INTRODUCTION. Natural healing factors (NHF) — mineral waters, therapeutic mud, climate, and saline solutions — have a centuries-long history of use in pediatrics. However, to date, there is no systematic analysis of the evidence base for the effectiveness of NHF for various childhood diseases, with a gradation of levels of evidence according to GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. AIM. To conduct a systematic analysis of modern scientific data on the effectiveness of natural healing factors in children, structure the evidence base by nosological groups, and identify promising areas for the development of pediatric balneology. MAIN CONTENT OF THE REVIEW. A search of publications was performed in PubMed, Cochrane Library, Embase, and eLIBRARY.RU databases for the period 2000–2025. Systematic reviews, meta-analyses, randomized controlled trials, and cohort studies were included. Evidence was assessed using the GRADE criteria. The analysis included 42 studies, including 8 systematic reviews with meta-analysis, 12 randomized controlled trials, and 22 observational studies. The strongest evidence base (levels A–B) was found for the use of mineral waters and salt baths in respiratory diseases (asthma, recurrent respiratory infections), skin diseases (atopic dermatitis, psoriasis), and musculoskeletal disorders (juvenile arthritis). Level C–B evidence was established for the use of therapeutic mud and climatotherapy in diseases of the nervous system, digestive organs, and genitourinary system. High potential for extrapolation of these studies to pediatric practice was identified, consistent with modern approaches to developing medicines for children. CONCLUSION. Natural therapeutic factors have proven efficacy in a wide range of childhood diseases. The highest level of evidence has been established for balneotherapy for respiratory, dermatological, and rheumatological pathologies. Key limitations of the evidence base include heterogeneity of treatment protocols, small sample sizes in some studies, and insufficient validation of pediatric efficacy assessment scales. Further randomized controlled trials with standardized protocols are needed to improve the level of evidence and expand the indications for the use of NHF in pediatrics.
INTRODUCTION. Motor development is intricately connected to cortical processes in the brain, and these processes show distinct features in children with intellectual disabilities. Evaluating motor function, creating effective physical rehabilitation programs, and assessing changes in performance indicators relative to neurotypical peers are crucial tasks. AIM. To evaluate the musculoskeletal system and develop a programme of exercise therapy tailored to the specific nature of the disorder, and analyze its effectiveness. MATERIALS AND METHODS. The study was conducted in special education and mainstream schools in Yekaterinburg between 2021 and 2023. It involved 160 children aged 12–14, who were divided into four groups of 40: groups 1 and 2 (control and experimental) comprised individuals with mild intellectual disability, whilst groups 3 and 4 (control and experimental) comprised individuals with neurotypical development. Intellectual development was measured using the Wechsler test, and the condition of the musculoskeletal system was assessed using the Humac Norm biomechanical therapeutic and diagnostic system. Statistical analysis was carried out using SPSS software. For a comparative analysis of the significance of differences between the groups, the non-parametric one-way Kruskal — Wallis ANOVA was used. Correlation analysis was carried out using Spearman's rank correlation test. Quantitative data are described with the median, the 1st and 3rd quartiles. RESULTS. A statistically significant reduction in muscle deficit indicators (ΔD) was observed after 4 courses of exercise therapy using the developed methodology among participants in the experimental groups (ranging from 2 to 15 %). For those muscles where no positive changes were observed, the percentage of negative progress in terms of asymmetry was only 0.5 %. In the control groups, particularly among individuals with intellectual disabilities (IWID), an increase in deficit was diagnosed across all muscle groups studied (ranging from 3.5 to 18.5 %). The changes in strength indicators ranged from 16.73 to 50.7 % in the control group of IWID, and from 23.46 to 63.85 % in the experimental group of IWID; in the control group of individuals with neurotypical development, the range was from 14.22 to 44.35 %, and in the experimental group of individuals with neurotypical development, the range was from 15.1 to 47.85 %. DISCUSSION. Individuals with intellectual disabilities typically exhibit lower baseline muscle strength than their neurotypical peers. However, our study results demonstrated signifi cant strength gains across various muscle groups for all participants, regardless of the severity of their condition. Notably, the experimental group of individuals with intellectual disabilities achieved the greatest improvement in overall performance. CONCLUSION. Methods of exercise therapy, which focused on correcting movement disorders through strength training and the stimulation of interhemispheric interaction using the TRX (Total Body Resistance Exercise) and elastic bands with varying degrees of resistance, has proven effective in promoting physical development and reducing muscular asymmetries.
