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卷 23, 编号 1 (2024)
Original studies
Therapeutic physical factors in the stage medical rehabilitation of patients with benign prostatic hyperplasia in the postoperative period: a randomized controlled study (based on long-term observations)
摘要
BACKGROUND: Benign prostatic hyperplasia is one of the most common urological diseases in older men. The incidence of complications arising after transurethral resection is quite high, despite the many developed surgical and rehabilitation medical technologies.
AIM: Is to study the efficiency of the staged medical rehabilitation of patients with benign prostatic hyperplasia after using pharmacotherapy and therapeutic physical factors according to long-term observations.
MATERIALS AND METHODS: Observations were carried out on 106 patients with benign prostatic hyperplasia after transurethral resection of the prostate gland. Using simple randomization, 2 groups were formed: the first (control; 1G, n=52) received treatment in accordance with clinical recommendations; the second (main; 2G, n=54) received staged rehabilitation: at the inpatient stage ― the immunomodulator Tamerit, in day care inpatients ― extracorporeal magnetic stimulation, in outpatients ― nordic walking. Assessment of the effectiveness of rehabilitation was carried out using I-PSS, QoL quality of life scale, uroflowmetry, determination of pelvic floor muscle strength according to the Oxford scale and load tolerance using the six-minute walk test.
RESULTS: Staged rehabilitation of patients with benign prostatic hyperplasia in the postoperative period ensured a significant restoration of the function of the neuromuscular apparatus of the pelvic floor, which was recorded on all scales and uroflowmetry. This led to a decrease in the frequency and severity of lower urinary tract symptoms, which was significantly more significant (p <0.05) in relation to the use of standard treatment measures. The well-known aftereffect of therapeutic physical factors contributed to the preservation of the positive effects achieved during rehabilitation for up to 6 months.
CONCLUSION: The inclusion of immunomodulators, extracorporeal magnetic stimulation and Nordic walking against the background of standardized drug therapy at various stages of rehabilitation ensures a significant restoration of the quality of life in patients with benign prostatic hyperplasia in the postoperative period.
5-14
Dynamics of markers of oxidative stress during the complex use of therapeutic physical factors in patients with true eczema associated with metabolic syndrome
摘要
BACKGROUND: Among various pathological conditions associated with true eczema, metabolic syndrome occupies a special place, the high social significance of which is determined by its dominant influence on the main demographic indicators — life expectancy and mortality of the population.
AIM: Assessment of the dynamics of parameters of pro- and antioxidant systems in patients with true eczema in combination with metabolic syndrome during the course application of broadband medium-wave phototherapy, mesodiencephalic modulation and their combination.
MATERIALS AND METHODS: A prospective, controlled, comparative, randomized study was performed involving 115 patients with true eczema combined with metabolic syndrome, who were divided into 4 groups using simple randomization. The first group (control) received only basic drug therapy. In the second (comparison 1), third (comparison 2), and fourth (main) groups, patients additionally underwent courses of broadband medium-wave phototherapy, mesodiencephalic modulation, and their combination, respectively. The results of the course application of physiofactors were assessed by the dynamics of pro- and antioxidant system indices before and after the end of therapy.
RESULTS: When comparing the main markers of oxidative stress between the group of healthy people and patients with true eczema in combination with metabolic syndrome, a pronounced imbalance in the "prooxidants-antioxidants" system was established, which indicates the development of oxidative stress. Conducting complex therapy had a corrective effect on the parameters of the lipid peroxidation process. More pronounced shifts in lipid peroxide metabolism indicators were revealed in the groups with the additional use of physiotherapeutic factors. The maximum corrective effect in relation to oxidative stress was established in the group with the complex use of physiofactors. An integrative assessment of the dynamics of oxidative stress markers using the antioxidant protection coefficient confirmed the results obtained.
CONCLUSION: The use of therapeutic physical factors in the therapy of true eczema and metabolic syndrome is largely based on their ability to act as redox regulators of intracellular processes, exhibiting a stress-limiting effect and restoring oxidation-reduction homeostasis. The most promising in this regard are broadband medium-wave phototherapy and mesodiencephalic modulation.
