Vol 22, No 4 (2023)

There are three main citation databases in the world (Web of Science, SCImago and Scopus) determining journal quartiles annually according to their own datasets and methodologies. The aim of this editorial is to analyze bibliometric indicators of the journal “Bulletin of Rehabilitation Medicine” (BRM) in Scopus. According to CiteScore 2022, BRM ranked 101/146 in the subject category MEDICINE-REHABILITATION which placed BRM in Q3. Over a past year, BRM increased its citation 51-fold, and its CiteScore 8-fold. In the period of 2019–2022 more than 50 authors from almost 20 countries published in BRM. During the same period almost half of BRM articles received citations not only in Russian journals indexed in Scopus but also in sources from 13 other countries. Besides, BRM produces twice the average number of publications per year in its subject category. Thus, such bibliometric picture of BRM in combination with open access and no article processing charges, demonstrates a strong editorial position of the journal and a clear competitive advantage for authors.

INTRODUCTION. Applying a personalized approach in the treatment of urinary incontinence in patients after RP can significantly improve the rates of correction of postoperative incontinence.

AIM. To study the effect of personalized rehabilitation of patients with prostate cancer (PCa) after radical prostatectomy on the state of functional indicators of the lower urinary tract.

MATERIALS AND METHODS. The study included 60 patients with verified primary resectable prostate cancer who underwent laparoscopic nerve-sparing prostatectomy. Patient ages ranged between 46 and 77 years (median 62.8 years). The patients were divided into main and control groups of 30 people each. The patients of the main group received rehabilitation using a personalized approach. The rehabilitation programs for the patients in the control group were formed on the basis of a syndromic-pathogenetic approach. Functional parameters of the lower urinary tract were assessed using a 24-hour pad test and a comprehensive urodynamic study before and after surgery, after a course of rehabilitation and 1 year after surgery.

RESULTS. Assessment of the degree of urinary incontinence in patients with prostate cancer using a 24-hour pad test showed similar clinical pictures in both groups in the postoperative period in the form of mild or moderate disorders. After the rehabilitation course, a positive trend was observed, however, in the observation group, 66.7 % of patients completely retained urine, while in the comparison group only 40%. Similar trends were observed in a year after a surgical treatment. According to a comprehensive urodynamic study (CUDS), after rehabilitation in the observation group, 76.7 % of patients showed signs of restoration of detrusor activity to the preoperative level with retention of the effect a year after the intervention (p < 0.05). A peak decrease in maximum detrusor pressure was observed in the postoperative period with a partial recovery of the indicator after rehabilitation and after 1 year in both groups. In the comparison group, a more pronounced decrease in detrusor pressure was observed, but the difference was statistically insignificant (p > 0.05).

DISCUSSION. This study tested a personalized approach in the rehabilitation of patients with urological oncology. This concept allows the use of physical and rehabilitation medicine technologies with maximum efficiency by identifying a specific patient model. The results of functional research methods (pad test, KUDI) are one of the potential determinants of the effectiveness of the use of rehabilitation technologies.

CONCLUSION. The results of rehabilitation of patients in the group with a personalized approach can significantly improve the rates of correction of postoperative incontinence.

INTRODUCTION. The development of peripheral polyneuropathy in cancer patients after chemotherapy has a high prevalence and represents an important medical and social problem. Currently, a number of physiotherapeutic methods are used to treat peripheral polyneuropathy induced by chemotherapy (PPIC).

AIM. To study clinical efficacy of high-intensity pulsed magnetic therapy in patients with PPIC according to indicative quality of life indicators.

MATERIALS AND METHODS. 90 patients with PPIC were included in the study. The mean age of the patients was 57.3 ± 5.3 years. Two groups were formed by randomization method: control group patients (n = 45) received standard drug therapy; main group patients (n = 45) received 10 high-intensity pulsed magnetic therapy (HIPMT) procedures every other day against the background of standard therapy. We analyzed clinical complaints, pain syndrome according to VAS, EORTC QLQ-CIPN20 scale scores, and quality of life indicators according to SF-36 questionnaire in patients with PPIC on day 20 after the start of clinical intervention.

