Vol 24, No 6 (2025)
- Year: 2025
- Published: 17.12.2025
- Articles: 13
- URL: https://journals.eco-vector.com/2078-1962/issue/view/14526
Full Issue
Articles
Effectiveness of health-resort treatment of varying duration in adult patients with bronchial asthma: a multicenter randomized study
Abstract
INTRODUCTION. Bronchial asthma (BA) is one of the most common chronic diseases.
AIM. To assess the clinical effectiveness of health-resort treatment (HRT) for patients with asthma lasting 7, 14, 18, and 21 days in order to determine its optimal duration.
MATERIALS AND METHODS. In 2024, a multicenter randomized study was conducted at 3 scientific and clinical branches of the National Medical Research Center for Rehabilitation and Balneology of the Ministry of Health of the Russian Federation, including 64 patients with BA. Before and after the treatment courses, a general clinical examination, testing (exercise tolerance, quality of life test, ACT, hospital anxiety and depression scale), general blood test, spirometry were performed. Treatment of patients included: aerotherapy, halogenation, therapeutic exercises according to the method for diseases of the respiratory system, exposure to low-intensity laser radiation on the projection of the roots of the lungs, exposure to an alternating magnetic field on the area of the back of the chest, inhalations with mineral water, gas-air carbon dioxide baths (Reabox, Russia), dosed walking along the terrain cure routes.
RESULTS AND DISCUSSION. After 7 days of HRT, there was a statistically significant reduction in the number of asthma attacks (McNemar's χ2 = 21.76, p = 0.005), the need for symptomatic treatment (McNemar's χ2 = 21.76, p = 0.005) and improvement in ACT questionnaire scores (Z = 2.02; p = 0.04), which persisted during 14, 18 and 21 days of health-resort treatment (p < 0.05 according to the Wilcoxon test). With health-resort treatment lasting 14, 18, and 21 days, there was a statistically significant decrease in the number of patients complaining of shortness of breath (McNemar's χ2 = 21.76, p = 0.005), and an increase in FEV1 and FVC values (Z = 3.4, p = 0.001; Z = 3.35; p = 0.0001 — comparison group 2; Z = 3.06, p = 0.002; Z = 3.06; p = 0.002 — comparison group 2; Z = 2.24, p = 0.03; Z = 2.24; p = 0.03 — comparison group 4, respectively). The patients in all groups showed a statistically significant increase in the distance covered in the 6-minute walk test (Z = 3.18, p = 0.0002; Z = 3.82; p = 0.0001; Z = 3.0, p = 0.001; Z = 3.62; p = 0.0003, respectively), with HRT durations of 14, 18, and 21 days – an improvement in quality of life (Z = 2.77; p = 0.006; Z = 2.37, p = 0.02; Z = 1.95; p = 0.049, respectively), with a 21-day duration — a decrease in depression levels (Z = 2.2; p = 0.028). When comparing the increase or decrease in indicators between the patient groups, no statistically significant differences were found.
CONCLUSION. The minimum sufficient period of health-resort treatment for patients with bronchial asthma was determined to be 7 days, with 14 days being the optimal period.
8-17
Analysis of an individual's psychological well-being in a professional environment: from motivation to job satisfaction
Abstract
INTRODUCTION. The professional activity of the subject of labor is viewed primarily through the phenomenon of professional activity, understood as a manifestation of subject activity, the need to “serve”, enthusiasm, demonstrated in professional activity and providing the degree of interaction and the nature of relationships, and reflecting the hierarchy of personality motives, designed to ensure the optimal functioning of a person in the profession and in life. The key importance is given to the structure of motivation of professional activity. Job satisfaction is thus considered to be one of the significant characteristics of the quality of satisfaction of a person’s psycho-emotional, personal, and social needs, affecting his or her psychological well-being. The article is focused on the study of the structure of professional motivation among education workers with different levels of professional satisfaction.
AIM. Research into the structure of professional motivation among education workers with different levels of professional satisfaction.