15-27
Changes in clinical condition and quality of life of patients with involutional changes of facial skin and metabolic syndrome after the course of treatment with therapeutic physical factors
摘要
BACKGROUND: The presence of concomitant chronic non-infectious diseases, which significantly increase in probability and severity with age, contributes to the intensity of external manifestations of involutional processes. This is absolutely true for the metabolic syndrome, which is confirmed to be associated with involutional changes in the skin and soft tissues of the face through systemic mechanisms of comorbidity, determining mutual additive influences.
AIM: The aim of the study was to evaluate the clinical efficacy of the combined use of transcranial magnetic field therapy, oxygen bar therapy, and laser phoresis of hyaluronic acid for the treatment of involutional skin changes in patients with metabolic syndrome.
MATERIALS AND METHODS: Using a simple randomization technique, patients with involutional skin changes associated with metabolic syndrome (n=120) were divided into 4 groups of 30 subjects each. Subjects in group 1 (control group) received only laser phoresis of hyaluronic acid; subjects in group 2 (comparator group 1) received one course of transcranial magnetic therapy; subjects in group 3 (comparator group 2) received one course of oxygen bar therapy; subjects in group 4 (experimental group) received one course of combined treatment (laser phoresis of hyaluronic acid + transcranial magnetic therapy + oxygen bar therapy). Results were evaluated based on changes in the severity of key clinical and functional signs of age-related skin changes. In addition, the quality of life of the patients was evaluated using the Dermatologic Index, and the overall aesthetic improvement was evaluated using the Global Aesthetic Improvement Scale (GAIS).
RESULTS: The comorbidity of chronoaging with metabolic syndrome is associated with subjectively more severe major clinical manifestations of facial skin aging and indicative changes in its morphological and functional parameters. A comparative analysis of the effectiveness of using different monotherapy regimens showed the most significant regression of clinical manifestations with the laser phoresis of hyaluronic acid. The total subjective score of major clinical manifestations of age-related skin changes decreased by 39.8% on a visual analog scale (VAS), and the quality of life increased by 61.7%. The GAIS score was 2.48. Visual analog scale scores were largely consistent with changes in objective skin parameters. In the transcranial magnetic therapy and oxygen bar therapy groups, the effect was weaker and almost equal. The highest efficacy was reported in the experimental group: regression of clinical manifestations of skin chronoaging and restoration of objective dermal parameters were reliable and exceeded the level of the control group after the treatment.
CONCLUSION: The combined treatment shows a significant increase in clinical efficacy due to the pathogenetic effect on the metabolic syndrome. Sinergy of therapeutic physical factors is achieved by different modalities, sites of treatment, and mechanisms of biological potential.
28-42
Long-term outcomes of complex medical rehabilitation of patients with rhinosinusitis with nasal polyposis and comorbidities
摘要
BACKGROUND: Comparative evaluation of courses of alternating magnetic therapy, low-intensity laser therapy, low-intensity laser radiation and hypoxic training in complex medical rehabilitation of atopic dermatitis and asthma patients with rhinosinusitis with nasal polyposis showed high efficacy of the additional use of physical factors in enhancing the regression of major clinical manifestations of the disease and improving the quality of life.
AIM: The aim of the study was to evaluate the long-term (6, 12, and 18 months) outcomes of complex medical rehabilitation of patients with rhinosinusitis with nasal polyposis, including those with atopic dermatitis and asthma, to assess the preventive potential of instrumental physiotherapy, and to determine the optimal time parameters for retreatment with these therapeutic options.
MATERIALS AND METHODS: Patients were divided into groups with isolated rhinosinusitis (n=90), atopic rhinosinusitis (n=93) or asthma (n=105) according to the severity of rhinosinusitis with nasal polyposis. Each group was in turn randomized into 3 subgroups: the control one, the comparator one, and the experimental one. All subjects received a standard treatment program (endonasal Nasonex, 2 doses twice a day; daily nasal rinsing twice a day). Patients in the comparator subgroups also received dupilumab (300 µg once every 2 weeks); the experimental subgroups received alternating magnetic therapy and low-intensity red laser radiation (633 nm). For atopic dermatitis, narrowband medium wave (311 nm) and broadband long wave (320–400 nm) radiation was added to this treatment program. For asthma, alternating magnetic therapy and low-intensity laser radiation were supplemented with hypoxic interval training.