RESULTS. After the conducted course of high-intensity pulsed magnetic therapy there was a significant increase in the cohort of patients with a lower degree of severity of PPIC, the proportion of patients with PPIC belonging to subgroups 0–1 degree of severity increased by 6.6 % (p < 0.01). Initial limb pain syndrome according to the VAS system in patients with PPIC in the main group decreased from 6.8 ± 1.2 to 2.4 ± 0.8 points (p < 0.05). In the control group VAS changed from 7.0 ± 1.1 to 6.3 ± 0.9 scores (p > 0.05), which was not statistically significant. It was found that inclusion of high-intensity pulsed magnetic therapy in the treatment program allows for more significant positive changes in sensory, motor and autonomous-vegetative manifestations of PPIC. According to the SF-36 scale, statistically significant differences were found in relation to physical functioning in patients of the main group. There was also an improvement in the indicators reflecting the social components of the quality of life in patients who received the course effect of (HIPMT) from 61 [58.6; 64.4] points to 66 [59.7; 70.0] points by 8.2 % (p < 0.05). Psychological health in the main group improved by 17.02 % (p < 0.01). In the control group, there were no significant shifts on any of the scales (p > 0.05).

CONCLUSION. The use of the high-intensity pulsed magnetic therapy procedures proved to be highly effective in correcting the main indicators of the quality of life of patients with PPIС.

INTRODUCTION. Oral cavity and oropharyngeal cancers usually require extensive surgeries accompanied by damages to anatomical structures and impaired speech function.

AIM. To compare the effectiveness and terms of speech rehabilitation in patients with cancer of the oral cavity and oropharynx using various speech restoration techniques.

MATERIALS AND METHODS. We studied the effectiveness and length of speech rehabilitation in 140 patients with stages II–IV oral cavity and oropharyngeal cancer. The age of the patients ranged from 24 to 70 years. All the patients underwent hemiglosectomy. Combined modality treatment and postoperative speech rehabilitation were performed according to the technique developed in the Department of Head and Neck Tumors of the Oncology Research Institute. Speech rehabilitation effectiveness was studied on the basis of subjective and objective evaluation of speech using the computer-software complex (OnkoSpeech v 1.0).

RESULTS AND DISCUSSION. Impaired speech function of patients was observed before starting combined modality treatment and manifested as a change in the prosodic system of speech and subjective communication difficulties associated with the presence of a tumor. After surgery, all the patients demonstrated impaired speech function, ranging from distorted pronunciation to the complete absence of verbal communication. Speech rehabilitation started 8 to 29 days after surgery: in the study group I, Me = 9.6, in the study group II, Me = 9.8, values did not have statistically significant differences (p < 0.05). At the beginning of speech rehabilitation, to restore activity and coordinate the work of articulatory apparatus muscles and speech expiration, special complexes of articulation and breathing exercises followed by sound pronunciation correction were performed. Postoperative speech rehabilitation resulted in the improvement of speech function in 100 % of cases. In group II, where the correction of sound pronunciation was performed on the basis of speech diagnosis data using the OnkoSpeech v 1.0 computer-software complex, it was possible to achieve a better result of sound pronunciation correction of all the studied sounds, except for hissing (lingual-frontal) [sh], [zh], [shch], [ch].

CONCLUSION. The use of the OnkoSpeech v1. ± software package for speech computer-aided diagnosis made it possible to objectively evaluate and quantify the effectiveness of the correction of the sound pronunciation of six phonemes of the Russian language, improve the results of the correction of sound pronunciation and reduce the time of speech therapy.

INTRODUCTION. Stroke is the leading cause of disability of the population. In addition to motor disorders, cognitive and affective disorders contribute to the development of disability. The development of effective neurorehabilitation programs aimed not only at reducing the severity of motor deficits, but also at timely correction of psychoemotional disorders in stroke patients is very relevant for restorative medicine. In view of the proven positive therapeutic effect of physical exercises on anxiety and depression, their protective effect on cognitive functions, it is of interest to study the effect of motor rehabilitation on psychoemotional disorders in stroke patients.

AIM. To study the effect of sensorimotor rehabilitation on affective and cognitive disorders in patients in the recovery period of stroke in comparison with a complex psychotherapeutic technique.