MATERIALS AND METHODS. The study was conducted using the “Integral satisfaction with work” method by Batarshev A.V., the “Motivation of professional activity” method (Zamfir K. in the modification of Rean A.A.), the “Self-assessment of professional development” and “Professional development and motivation” methods by Lazareva M.V. Statistical processing of the results was carried out using the SPSS Statistical 23 program.
RESULTS AND DISCUSSION. The authors reviewed the results of an empirical study of the structure of professional motivation among employees of general education organisations in five Russian regions (n = 371). The components of motivation for professional activity that are most significant for managers and teachers of modern schools were found: personal interest (average = 7.12), relationships with employees (average = 6.26), satisfaction with the level of professional aspirations (average = 5.74), preference for job content over earnings (average = 5.62). A divergence in the structure of the motivational organization of education workers was identified, categorized by high and low levels of professional satisfaction. It was found that teachers with high levels of satisfaction are characterized by a motivational structure in which internal motivation and a focus on professional development play a key role. Teachers with low levels of satisfaction have a more uniform motivational structure, which is mainly expressed in a focus on extrinsic incentives.
CONCLUSION. The results of the study, aimed at studying the psychological well-being of a person in a professional environment through the formation of satisfaction with professional activity, led to the conclusion about the different structure of professional motivation of teachers with high and low levels of job satisfaction, and therefore identified the need for a differentiated approach to building managerial decisions. Social conditions and pragmatic incentives are considered by us as a possible reason for a decrease in teachers’ satisfaction with their professional activities, and therefore their maintenance is important at the level of an educational institution. The research results can be used to develop organizational programs aimed at increasing teachers’ satisfaction with professional activities and improving their psychological well-being.
18-27
Comparative impact of dual-task (motor-cognitive) training and backward walking on balance improvement in older adults: a quasi-experimental study
Abstract
INTRODUCTION. The elderly are individuals who are in the final phase of life and have reached the age of 60 years or more. Along with ageing, the elderly experience various changes in physical, cognitive, emotional, and psychosocial aspects. In addition, the function of the sensory and musculoskeletal systems also decreases. In the musculoskeletal system, physiological changes that occur include decreased muscle strength, flexibility, elasticity, and limitations in joint range of motion.
AIM. To determine the difference in effect between Dual-Task (Motor-Cognitive) and Walking Backward on elderly balance.
MATERIALS AND METHODS. This research is an experimental study with a quasi-experimental design approach with a pre-and post-test design type, which divides the sample into two groups (two group samples). Group A and group B as treatment or experiment groups in the form of giving Dual-Task (Motor-Cognitive) for group A, for group B by giving Backward Walking. The sample comprise 60 people according to the inclusion criteria. Balance measurements were made using the Time Up Go Test (TUGT).
RESULTS AND DISCUSSION. The statistical test results for the paired T-test demonstrate that the test results obtained for the Dual-Task (Motor-Cognitive) treatment group are p = 0.00 (< 0.05) and for the Backward Walking group obtained p = 0.00 (< 0.05) which means that both treatment groups are significant in improving the balance of the elderly. And the results of the independent t-test obtained a value of p = 0.048 (< 0.05). It can be interpreted that there is no significant difference in effect between Dual-Task (Motor-Cognitive) and Backward Walking on improving he balance of elderly individuals.
CONCLUSION. The findings of this study suggest that the outcomes of the independent sample t-test for TUGT demonstrated a value of p = 0.048 (p < 0.05). So it can be concluded that the two treatment groups have no significant difference in effect between Dual-Task (Motor-Cognitive) and Backward Walking on improving elderly balance.
28-34
Decreased masticatory activity in adults with overweight and obesity: a cross-sectional study
Abstract
INTRODUCTION. Eating quickly is associated with an increased risk of developing obesity, likely due to impaired masticatory function leading to increased appetite. However, there is currently little objective data showing changes in chewing rhythm and muscle activity in individuals with high body weight.
AIM. The aim of the study was to compare time and electromyographic parameters of mastication in adults with normal and high body mass index (BMI) during an agar chewing test.
