Vol 24, No 5 (2025)

INTRODUCTION. Cardiovascular diseases, especially coronary heart disease and strokes, are the leading cause of death (31 % of cases), with hypertension being a key risk factor. Physical exercise, including moderate continuous training and high-intensity interval training, has been proven to reduce blood pressure, but the optimal protocol remains a matter of debate.

AIM. To compare the effectiveness of different physical activity regimens in reducing blood pressure and improving cardiorespiratory fitness in patients with arterial hypertension.

MATERIALS AND METHODS. The search was conducted in PubMed, eLIBRARY.RU, Google Scholar, and other databases using standardized PICOS criteria, including only RCTs with an intervention duration of ≥ 2 weeks. The analysis was performed with an assessment of the risk of bias (Rob 2), reliability of evidence (GRADE), and statistical models (SUCRA, node-splitting), including meta-regression to account for covariates. The results are presented as mean differences (MD) with 95 % CI.

RESULTS AND DISCUSSION. Of the 9,462 publications, 67 studies (4,466 participants) remained after elimination of duplicates and screening. Seven physical training protocols were analyzed (high volume high intensity interval training (HV-HIIT), Low volume HIIT (LV-HIIT), moderate continuous training (MICT), combined MICT + strength training (MICT + RT), Strength training (RT), Circuit training and control group (CON)). Among all the interventions, HV-HIIT demonstrated the greatest effectiveness in reducing office systolic blood pressure (SBP) (–6.85 mmHg (–9.20; –4.50); high level of evidence), whereas MICT + RT proved to be the most effective for lowering diastolic blood pressure (DBP) (–4.80 mmHg (–6.74; –2.84); moderate level of evidence). The central pulse wave velocity (CPWV) decreased most significantly with HV-HIIT (–1.33 m/s (–1.58; –1.08); moderate evidence), and maximum oxygen consumption (VO₂max) increased with the same protocol (+6.38 ml/kg/min (4.91; 7.84); high evidence). Circuit training and resistance training (RT) showed the least effectiveness in reducing blood pressure and improving cardiorespiratory parameters.

CONCLUSION. The study demonstrates that HV-HIIT is the most effective method for reducing systolic blood pressure (SBP) and improving cardiorespiratory endurance (VO₂max), while MICT + RT reduces DBP better. However, data on DBP needs to be clarified due to the heterogeneity of power programs. Long-term studies are needed to clarify the effects of different HIIT protocols on hypertension and to classify training regimens in more detail.

INTRODUCTION. After the end of the pandemic, there is still a need for medical rehabilitation for patients with long-term covid and post-covid syndrome. Given the complex pathogenesis of coronavirus infection, complex rehabilitation methods with a personalized approach are of the greatest interest.

AIM. To determine the effectiveness of medical rehabilitation using personalized normobaric interval hypoxic-hyperoxic therapy (NBIHHT) in patients after coronavirus pneumonia in a day hospital.

MATERIALS AND METHODS. 120 patients with moderate-severity coronavirus pneumonia, randomized into two homogeneous groups, were examined in a day hospital. 60 patients of the comparison group underwent the procedures of the basic rehabilitation program: physical therapy, hydrokinesiotherapy, selective chromotherapy, halotherapy, sessions of psychoemotional relaxation. In addition to the basic program, 60 patients in the main group underwent personalized NBIHHT procedures. In patients of both groups, the intensity and severity of dyspnea (mMRC, BDI/TDI scales), hypoxia tolerance (Stange and Genchi tests), cardiovascular system condition (Martine test), exercise tolerance (six-minute walk test), the function of external respiration (spirography), microcirculation (laser Doppler flowmetry), anxiety and depression severity (HADS scale), and quality of life (SF-36 before, after rehabilitation and in the follow-up after 3 and 6 months) were assessed before and after rehabilitation.

RESULTS AND DISCUSSION. After rehabilitation, a statistically significant positive trend was observed with a significance level of p < 0.05 in patients of both groups for most indicators. However, in patients of the main group, the positive result was statistically more significant, which was manifested by a decrease in the intensity and severity of shortness of breath (p < 0.001), an increase in the indicators of the function of external respiration: an increase in vital capacity by 12.8 % (p < 0.001), forced vital lung capacity by 5.9 % (р = 0.015), forced expiratory volume in the first second by 5.7 % (р = 0.032), peak volumetric exhalation rate by 7.4 % (р = 0.009), an increase in hypoxia tolerance: increased breathing retention time on inspiration (Stange test) by 51.15 % (p = 0.000), on exhalation (Genchi test) by 24.14 % (р = 0.006). There was also an improvement in the functional state of the cardiovascular system: a decrease in heart rate before exercise by 13.29 % (р = 0.000), after exercise by 24.54 % (р = 0.000), an increase in exercise tolerance according to the six-minute walk test by 19.87 % (р = 0.000), and also increased activation of microcirculation (p < 0.001), decreased anxiety and depression levels (p < 0.001), and an improvement in quality of life after rehabilitation (p < 0.001) and during a 3-month observation period (p < 0.001), as well as stabilisation in the follow-up after 6 months (p < 0.001).