MATERIALS AND METHODS. The study examined 2 groups of patients in the recovery period of ischemic stroke (up to 2 years) with the presence of anxiety and/or depressive disorders, comparable in gender, age, duration and focus of stroke localization, severity of neurological deficit. The 1st group — 24 patients — received a course of sensorimotor rehabilitation without targeted impact on affective disorders; the 2nd group — 25 patients — a course of complex medical and psychological adaptation lasting 18 days. The effectiveness of rehabilitation was assessed using validated scales and questionnaires (Rivermead Mobility Index, 6-point muscle strength assessment scale, modified Ashfort spasticity scale; Berg balance scales, Beck depression, Spielberger-Khanin anxiety, MMSE, MoCA; Schulte Table Methodology, SS-QOL Stroke Quality of Life Assessment Scale). Statistical analysis was carried out using the StatTech v. 2.8.8 program (developed by Stattech LLC, Russia).

RESULTS AND DISCUSSION. The preliminary assessment carried out in both groups showed a twofold predominance of anxiety states over depressive ones, concomitant cognitive impairments were detected in 88 % of patients, among whom attention disorders were most often recorded (there was no intergroup difference in these indicators). After completing the course of both sensorimotor and medico-psychological rehabilitation, both groups showed a significant decrease in the level of situational and personal anxiety on the Spielberger-Khanin scale, positive dynamics on the MoСа scale, the SS-QOL questionnaire, while a significant decrease in the level of depression on the Beck scale was registered only in patients of the 2nd group on against the background of the use of specialized psychotherapeutic techniques.

CONCLUSION. Motor rehabilitation is positively comparable with complex medical and psychological adaptation, it affects anxiety and cognitive functions in patients with ischemic stroke, it can be considered as one of the effective ways to correct anxiety states and prevent cognitive impairment in these patients, while in the treatment of depression the priority is should be given to specialized medical and psychological intervention.

INTRODUCTION. The COVID-19 pandemic has created threats and risks not only for the physical but for the mental health of people as well. To date, there is insufficient scientific data on anxiety, depression in patients who have undergone COVID-19, and the clinical effectiveness of comprehensive medical rehabilitation programs in patients with post-COVID disorders.

AIM. Tostudy the clinical effectiveness of the use of audiovisual stimulation and cognitive behavioral psychotherapy in the complex rehabilitation of patients with post-COVID syndrome.

MATERIALS AND METHODS. The study included 59 patients with the long COVID disorders from 1 to 6 months after the disease, of which 41 (69.5 %) women and 18 (30.5 %) men aged between 31 and 81, with the mean age being 59.73 ± 1.59 years. All the patients were randomized into two groups. Group I (main) included 29 patients, 9 men, 20 women, the mean age 60.72 ± 2.04 years, who underwent medical rehabilitation using audiovisual stimulation and cognitive behavioral psychotherapy techniques. The II (control group) included 30 patients, including 9 men, 21 women; the mean age was 58.63 ± 2.44 years, who underwentrehabilitation consisting of a standard set of measures. To objectify emotional disturbances, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program for assessing subjective comfort, situational and personal anxiety were used. Statistical data processing was carried out using the program “Statistica-10“. The degree of differences in quantitative indicators in the groups was assessed by the Wilconson test, the significance of differences between the groups after the treatment was made by the Mann-Whitney test (p). The assessment of qualitative indicators was carried out by analyzing multifield tables using the Pearson chi-square test.

RESULTS. The use of audiovisual stimulation and cognitive behavioral psychotherapy in the complex rehabilitation of patients with long COVID disorder syndrome contributed to the regression of emotional disorders, as evidenced by statistically significant changes in indicators on the HADS, Spielberger-Khanin, State Scale (p < 0.05). No signs of anxiety and depression were observed after the treatment in 27 (93.1 %) patients. Average (reference) levels of situational and personal anxiety were observed in 28 (96.6 %) and 21 (72.4%) patients, respectively. The subjective comfort index reached a high level in 19 (65.5 %) (p < 0.0001) patients.

DISCUSSION. The study showed that patients who had suffered COVID-19 and had long COVID disorders before the treatment were under the influence of a high-intensity stressful situation, experienced high-level anxiety and experienced severe psycho-emotional stress. The use of audiovisual stimulation and cognitive behavioral psychotherapy helped to increase the number of patients without anxiety and depressive symptoms (p < 0.05), reduce the high level of situational and personal anxiety on the Spielberger-Khanin scale (p < 0.05), and increase tolerance to psychological stress and the ability to independently cope with stress and its consequences.