MATERIALS AND METHODS. A cross-sectional study included 61 people with normal weight (BMI between 18.5 and 25.0 kg/m²) and 51 people with overweight or obese (BMI over 25.0 kg/m²). The groups were similar in gender (female was 66 % and 51 %, respectively) and age (mean age was 31.4 and 34.5 years, respectively). Chewing rhythm and electromyographic (EMG) activity of the masseter muscle, temporalis muscle, and suprahyoid muscles were determined in the initial, middle, and final phases of the chewing test.
RESULTS AND DISCUSSION. Adults with a high BMI used 16 % fewer chewing cycles in the initial phase of mastication compared to adults with a normal weight (11.1 vs. 13.2, p = 0.029). Although no other differences in chewing rhythm were found, the dynamic of the decrease in the cycle number, duration, and frequency of chewing was more pronounced in individuals with a high BMI compared to the control group (25 % vs. 30 %, 19 % vs. 21 %, and 8 % vs. 14 %, respectively). The maximal, mean, and area amplitudes of EMG signals were 22-31 % lower for the masseter muscle, 32-37 % lower for the temporalis muscle, and 36–49 % lower for the suprahyoid muscles in comparison with normal-weight individuals.
CONCLUSION. Adults with overweight and obesity had a reduced chewing cycle number at the beginning of mastication and low EMG activity in the masticatory muscles throughout the mastication. Medical rehabilitation for patients with obesity and impaired masticatory function should include the use of therapeutic methods aimed at restoring chewing rhythm and masticatory muscle activity.
35-41
Body composition analysis as a comprehensive method for assessing the effectiveness of medical rehabilitation for lymphedema associated with radical breast cancer treatment
Abstract
INTRODUCTION. Upper limb lymphedema is a common and disabling complication following radical breast cancer treatment, with a prevalence of 20–40 %. Although volumetry remains the gold standard for diagnosing limb lymphedema, it cannot differentiate between lymphatic edema and adipose hypertrophy. Bioimpedance analysis (BIA) offers a more comprehensive approach to assessing body composition. However, the impact of complex rehabilitation programs on multi-compartment body composition in postmastectomy upper limb lymphedema has not been sufficiently studied.
AIM. To investigate the effect of a comprehensive medical rehabilitation program, including laser therapy, magnetic therapy, exercise therapy, intermittent pneumatic compression, and cyclic trainer exercises, on body composition parameters assessed by BIA in patients with upper limb lymphedema, associated with radical mastectomy.
MATERIALS AND METHODS. A cross-sectional study included 30 women aged 35–75 years with post-mastectomy lymphedema. Over 10 days, patients underwent comprehensive rehabilitation alongside a high-protein diet. The effectiveness assessment included anthropometry (circumferences of upper limb segments) and BIA of body composition before and after treatment.
RESULTS. A statistically significant reduction was observed in the circumferences of all upper limb segments on both arms (p < 0.05), except for the right elbow circumference. The most pronounced changes were noted in the proximal segments. BIA revealed a significant decrease in total (p = 0.00035), extracellular (p = 0.00008), and intracellular fluid (p = 0.000002), as well as a reduction in waist (p = 0.00004) and hip circumference (p = 0.0003). Positive changes in lean body mass (p = 0.0018) and musculoskeletal mass (p = 0.004), along with an improvement in basal metabolic rate (p = 0.026), were observed.
DISCUSSION. The results demonstrate the effectiveness of the comprehensive approach in reducing lymphedema and normalizing fluid homeostasis. The pronounced effect in the proximal segments is consistent with literature data on the importance of restoring proximal lymphatic flow. The observed positive dynamics of changes in skeletal muscle mass (p = 0.004), active cell mass (p = 0.0018) and basal metabolic rate (p = 0.026) may indicate an increase in the level of metabolism in skeletal muscles due to an increase in the overall level of physical activity after the rehabilitation course.
CONCLUSION. The comprehensive medical rehabilitation program is an effective means of correcting not only local manifestations of lymphedema but also systemic body composition disorders. The combined use of BIA and traditional anthropometry provides an objective multi-component assessment of rehabilitation effectiveness.
