Vol 4, No 1 (2022)


Mechanisms of low-temperature rehabilitation technologies. Sports traumatic brain injury

Shevelev O.A., Smolensky A.V., Petrova M.V., Yuriev M.Y., Zhdanova M.A., Mengistu E.M., Kostenkova I.Z.


According to various data, sports traumatic brain injury (TBI) accounts for up to 20% of all injuries in athletes, and the number of cases of traumatization is progressively increasing year by year due to an increase in the number of people involved in sports, the growing popularity of extreme and contact sports, as well as a high level of motivation to achieve record results. The structure of sports TBI is dominated by mild TBI, which can provoke the development of a very wide range of complications and negative consequences that affect not only the result, but, most importantly, the quality of life of athletes. The pathogenesis of mild TBI has been studied, therapy and rehabilitation programs have been developed. At the same time, the features of sports TBI that significantly distinguish it from domestic, road or criminal injuries are not sufficiently taken into account: repeated frequent TBI, increased body and brain temperature, peripheral redistribution of blood flow and hypocapnia associated with physical exertion and significantly affecting cerebral blood flow. An athlete receives a TBI during the most vulnerable period for the brain. To a large extent, these features are associated with the high incidence of various kinds of neurological complications of sports TBI (cognitive disorders, memory impairment, sleep disorders, migraines, etc.). Special techniques that can prevent complications of sports TBI have not been developed. Brain injury is an independent cause of the development of cerebral hyperthermia, which significantly worsens the course and consequences of TBI. The well-known technology of craniocerebral hypothermia (CCG) allows to reduce physical general and cerebral hyperthermia, to increase the resistance of neurons of the cerebral cortex to hypoxia and trauma. However, this technology is used sporadically, which, apparently, is due to the lack of awareness of coaches and doctors of sports teams specializing in sports medicine and rehabilitation. The purpose of the review is to analyze the features of the action of selective hypothermia of the cerebral cortex, used to prevent complications of mild sports TBI.

Physical and rehabilitation medicine, medical rehabilitation. 2022;4(1):4-13
pages 4-13 views

Risk factors of the severe course and fatal outcome in COVID-19

Sсherbak S.G., Kamilova T.A., Golota A.S., Vologzhanin D.A.


Since its first detection, coronavirus disease 2019 (COVID-19) caused by coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has spread rapidly around the world. Although coronavirus SARS-CoV-2 primarily targets the respiratory system, complications in other organ systems (cardiovascular, neurological, and renal) can also contribute to death from the disease. Clinical experience thus far has shown substantial heterogeneity in the trajectory of SARS-CoV-2 infection, spanning from asymptomatic to mild, moderate, and severe disease forms with low survival rates. Accurate prediction of COVID-19 mortality and the identification of contributing factors would allow for targeted strategies in patients with the high risk of death. We aimed to identify clinical and laboratory features that contributed the most to this prediction. An improved understanding of predictive factors for COVID-19 is crucial for identify those with higher risk of mortality and for clinical decision making to reduce the risk of death. The main risk factors for the severe course of COVID-19, the development of complications and death include old age, concomitant diseases (cardiovascular diseases, chronic lung diseases, diabetes mellitus and hypertension), body temperature ≥37.8°C, oxygen saturation <92%, quantitative and functional depletion of innate immunity, bilateral pulmonary infiltrates, increased levels of laboratory parameters of systemic inflammation, respiratory, cardiac, renal and/or hepatic failure. Proper assessment of prognostic factors and careful monitoring to ensure the necessary interventions at the appropriate time in high-risk patients can reduce the fatality rate from COVID-19.

Physical and rehabilitation medicine, medical rehabilitation. 2022;4(1):14-36
pages 14-36 views


Algorithm for formulation a rehabilitation diagnosis using the international classification of functioning in a patient with a stroke: clinical case

Ivanova G.Е., Bodrova R.A., Builova T.V., Karimova G.M., Komarnitsky V.S.