CONCLUSION. A comprehensive rehabilitation program, including audiovisual stimulation and cognitive behavioral psychotherapy, helps to effectively relieve emotional stress and change the inappropriate behavior of patients with long COVID disorders.

INTRODUCTION. The interruption of the recovery process and the absence of patients’ activities at home after discharge from a medical institution leads to the loss of results achieved at various stages of medical rehabilitation. In this regard, the remote (telemedicine) form of rehabilitation assistance is of particular importance.

AIM. To present up-to-date data on the legal and regulatory framework for telemedicine in the Russian Federation, as well as an overview of domestic Internet platforms in the field of remote medical rehabilitation.

MATERIALS AND METHODS. The search for normative legal acts was carried out on the “The official Internet portal of Legal Information” (www.pravo.gov.ru). The literature review was performed using the databases eLibrary, Cyberleninka, PubMed, Scopus, Web of Science (Core Collection) and Google Scholar by July 31, 2023 for the following keywords: telemedicine, remote physical rehabilitation, medical rehabilitation, functional recovery.

RESULTS. The article elaborates on the legal and regulatory framework of telemedicine in the Russian Federation, provides a list of domestic Internet portals that are now being employed to provide remote medical care.

CONCLUSION. The remote form of arranging rehabilitation is supported by the regulatory and legal framework and has promising outlooks for development due to the advent of new information technologies that allow for active communication between a medical worker and a patient. Nevertheless, the issues of effectiveness and safety of remote physical rehabilitation remain insufficiently studied, therefore, it is necessary to conduct randomized comparative studies analyzing long-term results.

INTRODUCTION. Diaphragm is not only the main human respiratory muscle, it also plays an important role in maintaining intra-abdominal pressure, balance, upper limb motor function, swallowing and speech. In patients with cerebral stroke, the function of the diaphragm can be impaired on the side of hemiparesis in more than half of the cases and may negatively affect the entire recovery process. Moderate clinical manifestations of unilateral diaphragm dysfunction require special examination methods for diagnosis and planning of appropriate rehabilitation measures.

AIM. To analyze the predictors and compare of methods for diagnosing diaphragm dysfunction in patients with hemiparesis during the recovery period of stroke to improve the quality of the rehabilitation diagnosis and the effectiveness of further rehabilitation process.

DISCUSSION. An analysis of publications over the past five years was done. Anatomical and physiological aspects of the diaphragm are identified, and a comparison of manual and instrumental methods for the diaphragm function evaluation are presented. An assessment of diagnostic methods is given in terms of accuracy, accessibility and possibility of use for dynamic monitoring of patients. The main values of normal indicators of diaphragm function and their level in case of unilateral dysfunction are presented. Predictors of diaphragm dysfunction in patients with hemiparesis as a result of stroke are identified.

CONCLUSION. Timely diagnosis of diaphragm dysfunction will ensure the appropriate rehabilitation goal setting during the recovery period of a stroke and will help to optimize the interventions and increase the effectiveness of rehabilitation process. The information is addressed primarily to specialists working in rehabilitation. The search was carried out using the Pubmed and RSCI databases.

INTRODUCTION. Stress is one of the risk factors for chronic non-communicable diseases, such as cardiovascular diseases, autoimmune disorders, mental disorders, and neurotic conditions like depression and anxiety. Therefore, it is important to predict and correct stress-related problems early.

AIM. To assess the impact of stress on the human body, a comprehensive review of both Russian and international sources was conducted across databases like PubMed, eLibrary, and CyberLeninka for the period 2011–2023. The search terms used included “stress effect”, “predictive model”, “mathematical modeling”, “stress”, “mathematical model”, and “stress-related diseases”.

CONCLUSION. The literature review has revealed that chronic stress exerts a significant negative impact on the human body, verifiably leading to disorders of the digestive, nervous, endocrine, cardiovascular, and immune systems. At the current stage, stress diagnosis is conducted using both questionnaire methods and instrumental techniques, each having its respective advantages and limitations. Several scientific studies emphasize the importance of mathematical modeling as a tool for simulating the effects of stress on the body and analyzing the key mechanisms predisposing to the development of pathologies. The algorithms for constructing predictive models presented in this publication may serve as a foundation for the development of an automated expert advisory system.