42-50
Opportunities for optimizing comprehensive rehabilitation of children with chronic pathology: a single-center cohort prospective two-stage study
Abstract
INTRODUCTION. Assessment of the effectiveness of non-drug therapy in paediatrics is challenging for two reasons. Firstly, it is difficult to select the correct parameters, and secondly, it is challenging to take into account the energy load and the delayed effects of the treatment. The current focus of research in this field is on the development of universal predictors of the effectiveness of non-drug therapy in children, in order to create personalized rehabilitation programmes.
AIM. Analysis of the use of non-drug technologies in the structure of medical care for children in a multidisciplinary paediatric in-patient facility.
MATERIALS AND METHODS. The article presents our results of a 2-stage in-depth research of the modern non-drug technologies effectiveness on 3 models of patients with sequelae of perinatal damage of central nervous system (n = 127), asthma (n = 104) and remitting multiple sclerosis (n = 97), as well as for children aged 5 years and over, indicators of the total spectrum power and adaptive reserves for heart rate variability and the average time of a simple visual-motor reaction according to neurophysiological testing.
RESULTS. The study has shown that patients with chronic conditions, particularly young children, tend to have reduced adaptive and functional reserves, making it difficult to select adequate non-drug correction methods.
DISCUSSION. The key point of the study was the assessment of non-specific predictors of effectiveness in the implementation of complex rehabilitation of children with chronic pathology on three models of patients with bronchial asthma and relapsing-remitting multiple sclerosis.
CONCLUSION. Rehabilitation of these patients requires individualized selection of non-drug intervention parameters based on the assessment of non-specific predictors of effectiveness.
51-58
Effectiveness of high-intensity pulsed magnetotherapy in complex rehabilitation of patients with coxarthrosis and concomitant spinal osteochondrosis: a clinical trial
Abstract
INTRODUCTION. An innovative trend in magnetotherapy involves the use of devices generating strong magnetic fields with an induction of 100–700 mTl for therapeutic and rehabilitation purposes, among which is the Exotherapy device.
AIM. To study the clinical effectiveness of the Exotherapy device in the complex rehabilitation of patients with coxarthrosis and concomitant spinal osteochondrosis.
MATERIALS AND METHODS. A clinical prospective randomized trial was conducted at the National Medical Research Center for Rehabilitation and Balneology of the Ministry of Health of the Russian Federation. The patients in the control group (n = 30) completed a comprehensive medical rehabilitation programme consisting of laser therapy on the projection area of the hip joint, paravertebral electrotherapy on the lumbosacral region, robotic mechanotherapy, therapeutic massage, and group sessions of exercise therapy sessions. In addition to this, the patients in the main group (n = 30) received high-intensity pulsed magnetic field therapy from an Exotherapy device, according to Method No. 12. The effectiveness of the rehabilitation programme was assessed using functional research methods and scales and questionnaires on the 14th day after its commencement.
RESULTS AND DISCUSSION. After the rehabilitation course, there was a more pronounced decrease in pain on the visual analog scale in patients of the main group (p = 0.00005). When analyzing the test results on the ProKin device after the rehabilitation course, a more pronounced positive trend was revealed in patients of the main group in terms of postural stability with both open and closed eyes (ellipse area, perimeter). Patients in the main group also showed statistically significant positive dynamics in the indicators of maximum extension of the lower extremities, maximum extension force, average extension force, average force in 0.20 seconds, and peak torque (p < 0.05) according to isokinetic dynamometry. According to the video analysis of gait, it was found that in the main group there was a positive trend in the following indicators: the contribution (%) of the support phase increased, the contribution of the transfer phase decreased, the number of steps per minute and walking speed increased.
CONCLUSIONS. Thus, the inclusion of the Exotherapy device in the medical rehabilitation program for patients with coxarthrosis and concomitant spinal osteochondrosis can significantly increase the effectiveness of standard rehabilitation programs.
59-69
Insufficient physical activity: terminology and diagnostics. A review
Abstract
INTRODUCTION. Physical activity (PA) among the population in most countries around the world is steadily declining, increasing the risk of developing non-communicable diseases. Numerous studies and publications have addressed this issue, but they lack terminological and methodological uniformity in defining the type and degree of physical activity impairments.
