Bulletin of Rehabilitation Medicine

INTRODUCTION. The consequences of perinatal lesions of the central nervous system (CNS) are one of the leading causes of childhood disability. Spasticity plays a leading role in the formation of motor disorders. An important aspect of the medical rehabilitation of children with perinatal CNS lesions, including premature infants, remains the minimal use of drug therapy, in this regard, the main task is to develop and scientifically substantiate new non-drug technologies for medical rehabilitation.

AIM. To study the dynamics of motor activity of patients with cerebral palsy in the postoperative period using a robotic complex based on functional scales.

MATERIALS AND METHODS. The main 1 group (n = 30) consisted of 20 boys and 10 girls, the control 2 group (n = 30) consisted of 17 boys and 13 girls. The patients received comprehensive rehabilitation treatment: robotic mechanotherapy procedures at the Lokomat complex, individual therapeutic gymnastics procedures, physiotherapy, massage, in addition, some patients received botulinum therapy for the lower extremities. In the main group, in addition to the standard rehabilitation program, classes were held at the DIEGO complex. The functional scales of muscle strength scale (MRC), Manual Ability Classification System (MACS), and the Ashworth scale were used to assess the effectiveness of treatment.

RESULTS AND DISCUSSION. On the scale of muscle strength, the proportion of patients with an increase of 1 point was 40 % among the patients of the main group, 3.3 % among the control group; on the Ashworth scale, with a decrease of 2 points — 20 % and 10 %, respectively. The volume of movements in the affected limb after a course of treatment using DIEGO complex training in the main group increased statistically significantly in the shoulder joint during extension (p = 0.0197), retraction (p = 0.0216) and reduction (p = 0.0232).

CONCLUSION. The inclusion of additional classes on the DIEGO robotic complex in the treatment program for patients with cerebral palsy (GMFCS II–III art.) due to the positive dynamics of motor skills on the muscle strength and Ashworth scales allows us to recommend this method as an auxiliary for use in an individual rehabilitation program for such patients.

INTRODUCTION. Due to the growing prevalence of patients with cerebral palsy, unfavorable prognosis for full recovery in most cases and the need to overcome daily difficulties associated with limited motor activity and associated symptoms of the disease, special attention should be paid to the development of effective methods of rehabilitation in parallel with improving the quality of life of such patients and their family members.

AIM. To study the effect of rehabilitation of pediatric patients with cerebral palsy using the technology of “non-invasive brain-computer interface-hand exoskeleton” on the physical, mental state of patients and the role of the family in the process of rehabilitation.

MATERIALS AND METHODS. The study involved 108 children suffering from cerebral palsy was carried out. Of these, 83 children underwent rehabilitation using robotic complexes “non-invasive brain-computer-exohand interface”, 25 children with cerebral palsy formed the control group. All children participating in the study underwent a psychophysiological tests before and after the rehabilitation course. The level of arm motor activity and spasticity, the ability to perform daily living motor skills, and psychological state were assessed in comparison with the control group. A questionnaire was administered to the parents of patients before and after the course of treatment.

RESULTS AND DISCUSSION. Statistically significant changes in both neurological and psychological indicators were identified after the rehabilitation of children with cerebral palsy in the “Exohand-2” and “Junior” groups. The ability to perform daily tasks improved, household skills and self-care abilities increased (z = 5.938, p = 0.0001), spasticity levels decreased (for the right (z = 4.720, p = 0.0001) and left (z = 4.742, p = 0.0001) hands), and hand muscle strength increased (z = 6.092, p = 0.0001). There were also positive changes in the level of daily activity (z = 5.776, p = 0.0001). An increase in self-esteem scores was observed (z = 2.58, p = 0.003). The observed changes led to a decrease in dependence on others and had a positive impact on family relationships. Changes in the attitude of parents to the rehabilitation process were noted. Parents participated in the discussion of the results, noted positive changes in their children’s condition, and the emotional atmosphere in the family improved after the rehabilitation course.