RESULTS: Positive changes in evaluated clinical parameters were reported in all groups during the entire follow-up period. However, the presence of comorbidities reduced the therapeutic potential of the standard treatment program, according to the results of the long-term observation. The addition of dupilumab significantly improved the condition of patients with isolated rhinosinusitis with nasal polyposis. However, a history of atopic dermatitis and especially asthma reduced the duration of disease remission. The addition of physical factors to the treatment program, pathogenetically justified in the treatment of atopic dermatitis (phototherapy) and asthma (hypoxic training), reliably prolonged the remission period. Complex physiotherapy leads to long-term reduction of pathological correlations, which is manifested by decrease in weight of correlation graphs.
CONCLUSION: The main aim of the follow-up phase of the study was to evaluate the duration of the clinical result achieved, which determines the preventive potential of instrumental physiotherapy techniques, frequency and regularity of physiotherapeutic interventions. Retreatment is recommended after an average of 9–12 months for isolated rhinosinusitis with nasal polyposis and 15–18 months for atopic dermatitis and asthma.
44-56
Effect of systemic ozone therapy added to pharmacological treatment on brain-derived neurotrophic factor (BDNF) and cognitive status in post-COVID patients
摘要
BACKGROUND: Treatment is required for post-COVID cognitive impairment associated with functional limitations, reduced work capacity, and significant deterioration in quality of life. Pharmacological treatment is ineffective. In this context, physical therapy, especially systemic ozone therapy with potential neuroprotective effects, appears promising.
AIM: The aim of the study was to evaluate the effect of systemic ozone therapy added to pharmacological treatment on plasma brain-derived neurotrophic factor (BDNF) levels and cognitive status in patients with post-COVID cognitive impairment.
MATERIALS AND METHODS: A total of 140 patients aged 18-45 years with post-COVID asthenic syndrome were evaluated and treated. They were randomized into two groups: an experimental group with 70 subjects who received systemic ozone therapy in addition to pharmacological treatment and the comparator group with 70 subjects who received pharmacological treatment only. Pre- and post-treatment outcomes were assessed using plasma BDNF levels and the Montreal Cognitive Assessment (MoCa) score.
RESULTS: Statistically significant differences in BDNF levels (р=0.034) and MoCa scores (р=0.002) were found between the compared groups at the end of therapy (day 30). In our study, adding systemic ozone therapy to pharmacological treatment in patients with post-COVID cognitive impairment normalized BDNF levels and completely improved clinical manifestations of cognitive impairment in 95% of subjects.
CONCLUSION: Therefore, systemic ozone therapy can be considered as one of the effective and pathogenetically proven strategies for comprehensive treatment of patients with post-COVID cognitive impairment in the outpatient setting.
57-67
Review
Review of domestic inventions on methods for diagnostics of postural disorders of the musculoskal system
摘要
The development of the musculoskeletal system depends on many components of anatomically determined changes in the body, the structure of movement patterns and the mechanisms of action involved in it. Postural disorders can arise as a result of various reasons and be a source of further changes in the body, influencing the development of compensatory changes and functional transformations of the motor sphere. Diagnosis of the state of the musculoskeletal system is an urgent task, through which many somatic changes can be corrected or compensated in a timely manner.
This article reviews patent documents from databases such as FIPS, Orbit, Google patents over the past 30 years. It was revealed that the study of postural disorders is carried out in four areas of study: visual assessment in a standing position; diagnostic methods using stabilometric platforms; characteristics of disturbances in the assessment of muscle electrical potentials and analysis of the kinematics of motor actions during movement. In their content aspect, these diagnostic methods are focused on the quantitative and qualitative characteristics of the location of the boundaries of the regions of bone segments, the center of gravity of the body and the parameters of its movement during motor action; assessment of electromyographic indicators of coordination of muscle efforts in static and dynamic positions; analysis of the biomechanics of movement patterns with consideration of various components of the motor act.
68-75