AIM. Developing a classification of PA levels to serve as the foundation for a comprehensive diagnostic methodology for insufficient physical activity (IPA). This methodology is designed to identify hypokinesia and hypodynamia and assess their consequences.
MATERIALS AND METHODS. The selection of publications was carried out in the PubMed and Web of Science databases, as well as in the eLIBRARY.RU and CyberLeninka scientific electronic libraries, covering the period from January 1985 to July 2025. Initially, 176 publications in Russian and English were selected by such keywords as “physical inactivity”, “hypokinesia”, “physical activity”, “sedentary lifestyle”, as well as 88 publications by keywords: “MET system”, “exercise tolerance”, “cardiorespiratory endurance”, “muscular endurance”. After excluding duplicate articles, 127 sources remained, from which 52 were selected that best corresponded to the purpose of the review, with preference given to publications published in the last 5 years. Experimental scientific articles, reviews, and meta-analyses devoted to the problem of PA reduction and poor exercise tolerance were studied.
RESULTS AND DISCUSSION. Publications analysis showed that the terms “hypokinesia” and physical inactivity (“hypodynamia”) are often used in three different senses: as cause and effect, as synonyms and as independent concepts. In addition to the presence of terminological uncertainty, there is no single standard for assessing the degree of decrease in physical activity, and existing methods have shortcomings. We have developed a classification of physical activity types that eliminates terminological ambiguity. Within the framework of this classification, subtypes of insufficient physical activity are identified, taking into account the contribution of its constituent components: hypokinesia — lack of movement time and physical inactivity — lack of intensity (speed and strength) of physical activity. This classification served as the basis for the creation of a methodology for the comprehensive diagnostics of insufficient physical activity, including survey, specialized questionnaires and testing of exercise intolerance. The methodology is aimed at identifying and evaluating two types of deficiency, manifested by a decrease in cardiorespiratory endurance in hypokinesia and a decrease in muscle strength and endurance in physical inactivity.
CONCLUSION. The developed classification of insufficient physical activity, which takes into account the contribution of hypokinesia and physical inactivity, eliminates semantic uncertainty surrounding the issue of decreased physical activity. The proposed method for the comprehensive diagnosis of insufficient physical activity makes it possible to differentially assess the lack of training degree of the cardiorespiratory and muscular systems, which can become the basis for the development of personalized programs for the normalization of physical activity.
70-81
Remote rehabilitation potential for ischemic stroke patients with complex motor aphasia: a review
Abstract
INTRODUCTION. Speech disorders such as aphasia and dysarthria often occur in patients after a stroke. They are considered second only to motor disorders in terms of severity. Aphasia is one of the most common speech disorders. Due to the vast size of Russia, there are remote communities without qualified speech therapists to restore lost speech function.
AIM. To study the available scientific data on the effectiveness of motor aphasia recovery in patients who have suffered ischemic stroke in a remote format.
MATERIALS AND METHODS. We searched for publications, including 6 meta-analyses, 39 full-text and 16 review publications in Russian and English in the eLIBRARY.RU, PubMed, and Springer Nature Link databases. The search period for publications on remote rehabilitation methods for stroke patients with complex motor aphasia was five years, from January 2020 to February 2025. The review also included a number of earlier seminal works on speech recovery in patients after stroke with complex motor aphasia. Key words in Russian and English are as follows: stroke, complex motor aphasia, rehabilitation, telemedicine, remote format.
RESULTS AND DISCUSSION. Remote patient management in the rehabilitation of motor aphasia is becoming increasingly necessary. This article analyzes available data on the effective use of remote methods for the rehabilitation of patients with motor aphasia.
CONCLUSION. Telemedicine technologies and mobile applications represent a promising area in remote rehabilitation of patients after ischemic stroke with motor aphasia.