INTRODUCTION. This review presents an in-depth analysis of the use of medical xenon as a universal agent in modern anesthesiology and therapeutic practice. Particular attention is paid to the use of xenon for the management of chronic pain syndrome in osteoarthritis, where adverse effects and insufficient analgesic efficacy often limit traditional pharmacotherapy. A high safety profile, the absence of systemic toxicity, and the ability to modulate central sensitization make this inert gas a promising component of multimodal analgesia. AIM. To analyze the clinical application of medical xenon and substantiate its efficacy and safety in the treatment of pain syndrome in patients with osteoarthritis based on a systematic review of the literature. MAIN CONTENT OF THE REVIEW. This review was prepared through a systematic search and critical analysis of international literature focusing on the physicochemical properties, pharmacodynamics of medical xenon, and its clinical application in anesthesiology and the management of pain syndromes in osteoarthritis. Relevant publications were identified in Russian and international databases, including eLIBRARY.RU, PubMed, Scopus, and Google Scholar. The search period covered studies from the earliest fundamental research on inert gases (1898) to contemporary clinical guidelines and multicenter trials (2025). The paper examines the physicochemical determinants and molecular mechanisms of action of this inert gas, including its effects on NMDA receptors and metabotropic complexes. The stages of xenon anesthesia are described in detail, and its high safety profile in geriatric and pediatric populations is substantiated. Particular attention is given to an innovative method for managing pain syndromes in patients with osteoarthritis through local para-articular injections of highly purified xenon. The presented clinical experience demonstrates a significant reduction in pain intensity according to the Visual Analog Scale (VAS), along with prolonged analgesic effects in the absence of systemic toxicity. The use of specialized equipment enables optimization of dosing regimens and minimization of adverse effects, thereby opening broad prospects for the use of xenon therapy in the rehabilitation of patients with degenerative joint diseases and in reducing disability rates. CONCLUSION. Available data suggest that xenon can be considered a promising component of multimodal analgesia in patients with osteoarthritis. However, further randomized controlled trials specifically focused on this patient population are required, particularly to assess long-term efficacy and the impact on the neuropathic component of pain.
INTRODUCTION. Cardiac rehabilitation is an important part of the clinical care provided to patients with coronary heart disease. It is essential to clarify the principles governing patient referral in order to improve the effectiveness of rehabilitation programmes. AIM. To identify patient profiles that are most likely to 'respond' to stages 2 and 3 of rehabilitation treatment, drawing on the analysis of factors contributing to the effectiveness of cardiac rehabilitation. MATERIALS AND METHODS. The source of information was an online form comprising 8 sections, 134 performance indicators, which did not contain any patients' personal data. The study results were used in aggregated form; the study did not require approval from the ethics committee. In 2024, cases of patient rehabilitation following acute myocardial infarction in Sverdlovsk Region were analysed, focusing on patients who had completed stages 2nd and 3rd in 2023. The research was carried out throughout 2024 on the premises of A.B. Blokhin Ural Institute of Healthcare Management. A mathematical analysis was performed, comparing pairs of patient groups. The total sample size was 753 cases (594 in stage 2, 159 in stage 3). To assess the effectiveness, the increase in the 6-minute walk test scores and the change in functional class were used; 18 comparison groups were formed. The frequencies of characteristics in the subgroups were calculated, along with values for Pearson's χ2 test, Fisher's exact two-tailed test, and the odds ratio. To develop patient models, indicators showing statistically significant differences (p 0.01) were selected. Data processing and calculations were performed using Microsoft Office Excel-2016. RESULTS. In the subgroup of patients who responded most favourably to stage 2 of the rehabilitation programme — male patients aged under 59, diagnosed with I21.1, with an average Rivermid index (12–13 points), the best scores on the Berg scale (51–56 points), with the lowest risk of falls on the Morse scale (24 points or fewer), a low risk on the GRACE scale (1–108 points), average scores on the Borg scale (15–16 points), and high scores on the Barthel scale (91–100 points). Further consideration is required regarding the impact of patients' condition on admission, as assessed by the GRACE scale and the rehabilitation referral scale, on the success of the 3rd stage of rehabilitation. DISCUSSION. The developed models of patients who 'respond' to the stages of cardiac rehabilitation to the greatest extent and to an insufficient extent indicate the need for a comprehensive assessment using both cardiac-specific and general functional scales. CONCLUSION. When developing models of patients who are most likely to 'respond' to rehabilitation, in addition to the degree of dependency as measured on the rehabilitation referral scale, other criteria must be taken into account to ensure correct referral and to assess the effectiveness of rehabilitation for cardiac patients.