CONCLUSION. The inclusion of personalized NBIHHT procedures in the rehabilitation complex of patients with COVID-19 pneumonia can significantly improve immediate and long-term results in a day hospital environment.

INTRODUCTION. The prevalence of overweight and obesity has long been a global public health problem that becomes more acute every year. To increase the effectiveness of weight loss programs based on dietary restriction, including those used in the health resort treatment, it is necessary to take into account individual physiological characteristics associated with restrained eating behavior.

AIM. To measure electromyographic (EMG) parameters of masticatory muscle activity in restrained eaters during an agar chewing test.

MATERIALS AND METHODS. A cross-sectional study was conducted with 129 untrained participants (83 women and 46 men, mean age 32.4 ± 8.1 years) who were categorized as non-restrained (control) and restrained eaters based on scores on the restrained scale of the Dutch Eating Behavior Questionnaire. EMG parameters of masticatory, temporalis, and suprahyoid muscle activity were determined in the initial, middle, and final phases of the chewing test.

RESULTS AND DISCUSSION. Restrained eaters chewed agar gels with the same frequency (1.40 vs. 1.44 sec^-1, p = 0.305), using the same number of chewing movements (31.9 vs. 35.0 times, p = 0.979) and duration of chewing (23.2 vs. 24.2 s, p = 0.710) in comparison to controls. The maximal and mean amplitudes of the masseter muscle signal in restrained eaters were 17 % lower than in controls, despite the chewing cycle duration and frequency being similar. Regardless of eating behavior, the maximal and mean amplitudes of the EMG signal of contraction in the temporalis muscle were 18–21 % and 15–17 % lower than those in the masseter muscle, respectively. The maximal amplitude of the suprahyoid muscle’s EMG signal showed no differences across groups; however, the mean amplitude was 18 % lower in restrained eaters compared to controls. The activity of the masseter and temporalis muscles was reduced in the initial phases of chewing, whereas the activity of the suprahyoid muscles was reduced in the final phase of bolus formation and swallowing.

CONCLUSION. Restrained eaters demonstrated reduced masticatory muscle activation in the chewing test. It is advisable to identify restrained eating behavior and assess chewing function when prescribing calorie-restricted dietary therapy to patients in health resort treatments. Medical rehabilitation of patients with restrained eating behavior should include the use of treatment technologies aimed at restoring the activity of the masticatory muscles.

INTRODUCTION. Physiotherapy interventions are typically employed during the rehabilitation phase or as an adjunct to primary therapy, such as pharmacological or surgical treatment, for patients with chronic or acute conditions. Interest in the immunological aspects of physiotherapy is growing rapidly.

AIM. To summarize the data on the immunological aspects of physiotherapy presented in foreign publications of the last five years.

MATERIALS AND METHODS. The search was conducted in the PubMed and Google Scholar databases using the following keywords: physiotherapy, immunology, innate immunity, acquired immunity, cellular immunity, humoral immunity, and clinical trials. Following the application of the exclusion criteria, 66 studies were selected from the initial 207 articles that were retrieved.

THE MAIN CONTENT OF THE REVIEW. Chronic diseases, as well as the consequences of traumatic injuries, are characterized by chronic inflammation and immune imbalance. Despite impressive clinical successes of rehabilitation, it is not always effective in some patients, which highlights the need to understand and overcome the mechanisms of therapeutic refractoriness. Like other therapeutic modalities, physiotherapy faces the challenge of predicting patient response to intervention. It is assumed that the beneficial effects of physiotherapy are related to its anti-inflammatory, cytoprotective, and antioxidant properties and synergistic effects on immune functions. Our review article provides a concise overview of clinical studies exemplifying such effects, demonstrating the influence of physiotherapeutic manipulations on the population structure of the immune system and cytokine secretion. The review material is structured according to the main methods of physiotherapy, such as traditional methods (massage, treatment with heat, cold, water, mud, ultrasound, laser, magnetic field, hyperbaric oxygenation, pelotherapy), as well as newer ones (thermal and mechanical ablation with high-intensity ultrasound).

CONCLUSION. The materials presented in the review offer a novel insight into the potential of physiotherapeutic interventions on both innate and acquired immunity, as well as their cellular and humoral components. The present state of research in this area is at an early stage. Further large-scale clinical studies are needed to develop recommendations for the safe use of immunomodulatory physiotherapy in the context of specific pathologies. In addition, physiotherapists should acquire additional knowledge in the field of immunology, which is currently beyond their competence, to accurately interpret and use the data.

