Vol 15, No 3 (2016)

The article presents the research results of influence of the method of functional taping on the contractile ability of muscles in patients with humeroscapular pain syndrome. In the study participated 20 patients with diagnosed reliably humeroscapular pain syndrome in the acute stage. In the main group (13) were subjected to functional taping with a moderate degree of tension of elastic bandages (25-50%) in the control group (7 people) - the degree of tension was maximum (100%). The degree of tension of the patch was estimated from the increase in original length at 140% with a maximum tensile and 120% with moderate. To analyze the efficiency of the method of functional taping were compared with quantitative changes in bioelectrical activity of the shoulder muscles using surface EMG. As a result of the study revealed that the functional application of the tape lead to the decrease of quantitative indexes of contractility of muscles. The degree of tension of the elastic bandage had no effect on changes in the indices of electromyography signal. Thus, functional taping contributes additional support from interested muscle groups and can be used as an alternative to other elastic bandages.

The work is devoted to the problem of rehabilitation of elderly people suffering from various diseases, causing destructive-dystrophic changes in the bone such as osteoporosis, cancer and complications that cause pathological fractures, as well as the study of experimental methods of preventive reinforcement of the proximal part of the femur. We have developed the methodology of preventive reinforcement and construction of the original implants for her conduct, to which the patents of the Russian Federation (No. 2316280, 91845, 98901, 101,351, 121,725, 136,703, 136,704, 140684). Manufactured prototypes of implants of nano-titanium and set of tools for the operation of preventive reinforcement. For the study of biomechanical properties of bone tissue, as well as changes in strength characteristics as a result of the introduction of implants in bone us studies by mathematical modeling, which proved that the voltage at the load in the area of the proximal part of the femur occurs unevenly. This leads to the formation of zones started destroying the bones as the load increases, and after exceeding the critical voltage rise to fracture. In points of destruction reinforced systems bone-implant studies have shown that when critical loads, the voltage is reduced by 11.6% -12.1 in contrast to the intact samples of the bone. Bench testing for the purpose of studying the changes of strength reinforced system of bone-implant in comparison with healthy samples of bones show increased resistance to fractures of the proximal femur reinforced on 23-93% depending on the form and combination used implants. As a result, tests revealed that bone reinforced even after the appearance of the fracture is not accompanied by the fragment offset, which held vnutrikostnymi implants. Studies are entitled to argue that when there is a low-energy trauma, bone-implant system less prone to fracture.

In the article there is given an example of diseases with the similar clinical pattern, with the pain in calcaneus area. The differencial analysis of occasion the pain in calcaneus was done. The success of the treatment the pain in calcaneus area depends directly from the right diagnostics. Shock-wave therapy, corrective shoes, dosed load on foot prevent acute and chronic pain in calcaneus area.

This article explains the importance and the necessity of a conceptually new method of rehabilitation of children in reduced state of consciousness after severe brain injury. During the period from 2014 to 2015 29 children in a reduced state of consciousness have been treated in the Clinical and Research Institute of Urgent Pediatric Surgery and Trauma. 14 children ages 7 to 17 have been passed neurorehabilitation course in an approach of clinical anthropocentrism. Using comparative method the authors present the results of the recovery process of working with children in reduced state of consciousness, with the use of clinical and anthropocentric approach and standard comprehensive rehabilitation. The results of the two groups of patients were evaluated on the parameters: 1. Level of consciousness - GCS, Scale of Dobrokhotova-Zaitsev, Scale communicative activity (SCABLn). 2. Motor opportunities - The scale of the Committee for Medical Research (for R.Van der Ploeg, 1984), Scale of spasticity Ashfort. The methodology of the clinical anthropocentrism is based on: A. The priority of the individual necessities and possibilities of the patient B. Identification and registration of "The Zone of Proximal Development" of the patient (by Vygotsky) C. The primary principle of the work is "the processuality but not situationality." D. No strict instructions in training. The dialogue between the rehabilitation team and the patients in altered states of consciousness in the paradigm of clinical anthropocentrism allows us to see, to understand and to "return" the missing puzzles in the mosaic of destroyed and/or lost patient’s internal integrity. The summary table shows the data of two children from each group. Both children were discharged from the hospital with the improvement in their condition and in the level of consciousness, and in motor abilities. At the same time, the authors have shown that the use of clinical anthropocentrism in dealing with patients, who are in deep altered states of consciousness, is not only possible but also necessary.

Among most important tasks of modern medicine are the solution to the problems of preserving and strengthening the health of citizens. An essential part in solving these problems occupy rehabilitation methods in traumatology and orthopedics, allow a person to prolong the active life, even in the event of an organic pathology or bone injury, causing restriction of its motor activity. Among these methods, it is necessary to include physical therapy, implementation of which, according to clinical studies, increases the regenerative function of bone tissue, as well as increase the periods of remission after complex treatment. The effectiveness of development and application of these methods is largely determined by organizational and economic forms of organization studies and their introduction into clinical practice.

There is a growing number of women worldwide, who experience anxiety disorder during the whole period of pregnancy and take psychotropic medications. Obstetricians, pediatricians, neonatologists and general practitioners are seriously concerned and are interested in alternative methods of psycho-emotional state correction in pregnant women, as pharmacological treatment is considered unsafe for the fetus. The assessment of clinical-pathological characteristics and personality traits during normal pregnancy revealed an increase of trait and state anxiety by the third trimester. High anxiety level during pregnancy has a widely accepted adverse influence on maternal and fetal physiologic state and correlates, according to many researchers, with intense fear of childbirth. It is well-known that women with anxiety and depressive disorders are prone to childbirth fear (tokophobia), compared to women with no mental disorders. There arises an intensive need for the evaluation of non-pharmacologic treatment efficacy of psycho-emotional states during pregnancy and for the development of psychotherapy efficacy criteria in women during the third trimester of pregnancy. The article reviews different non-pharamcologic treatment modalities aimed at the improvement of psychological functioning of pregnant women. Authors emphasize lack of evidence-based data on comparative efficacy of different methods of prenatal care. Authors postulate there is a need for the development of efficacy criteria for prenatal care methods, including objective and subjective, patient-oriented. The main efficacy criterion should be based on comparative data, demonstrating significant differences in subjective well-being and behavior of pregnant and parturient women both according to obstetricians of maternity wellbeing centers, delivery rooms and on the retrospective self-assessment made by women 3-4 days and 1-2 months after delivery.

Разработаны клинические рекомендации по проведению реабилитационных мероприятий при повреждении капсульно-связочных структур коленного сустава, когда проводится оперативное лечение. Описаны основные этапы реабилитации данной категории пациентов. Указаны конкретные сроки назначения физических упражнений. Даны рекомендации по программе реабилитации в амбулаторных и стационарных условиях стационара. Приведены критерии оценки эффективности реабилитационных мероприятий. Клинические рекомендации (КР) предназначены для врачей травматологов-ортопедов, врачей ЛФК и инструкторов-методистов ЛФК (инструкторов ЛФК), врачей-физиотерапевтов и медицинских сестер по физиотерапии, медицинских сестер по массажу, постовых медицинских сестер. Уровень использования клинических рекомендаций: федеральный.