INTRODUCTION. Dysfunction of the lower leg muscle-venous pump (MVP) in post-thrombotic syndrome (PTS) can be considered a therapeutic target in the treatment of chronic venous insufficiency. Correction of muscle dysfunction and reduction of functional deficit (arthritic muscle inhibition / AMI) can be achieved by improving neuromuscular control and proprioception during robotic isokinetic MVP training, which will improve the effectiveness of comprehensive rehabilitation for PTS. AIM. To study the effectiveness of a comprehensive rehabilitation program using robotic isokinetic lower limb muscle training with biofeedback (BFB) on lower leg MVP performance and ankle range of motion in patients with PTS. MATERIALS AND METHODS. The study included 30 patients with lower extremity PTS (C3–C5 according to the CEAP classification), with an average age of 57.24 ± 10.17 years, a disease duration of 8.67 ± 1.14 years, and a BMI of 32.61 ± 5.81 kg/m2. All patients had a documented history of DVT of varying duration. The dynamics of the ankle joint range of motion (AROM) (dorsiflexion, plantar flexion) indicators were studied in degrees according to goniometry data. The performance indicators of the lower leg MVP were investigated according to isokinetic dynamometry of the lower limb muscles, including peak torque, work of the extensor and flexor muscles of the foot and the fatigue coefficient characterizing proprioception. Each patient underwent measurements before and after a rehabilitation course, including intermittent pneumatic compression of the legs No. 12, intravenous laser irradiation of blood using Low-level laser radiation in the infrared range (wavelength 890 nm) No. 12, as well as 12 isokinetic training sessions on a robotic Isokinetic Extremity System "Leg press" with biofeedback. The study was conducted at the National Medical Research Center for Rehabilitation and Balneology from February 2024 to August 2025. RESULTS. At baseline, patients with PTS showed a significant decrease in muscle strength in both limbs (affected and intact). In the affected limb with edema, the extensor strength deficit reached 55–64% of the lower limit of normal, and an even more pronounced deficit of 75–83 % was recorded for the flexors. Moreover, the muscles of the back of the leg (m. gastrocnemius, m. soleus) were weakened to a greater extent than the anterior tibialis and other dorsiflexors. After the rehabilitation course, an increase in AROM (dorsiflexion) goniometry values was noted from 9.88 ± 2.92° to 12.44 ± 4.35° (p 0.001); AROM (plantar flexion) from 26.90 ± 10.06° to 31.27 ± 9.08° (p 0.001). After the rehabilitation course, a significantly more pronounced improvement in the maximum extension torque on the affected limb was noted by 36 % (p = 0.019), compared with an increase of 16.1 % (p = 0.04) in the intact limb; an improvement in the relative extension torque on the intact limb was 45.5% (p = 0.006), compared with the affected limb, where the increase was 16.7 % (p = 0.028), indicating the effectiveness of MVP training in an isokinetic mode and with biofeedback, due to the correction of proprioceptive sensitivity, muscle strength, and, possibly, due to improved coordination abilities. A decrease in the malleolar circumference by 10.4 % (p 0.05) was also noted after treatment. DISCUSSION. In previous studies it has been proven that supravenous Low-level laser therapy provides an anti-inflammatory effect, reducing the severity of perivascular venous inflammation, while pressotherapy promotes lymphatic drainage in PTS. Isokinetic training is an effective method for increasing the hemodynamic efficiency of the muscle pump, overcoming the mechanisms of AMI by activating proprioceptors, as well as muscle strength, as evidenced by an increase in AROM, peak torque, overall work of the extensor and flexor muscles of the foot, and the fatigue coefficient. CONCLUSION. Incorporating isokinetic training of the lower extremity muscles into a rehabilitation program (with intermittent pneumatic compression and Low-level laser therapy) improves the function of the muscles involved in the MVP by reducing the identified functional deficit (AMI).
