circulatory system, the vegetative balance of the athlete’ body.

AIM. To study the features of heart rate variability and reactivity of the autonomic nervous system in the regulation of heart rate in athletes with hearing impairment.

MATERIALS AND METHODS. Male highly qualified volleyball athletes with congenital sensorineural hearing impairment (26.42 ± 1.38 years old) were examined in a longitudinal controlled study. The comparison group was represented by male volleyball players without hearing impairment. The design of the study included a survey of volleyball players in the transition and competitive phases of sports training. Studies of the autonomic regulation of the cardiovascular system were carried out on the basis of a five-minute recording of cardiac intervals in a horizontal position of the subjects using the Poly–Spectrum–12/E complex according to the generally accepted research protocol.

RESULTS AND DISCUSSION. The study shews that the transition phases of sports training in volleyball players with hearing impairment was characterized by a low stress index (SI — 69.52 arb. unit). The values of HR (69.05 bpm), SDNN (58.50 ms), pNN50 (17.80 %), Mo (0.87 sec), AMo (35.85 %), CV (0.35 sec), PSD (3258.00 ms²) were within the normotonia. The competitive stage of training for athletes with hearing impairment was accompanied by a significant increase in SDNN (143.00 ms), Mo (1.07 sec), CV (0.94 sec), PSD (6078.00 ms²), VLF (3968.00 ms²), LF (1577.00 ms²) and a decrease in the stress index (15.76 arb. unit) compared with the group of volleyball players without hearing impairment. Regardless of the stage of sports training, the humoral-metabolic channel of regulation dominated the spectrum of cardionetrvals.

CONCLUSION. The vegetative status of volleyball players with hearing impairment during the recovery period was characterized by moderate dominance of the autonomous regulation circuit with high activity of humoral and metabolic channels of heart rhythm regulation. During the competition period, significant differences in vegetative support were noted in athletes with hearing impairment, which were characterized by high variability and power of the spectrum of cardiointervals, the development of pronounced parasympathicotonia.

INTRODUCTION. The high prevalence of stress conditions among the Russian population contributes to the development of a large number of psychosomatic disorders associated with them, which cause frequent referral of these functional conditions to somatic medical institutions, along with the difficulty of timely diagnosis, which keeps the search and development of diagnostic algorithms aimed at their verification relevant. The National Medical Research Center for Rehabilitation and Balneology is working on the creation of a questionnaire “Comprehensive assessment of the physiological symptoms of stress”, in which a preliminary survey of specialists was conducted.

AIM. Collecting information on somatovegetative symptoms of stress from senior medical staff directly caring for patients.

MATERIALS AND METHODS. According to a pre-developed questionnaire, which includes 12 dysfunctional blocks related to various systems and functions of the body, 160 doctors and medical psychologists were interviewed, who were asked to describe patients’ complaints of disorders of various organs, systems and/or functions, having a functional, stress-related character, which they observed in their practice. Descriptive statistics methods were used to process the results.

RESULTS AND DISCUSSION. The analysis of the survey results allowed us to identify 47 dysfunctional symptoms from various organs and body systems that were not yet present in any of the existing blank forms of scales and questionnaires for stress diagnosis. They formed the basis of the questionnaire being developed, but turned out to be non-specific: they could not only be somatovegetative manifestations of stress conditions, but also be the cause of other diseases.

CONCLUSION. The survey made it possible to identify a wide range of psychovegetative symptoms. Due to their non-specificity, when developing a new questionnaire, it is necessary to add additional clarifying characteristics that make it possible to accurately determine their stress-related nature. Modern digital technologies make it possible to create algorithms that include a large amount of clarifying data, and, at the same time, select only the information necessary for a particular case during diagnostics, saving time. It is expected that the creation of a new questionnaire in a modern digital format will make it possible to optimize the diagnosis of psychosomatic pathology.

INTRODUCTION. The clinically frequently detected combination of ronchopathy (snoring) and obstructive sleep apnea is an important problem in modern medicine. Correction of this pathology is performed surgically with known success, however, in this regard, it is necessary to point out the features of the condition of most patients that prevent surgical intervention, as well as the observed frequency of recurrence of the process. In addition, the importance of transient factors in upper respiratory tract obstruction, which require correction during the acute phase, indicates the prospects for the development of modern therapeutic approaches.

AIM. To study the effectiveness of the original spectral phototherapy method in the complex treatment of patients with ronchopathy and obstructive sleep apnea syndrome.

MATERIALS AND METHODS. The study included 90 patients (67 men and 23 women) aged 30 to 75 years with bronchopathy and moderate obstructive sleep apnea. The examination of these individuals was carried out using questionnaires, pharyngoscopy, respiratory monitoring, and biochemical analysis (calculating the balance of a number of trace elements) before, 10 days, and 3 months after treatment. These patients were divided into three groups, each consisting of 30 people. In all groups, standard treatment was performed, including positional therapy, exercises for facial muscles, etc. In group 1, they limited themselves to this, while in group 2, they additionally used intraoral mouthguards, and in group 3, mouthguards and spectral phototherapy were used.