82-90
Functional (manual) muscle testing in the diagnosis of peripheral neuropathies in piriformis syndrome: a single-center prospective non-randomized study
Abstract
INTRODUCTION. Piriformis syndrome is one of the most common nosologies encountered by doctors of various specialties. It significantly reduces patients’ quality of life and leads to the formation of an suboptimal motor stereotype accompanied by persistent pain. Early diagnosis and adequate manual and physiotherapeutic correction are difficult due to the lack of generally recognized morphological diagnostic criteria.
AIM. To determine the possibilities of a therapeutic and diagnostic algorithm involving the method of functional (manual) muscle testing based on the developed methodology for examining patients with lower back pain, including those afflicted with various myofascial pain syndromes in the lower extremities.
MATERIALS AND METHODS. Between July 2024 and June 2025 37 patients were under observation (F = 1.04, p < 0.01) — 18 (48.65 ± 4.86 %) women and 19 (51.35 ± 5.14 %) men aged 18 to 52 (34.64 ± 3.46) years with the final clinical diagnosis “piriformis syndrome. G57.0”; The history of the disease ranged from 0.12 to 1.24 (0.51 ± 0.06) years. Each patient was supposed to assess his or her pain syndrome on a visual-analog scale (VAS) of pain from 0 to 10 points. The doctor consistently performed: 1) visual diagnosis of the patient’s postural balance; 2) flexion test; 3) functional (manual) muscle testing of the indicator muscle (anterior [clavicular] portion of the deltoid muscle) in the patient; 4) assessment of the functional state of muscle contraction (hypo-, normal- or hyperreaction); 5) selection of aromatherapy to achieve normoreaction muscle contraction in the patient; 6) functional (manual) muscle testing of the piriformis muscles on both sides of the patient; 7) following the establishment of the side of the fascial shortening of the piriformis muscle, the patient was positioned supine with flexion of the shin in the knee joint. Thereafter, its postisometric relaxation was performed according to Professor V.P. Veselovsky’s methodology.
RESULTS AND DISCUSSION. Hyporeaction was detected in 59.45 ± 5.95 %, and hyperreaction in 40.54 ± 4.05 % of cases. After correction, normoreaction of muscle contraction of the tested muscles was achieved in all observed patients and pain reduction during postisometric relaxation of the affected muscle in 86.49 ± 8.65 % of cases.
CONCLUSION. The use of functional (manual) muscle testing as an express method of early detection of muscle tissue dysfunction has shown its effectiveness in all subjects diagnosed with piriformis syndrome, who have subsequently developed neuropathies.
91-99
Functional electrical stimulation in medical rehabilitation after lower limb joint replacement: a review
Abstract
INTRODUCTION. Total hip and knee arthroplasty (THA/TKA) is a highly effective yet common procedure (> 1.5 million annually worldwide), after which patients face complex and prolonged challenges in restoring muscle strength, proprioception, joint stability, and function. The search for effective adjuvant rehabilitation methods optimizing neuroadaptation in the early postoperative period remains highly relevant.
AIM. To analyze global literature data on the effectiveness of functional electrical stimulation (FES) in the rehabilitation of patients after total hip or knee arthroplasty.
MATHERIALS AND METHODS. The authors conducted an electronic search of publications in the PubMed, Scopus, Web of Science, Google Scholar databases and eLIBRARY.RU. The search was performed using the following keywords: "functional electrical stimulation", "rehabilitation", "arthroplasty", "postoperative recovery", "physiotherapy". The authors independently screened relevant studies. The review included studies published in English and Russian, primarily over the last 10 years. Inclusion criteria were as follows: original research, use of biofeedback methods, and clinical evaluation of the applied techniques.
MAIN CONTENT OF THE REVIEW. Analysis of relevant studies revealed heterogeneity in FES application approaches. In the early postoperative period (2–6 weeks), FES demonstrated statistically significant (p < 0.05) improvements in neuromuscular control (increase in integrated EMG activity by 28.7 ± 3.2 %), proprioceptive sensitivity (reduction in kinesthetic perception threshold by 15.3 ± 2.1°), and dynamic joint stability (improvement in stabilometric parameters by 22.4 ± 1.8 %).