INTRODUCTION. Platelet-rich plasma (PRP) therapy is a promising minimally invasive method for treating musculoskeletal disorders based on the use of platelet-rich plasma. Its relevance is due to the growth of degenerative-dystrophic joint diseases and the need for alternatives to surgical intervention.

AIM. Analysis and generalization of modern data on the molecular mechanisms of action of autologous platelet plasma treatment, the results of recent clinical studies, as well as analysis of differentiated approaches to autologous platelet plasma treatment in various musculoskeletal pathologies, taking into account the age and clinical characteristics of patients based on high-quality scientific publications from 2020 to 2025.

MATERIALS AND METHODS. A systematic analysis of scientific publications for 2020–2025 from the PubMed, Scopus, Web of Science, and eLIBRARY.RU databases was conducted using the keywords In Russian and English: platelet-rich plasma, PRP therapy, regenerative medicine, osteoarthritis, sports injuries, musculoskeletal disorders. The analysis included randomized trials and meta-analyses on the use of autologous platelet-rich plasma treatment for musculoskeletal disorders. The efficacy was assessed using pain scales, functional indicators, and instrumental diagnostic data. The analysis included 45 scientific publications, including 38 foreign and 7 Russian.

MAIN CONTENT OF THE REVIEW. In knee osteoarthritis, a positive effect in the form of pain reduction and improved function lasting 6–12 months has been observed, offering advantages over hyaluronic acid. In the treatment of tendinopathies, especially epicondylitis, the use of PRP (autologous platelet rich plasma) shows moderate efficacy. In ligament and muscle injuries, the results are mixed. The quality of PRP, platelet concentration, and individual patient characteristics have a key influence.

CONCLUSION. PRP therapy is effective in the comprehensive treatment of musculoskeletal pathologies, especially in osteoarthritis and tendinopathies. The autologous nature of the method ensures its safety. Standardization of protocols, large-scale studies, and development of personalized approaches are needed to improve the effectiveness of treatment and the quality of life of patients.

INTRODUCTION. Postamputation pain is a complex, multifactorial condition that significantly reduces the quality of life in patients after limb amputation. According to our data, among 539 patients who underwent amputation at various levels, postamputation pain occurred in 55.3 %, most frequently after below-knee (64.5 %) and above-knee amputations (62.7 %), and less commonly after amputations of the forearm (31.0 %), upper arm (41.7 %), foot (25.8 %) and hand (26.3 %). Despite considerable progress in elucidating its pathophysiology, effective management of postamputation pain remains a major clinical challenge. The issue has gained further relevance due to the growing number of patients with combat-related injuries, particularly high-energy mine-blast injury, underscoring the need for optimal treatment and rehabilitation strategies.

AIM. To summarize current data on therapeutic and rehabilitation approaches to postamputation pain within a multimodal strategy, taking into account the pathophysiological type of pain.

MAIN CONTENT OF THE REVIEW. This review analyzes current strategies for managing postamputation pain within a multimodal framework. Particular attention is given to pharmacotherapy tailored to the pathophysiological type of pain — nociceptive, neuropathic, nociplastic, or mixed. Non-pharmacological approaches are also discussed, including neurorehabilitation techniques, neuromodulation interventions, and reconstructive surgical procedures. The necessity of a personalized therapeutic plan, with continuous monitoring of pain dynamics and quality-of-life indicators, is emphasized.

CONCLUSION. Postamputation pain has a multifactorial and incompletely understood pathogenesis, which supports the potential effectiveness of both conservative and surgical treatment approaches. However, standardized protocols and convincing evidence favoring specific interventions are lacking. Further investigation into the mechanisms underlying this condition will help define optimal therapeutic and rehabilitation strategies for affected patients.

INTRODUCTION. Adherence to treatment, that is, the patient’s strict compliance with the treatment regimen prescribed by the doctor, is an important problem of modern healthcare around the world.

AIM. Analysis of modern foreign and Russian studies on the importance of adherence to drug therapy in patients with cardiovascular diseases and diabetes mellitus.

MATERIALS AND METHODS. 90 sources from international and domestic databases published for 2025 were analyzed.

RESULTS AND DISCUSSION. Up-to-date information is provided on the terminology, scale of the problem, and economic losses from low adherence to treatment, typical for patients with chronic non-communicable diseases. Adherence factors associated with the drug itself (price, frequency of administration, number of prescribed drugs), with the patient’s personal qualities and medical characteristics (forgetfulness, age, gender, diagnosis and concomitant pathology, history of complications, education, quality of life), with insufficient awareness of the disease and/or drugs, side effects were determined.

CONCLUSION. Thus, the patient’s adherence to drug therapy is determined by a large number of heterogeneous factors, the identification of which is an important step towards choosing the optimal method of influencing the patient’s motivation, behavior and choice. It is also often problematic to build a partnership between a doctor and a patient due to the peculiarities of the clinical picture, the psychological characteristics of certain groups of patients or the low quality of the organization of medical care.