RESULTS AND DISCUSSION. The data from the questionnaire survey performed after treatment reflected the regression of disease manifestations in patients of all groups, however, with the priority of the third group, the treatment of which included spectral phototherapy. A decrease in the intensity of snoring and a decrease in the number of episodes of sleep apnea with improved sleep quality was noted after 10 days of treatment in 12 patients of the first group, 18 in the second and 21 in the third, and after 3 months of treatment, the preservation of the therapeutic effect was noted in 9 patients of the first group, 11 in the second and 15 in the third, which correlated with an increase in potassium, magnesium, manganese, and calcium, and corresponded to the transition of OSA from moderate to mild.

CONCLUSION. Spectral phototherapy is an effective method indicated for use in the complex treatment of patients with ronchopathy and obstructive sleep apnea syndrome of moderate severity.

INTRODUCTION. Diastasis rectus abdominis (DRAM) is a pathologic condition of connective and muscular tissue in which there is thinning and stretching of the white line of the abdomen. The latest current statistics indicate that women are at high risk of developing DRAM both during pregnancy and in the postpartum period. The optimal means for DRAM correction is exercise therapy.

MAIN CONTENT OF THE REVIEW. This review analyzes the features of correction of DRAM in postpartum women with exercise. The review was based on the research methodology developed by the Joanna Briggs Institute (JBI) — an international research organization specializing in evidence-based medicine in collaboration with partners; treatment guidelines; and Scoping Review meta-analysis data. Randomized controlled clinical trials, descriptive studies, articles published in English and in full-text, without any restrictions on the date of publication, were also studied.

CONCLUSION. The findings allowed us to determine the main focus areas in the use of physical rehabilitation in the postpartum period to correct DRAM.

INTRODUCTION. Patients who have suffered a stroke require long-term and intensive rehabilitation measures to restore both vital and motor, cognitive, psycho-emotional and other functions of the body. Along with the use of physiotherapy methods, transcutaneous electrical neurostimulation can be used already at the stage of the patient’s stay in the intensive care unit; however, due to the lack of modern information on its effectiveness, this method is extremely rarely included in rehabilitation programs at the early stages.

AIM. To evaluate the clinical effectiveness of using electrotherapy with different durations of procedures at the II stage of medical rehabilitation, including the period of patients with stroke in the intensive care unit.

MATERIALS AND METHODS. A randomized controlled trial was conducted at the National Medical Research Center for Rehabilitation and Balneology between 2024 and 2025, involving 61 patients who had suffered an ischemic stroke. All patients were divided into 4 groups, which underwent a standard medical rehabilitation scheme, as well as additional electrotherapy with a duration of 10, 20 and 30 minutes, a course of 14 procedures. BEFORE the start of the course of procedures, as well as after its completion, muscle strength in the affected limbs was assessed on a five-point scale, as well as an assessment on the Rivermead, Rankin, NIHSS, and rehabilitation routing scales.

RESULTS AND DISCUSSION. A total of 61 patients of both sexes (27 men (44 %) and 34 women (56 %)) took part in the study. The average age of the patients was 59 years. All patients suffered from acute cerebrovascular accident (ACVA) of the ischemic type in the basin of the right/left middle cerebral artery. At the end of the course of electrotherapy procedures in the main group, with an exposure of 30 minutes, muscle strength in the affected limbs in the distal sections increased (shoulder muscles 1.9b. (1.0; 2.3); forearm/hand muscles 1.5b. (0.5; 1.8); thigh muscles 2.2b. (1; 2.5); lower leg/foot muscles 1.5b. (1.1; 1.8)) compared to the control group (0.9b. (0; 1.5); 0.3b. (0; 1); 1.1b. (0; 2); 0b. (0; 0.5), respectively) (p < 0.05).

CONCLUSION. Additional physiotherapeutic treatment in the form of transcutaneous electrical neurostimulation of patients who have suffered a stroke, initiated during their stay in the intensive care unit at the second stage of medical rehabilitation, proved to be more effective in improving the motor activity of paretic limbs compared to the standard rehabilitation programme. The best results were in the group with a duration of electrotherapy of 30 minutes, significantly improving muscle strength in the affected limbs in the distal sections (shoulder muscles 1.9b. (1.0; 2.3); forearm/hand muscles 1.5b. (0.5; 1.8); thigh muscles 2.2b. (1; 2.5); calf/foot muscles 1.5b. (1.1; 1.8)) (p < 0.05) at the end of the rehabilitation course lasting 20 days.