CONCLUSION. FES is a promising adjuvant method for early post-arthroplasty rehabilitation, modulating neuroadaptation processes. Optimization of stimulation parameters (e.g., biofeedback integration and personalized activation patterns) may enhance its clinical effectiveness. Further multicenter studies with standardized protocols are needed to evaluate long-term functional outcomes.
100-109
Current therapeutic strategies for the treatment of radiation-induced skin damages: a literature review
Abstract
INTRODUCTION. Radiation-induced skin damage remains a serious clinical problem, affecting a significant proportion of patients undergoing radiation therapy, as well as individuals exposed to radiation due to accidents or environmental factors. The pathogenesis of such damage is extremely complex and includes both acute and delayed cellular responses — deoxyribonucleic acid (DNA) damage, oxidative stress, inflammation, vascular abnormalities, as well as activation of apoptosis, necrosis, and cellular senescence in epidermal and dermal structures.
AIM. To summarize current understanding of the molecular mechanisms underlying radiation-induced skin damage and evaluate current therapeutic approaches, including regenerative medicine technologies.
MATERIALS AND METHODS. A review of the literature was conducted using the PubMed and ScienceDirect databases. Dates of access: September–October 2025.
MAIN CONTENT OF THE REVIEW. This review systematizes current data on the molecular and cellular mechanisms of radiation-induced skin damage, including DNA damage, redox homeostasis disruption, inflammatory and vascular responses, apoptosis, necrosis, and senescence. Particular attention is paid to the analysis of new regenerative approaches cellular, acellular, and bioengineered technologies aimed at restoring skin structure and function. The outlooks for the use of mesenchymal stem cells, the cellular component of the stromal-vascular fraction, exosomes, as well as hydrogels and biopolymer coatings are considered.
CONCLUSION. The topic is relevant due to a high incidence of skin complications in patients undergoing radiation therapy and a lack of universal treatment standards. A comprehensive understanding of the pathogenetic mechanisms and the development of regenerative technologies offer the potential to create personalized therapeutic protocols aimed at restoring morphofunctional integrity and improving patients’ quality of life.
110-117
Cerebrovascular diseases and adherence: a cognitive barrier to achieving treatment goals. A literature review
Abstract
INTRODUCTION. Cerebrovascular diseases (CVD), characterized by a progressive course, are widespread and are one of the leading causes of death worldwide. Patients with CVD have a high level of disability as a result of stroke and cognitive impairment (CI), up to dementia, which can negatively affect treatment adherence and become a barrier to recovery/prevention of further disease progression.
AIM. To examine the characteristics of CI and their impact on treatment adherence, the current possibilities for preventing severe CI, and methods aimed at improving adherence in patients with CVD and concomitant CI.
MATERIALS AND METHODS. Publications were identified through searches of the PubMed, Medline, and eLIBRARY.RU databases, including meta-analyses, review articles, and full-text publications. The search was conducted using the following keywords in Russian and English: cerebrovascular diseases, stroke, cognitive impairment, treatment commitment, cognitive rehabilitation. Emphasis was placed on publications from the last five years.
RESULTS AND DISCUSSION. The analysis showed that the presence of CI in patients with CVD may not only reduce treatment adherence among the patients themselves but also negatively influence medical decision-making. Control of vascular risk factors has little effect on cognitive functioning in patients with CVD. Timely diagnosis of CI, targeted pharmacological treatment, comprehensive cognitive rehabilitation approaches, and dietary strategies aimed at slowing the progression of CI may provide a significant benefit. Modern measures to improve adherence in patients with CVD and concomitant CI are aimed at actively involving relatives, educating healthcare professionals about the specific features of CI in CVD patients, improving doctor–patient communication, and actively implementing telemedicine.
CONCLUSIONS. The problem of adherence to treatment in patients with CVD and concomitant CI remains highly relevant. However, the situation continues to evolve: existing and actively developing interventions aimed at improving adherence through the active involvement of relatives and healthcare professionals, and at early diagnosis, restoration, or slowing of CI progression, can significantly enhance compliance, rehabilitation potential, and the overall well-being of these patients.
118-130