CONCLUSION. The results obtained indicate the effectiveness of the method of rehabilitation of children diagnosed with cerebral palsy using robotic complexes “non-invasive brain-computer-exohand interface” and the need for special attention to the quality of life of patients with cerebral palsy and their parents, since psychological support of family members increases commitment to the rehabilitation process.

INTRODUCTION. The authors present the data of the literature review devoted to the problem of treating intervertebral disc herniations by various methods, the choice of surgical and conservative approaches to treatment, the timing of symptom relief, and resorption of the hernial protrusion.

AIM. To analyze the used techniques of acupuncture, indications and contraindications to its use.

MATERIALS AND METHODS. The authors present in detail their own treatment method within the framework of traditional Chinese medicine using the methods of corporal and auricular acupuncture and moxibustion, and indicate specific points of influence. A total of 127 patients were treated using this method over the period 1993–2022.

RESULTS AND DISCUSSION. Acute pain syndrome was relieved on average on the second day (1.98 + 0.9 (1–4 days)), and residual pain syndrome on the 6th day (5.73 + 2.1 (3–16 days)). The time of lifting the restrictions on motor activity (often due to the fear of recurrence of pain) was more individual and amounted to 1–1.5 months. The time of resorption of the hernial protrusion was from 4 to 11 months. The time of hernia regression in studies devoted to this issue averaged 17.0 + 7.2 months or from 8.5 to 24 months. Recurrence of hernias was noted in 18 patients against the background of repeated inadequate physical activity. Clinical examples with data from objective research methods before and after acupuncture treatment are given.

CONCLUSION. According to the authors, the key to the success of conservative treatment of intervertebral hernias lies in the synthesis of classical methods proven over thousands of years and the most effective and evidence-based methods of modern medicine.

INTRODUCTION. Stress can act as an etiological factor in about 80 % of diseases, its impact on health is multifaceted and the burden of stress continues to grow. Currently, every fifth adult in Russia experiences a high level of psychoemotional stress. Stressful conditions are characterized by a high prevalence, which contributes to the high incidence of patients with vegeto-somatic symptoms of stress in non-psychiatric medical institutions, where the detection of these disorders is difficult. The search and development of optimal diagnostic methods for stress-related psychosomatic disorders remains a very important and urgent problem.

AIM. The current scales and questionnaires for stress diagnosis, to evaluate the features of their presentation of vegeto-somatic symptoms of stress and the possibility of their use to identify stressful conditions in medical institutions.

MATERIALS AND METHODS. The databases used were: PubMed, eLIBRARY.RU, Frontiers platform. The search was conducted by keywords in Russian and English: stress, stress diagnosis, psychological diagnosis of stress, stress psychometrics, somatoform disorders, stress tension. The search depth for publications is 10 years.

MAIN CONTENT OF THE REVIEW. The scales and questionnaires for assessing stress conditions, which are most often used in modern foreign and domestic research (including in medicine), are analyzed, taking into account the representation and specifics of the description of vegeto-somatic symptoms of stress in them.

CONCLUSION. Current stress diagnostic questionnaires were developed in the second half of the 20th century and have a blank form. In modern foreign studies, when choosing a method for diagnosing stress, priority is given to brevity: the fewer items in the questionnaire, the more often it is used; in domestic studies, the frequency of use of the questionnaire is additionally influenced by the period of its Russian-language adaptation. In the studied blank forms of questionnaires, somatic manifestations of stress are either not taken into account at all, or only individual symptoms are taken into account.

INTRODUCTION. The use of antitumor therapy in patients with breast cancer has led not only to an increase in their life expectancy, but also to the need to correct various side effects, including manifestations of cardiotoxicity. Rehabilitation of such patients in Russia is currently lacking.

AIM. To search and analyze the literature on the effectiveness of physical training for the prevention of cardiotoxic complications of antitumor therapy.