Background. The International Classification of Functioning, Disability and Health (ICF) is a universal system for assessing the health of the body as a whole, as well as problems that limit life. Using the ICF, it is possible at the level of the body, personality and society to quite accurately investigate the nature and severity of disabilities. Subsequently, this will make it possible, on a scientific basis, to substantiate the need and volume of rehabilitation measures and social protection. For medical professionals, one of the main criteria for using the ICF is the ability to formulate a rehabilitation diagnosis, which in turn makes it possible to determine the goal, objectives, rehabilitation program, and in the future to assess the effectiveness of rehabilitation measures. In the formulation of a rehabilitation diagnosis, the coding for the ICF domains is used. Rehabilitation diagnosis is a description of structural and functional disorders that have arisen in a patient as a result of a stroke, which entailed a restriction of activity and participation, the possibility of using environmental factors that may facilitate or hinder the performance of the described functions by the patient. Clinical case description. The patient, 65 years old, was admitted to the rehabilitation department with complaints of decreased muscle strength, instability when walking, limited mobility, dizziness, impaired pronunciation of words. Directional diagnosis: Ischemic stroke. After the rehabilitation diagnosis was made, the patient had an average rehabilitation potential and a relatively favorable prognosis. During rehabilitation, medical treatment, individual sessions with a psychologist, methods of rehabilitation of violations of regulatory functions, etc. were used. Upon discharge, the evaluation of the scales revealed the positive dynamics of the medical rehabilitation. Conclusion. The ICF evaluates all components of a post-stroke patient's health. The ICF is used in the preparation of a rehabilitation diagnosis and justifies the use of methods of medical rehabilitation. Formation of a rehabilitation diagnosis based on the principles of ICF is a key point in determining short-term and long-term goals for the patient, as well as assessing the rehabilitation potential and prognosis, drawing up an individual plan for medical rehabilitation and further recommendations upon discharge. Our experience of rehabilitation in the post-stroke period has shown that the use of the international classification of functioning in the formulation of a rehabilitation diagnosis in this category of patients allows for a higher efficiency of medical rehabilitation in general.

Physical and rehabilitation medicine, medical rehabilitation. 2022;4(1):37-54
pages 37-54 views

New methods and technologies, discussions

Comprehensive rehabilitation of patients with pneumonia caused by COVID-19 at the ambulatory stage

Novikova T.A., Popov E.A., Rubanik T.V., Shapiro N.V., Shaporova N.L., Tishkov A.V.


Lung damage caused by the SARS-COV-2 virus is a serious obstacle to recovery in patients with COVID-19-associated pneumonia. The treatment of post-COVID-19 syndrome is currently a significant problem in world health care. Therefore, pulmonary rehabilitation is important at all stages of the disease. The article presents programs of restorative treatment, such as physiotherapy, haloinhalation, exercise therapy and hyperbaric oxygenation. Their influence on the indicators of the function of external respiration, on blood tests, CT, pulse oximetry, and on the assessment of dyspnea according to the mMRS questionnaire was considered. It is known that with coronavirus infection, diffuse alveolar damage develops, which can lead to a violation of the diffusion capacity of the lungs (DSL). The article discusses the effect of hyperbaric oxygenation on DSL indicators.

Physical and rehabilitation medicine, medical rehabilitation. 2022;4(1):55-62
pages 55-62 views

Rehabilitation of patients after a new coronavirus infection COVID-19 in a sanatorium-resort institution

Fatuev O.E.


The work is devoted to the organization of post-COVID rehabilitation of patients using adaptive phage therapy technology in a sanatorium-and-spa institution. The use of a complex of agents with bacteriophages for inhalation and oral administration against the background of ongoing physical activity and physiotherapeutic methods of influence helps to restore the functional abilities of the body and optimize the results of previous treatment in patients who have undergone a new coronavirus infection COVID-19.

Physical and rehabilitation medicine, medical rehabilitation. 2022;4(1):63-67
pages 63-67 views

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