MATERIALS AND METHODS. Publications from the PubMed, Scopus, Web of Science, PEDro databases over the past 15 years were collected and analyzed 15 years by keywords in Russian and English: “cardiotoxicity”, “exercise”, “breast cancer”. 126 sources were selected, including systematic reviews and a Cochrane review.

RESULTS AND DISCUSSION. Preclinical studies have shown that physical exercise reduces the accumulation of antitumor drugs in the myocardium and increases the proliferation of cardiomyocyte progenitor cells. Conducting physical training during and after anticancer treatment increases cardiorespiratory endurance and reduces the manifestations of anthracycline cardiotoxicity. This rehabilitation intervention leads to less fatigue, decreased depression, improved physical fitness, cognitive functions, and quality of life. The greatest effectiveness during and after anticancer therapy was shown by aerobic and strength exercises of moderate intensity, performed for 30–40 minutes 3–5 times a week, which provide 150 minutes of physical activity per week. The limitation of the use of physical training in patients is due to the impossibility of predicting the training heart rate by age, as well as the need to take into account concomitant diseases and the patient’s condition.

CONCLUSION. The use of physical training can be used in cancer patients to prevent cardiotoxicity of anticancer therapy. Further research is needed to ensure their successful use in patients with different physical fitness and treatment tolerance.

INTRODUCTION. The development of an interdisciplinary consensus on the care of elderly and elderly patients with proximal femoral fractures is an urgent problem of modern medicine. The provisions of this Consensus will help to establish effective interaction between physicians of different specialties on the basis of their better understanding, which will contribute to the improvement of specialized medical care, saving lives and reducing disability of elderly patients with hip fractures through.

MAIN CONSENSUS CONTENT. Hip fractures through are one of the most frequent and severe complications of osteoporosis. Difficulties in the management of elderly and elderly patients with hip fractures through are due to both the severity of the injury itself and comorbidity, which is accompanied by high mortality and extremely poor quality of life of survivors. Effective management of such patients is possible only with the joint participation of doctors and nurses of surgical and therapeutic profiles within the framework of the so-called orthogeriatric approach. Experts in the field of traumatology and orthopedics, anesthesiology and resuscitation, geriatrics, regenerative medicine, clinical pharmacology, therapy, rheumatology and endocrinology on the basis of available clinical recommendations and orders of the Ministry of Health of the Russian Federation, literature data, scientific studies and general discussion have formulated the main provisions of the Consensus, interdisciplinary management of elderly and elderly people with hip fractures through.

CONCLUSION. The introduction of the Consensus provisions developed by experts into the practical work of specialized medical organizations in Russia will improve the quality of medical care for a complex category of elderly patients with hip fractures through, save many of their lives and reduce the level of disability, which will undoubtedly have positive social and economic consequences.

INTRODUCTION. The need to develop an effective rehabilitation complex for patients with acute viral pneumonia in the intensive care unit (the first stage of rehabilitation).

AIM. To assess the impact of rehabilitation measures on the acid-base state of the blood and the level of oxygenation of patients with a new coronavirus infection in the intensive care unit.

MATERIALS AND METHODS. The work analyzed the data obtained from 108 patients with a confirmed PCR test for a new coronavirus infection who were treated in the intensive care unit (ICU) for at least 7 days.

RESULTS AND DISCUSSION. The condition of the patients was assessed by blood saturation (SpO₂), the analysis of the acid-base state of the blood (CSF), the reaction of the blood medium (pH), the partial pressure of carbon dioxide in the blood (pCO₂) was carried out, from 33.01 to 37.18 mmHg at p < 0.05 and in the group with the use of sound gymnastics, an increase in blood saturation from 93.6 % to 95.03 %.

CONCLUSION. Based on the analysis of the data obtained, we came to the conclusion that the early start of rehabilitation and mobilization of patients with a new coronavirus infection statistically significantly increases blood saturation, and also manifests itself in stabilization of the acid-base state of the blood, which leads to a decrease in the effects of decompensation and the effects of metabolic disorders on the patient’s body and, in turn, may affect the outcome diseases and the duration of the patient’s stay in the ICU.