INTRODUCTION. Balneotherapy — defined as the therapeutic use of mineral-rich water, thermal baths, mud, and gases — has been practiced across cultures for centuries. Persian Medicine (PM), a holistic traditional medical system dating back more than a millennium, also incorporates extensive water-based therapies, medicinal clays, and thermal practices. AIM. To compare balneotherapy with related therapeutic modalities described in classical PM texts, highlighting historical foundations, mechanisms of action, clinical applications, and potential opportunities for integrative research. MAIN CONTENT OF THE REVIEW. A narrative review was conducted using scholarly databases (PubMed, Scopus, and Google Scholar) and classical PM sources, including works of Avicenna (Ibn Sina), Rhazes (Al-Razi), and Jorjani. Modern clinical evidence on balneotherapy was compared with PM concepts and historical applications. Significant conceptual and practical parallels exist between balneotherapy and PM. Both utilize hot and cold bathing, mineral waters, vapors, and medicinal muds for musculoskeletal disorders, dermatologic conditions, gastrointestinal dysfunctions, and mental well-being. Mechanistic overlaps include hydrostatic pressure, thermoregulation, mineral absorption, detoxification, and modulation of humoral balance (PM theory). PM contributes additional insights related to temperament (Mizaj), organ-specific bath prescriptions, and detailed therapeutic protocols. CONCLUSION. Balneotherapy and PM share rich therapeutic traditions with considerable conceptual convergence. Bridging these systems through integrative research could expand therapeutic options and support culturally-informed healthcare models. Further comparative clinical and mechanistic studies are recommended.
INTRODUCTION. Effective medical rehabilitation is based on person-centered goal setting, which determines the logic and scope of interventions by the multidisciplinary rehabilitation team (MDRT). However, to date, it remains unknown to what extent the actually prescribed procedures of the individual medical rehabilitation program correspond to the stated rehabilitation goal, as well as what proportion of "non-target" prescriptions are made by different specialists at the second stage of rehabilitation. AIM. To examine the relationship between the goal formulated by the multidisciplinary medical rehabilitation team and the procedures prescribed within the Individual Medical Rehabilitation Program (IMRP) in patients with central nervous system disorders at the second stage of medical rehabilitation, and to determine the frequency and structure of prescriptions not related to the rehabilitation goal, stratified by each multidisciplinary rehabilitation team (MDRT) specialist. MATERIALS AND METHODS. The retrospective study included 312 patients who completed a rehabilitation course in a department for patients with central nervous system disorders. The following were analyzed: all documented rehabilitation goals (n = 312); each procedure of the IMRP (total of 2,415 prescriptions) with an assessment of its relationship to the goal (related/unrelated); the proportion of goal-unrelated prescriptions, separately for the physical rehabilitation specialist, ergorehabilitation specialist, medical speech-language pathologist, medical psychologist, and physical and rehabilitation medicine (PRM) physician. RESULTS. Of all prescribed IMRP interventions, 54.3 % were directly related to the established rehabilitation goal, whereas 45.7 % showed no such relationship. The physical rehabilitation specialist delivered goal-related interventions in 82.3 % of cases. The proportion of goal-oriented prescriptions was considerably lower among other specialists: occupational therapy specialist — 26.1 %, PRM physician — 26.2 %, medical psychologist — 25.6 %, and medical speech-language specialist — 20.7 %. Consequently, between 73.9 % and 79.3 % of prescriptions from these specialists lacked documented justification by the stated rehabilitation goal. DISCUSSION. The predominance of mobility-related goals (walking, 86.9 %) creates documented grounds for a high proportion of goal-unrelated prescriptions among specialists whose professional scope extends beyond mobility (speech therapist, medical psychologist, occupation therapist). The low proportion of goal-oriented interventions in these specialists (20.7–26.1 %) reflects not a lack of competence, but rather the narrowness of goal formulation that fails to incorporate communication, cognitive, and daily-living needs. Thus, technically sound SMART goal-setting without multidisciplinary consensus does not guarantee content validity of the rehabilitation plan. CONCLUSION. At the second stage of medical rehabilitation for patients with central nervous system disorders, a substantial disconnect has been identified between goal setting and the actual intervention program (IMRP). For several multidisciplinary rehabilitation team specialists — specifically, the medical speech-language pathologist, medical psychologist, and occupational therapy (ergorehabilitation) specialist — nearly half of all prescribed interventions are unrelated to the stated goal. These findings support the need to develop and test standardized goal-setting tools for routine clinical practice in neurorehabilitation within prospective studies.
INTRODUCTION. Each year, over 12 million new stroke cases are reported globally, with up to 50 % of survivors experiencing persistent neurological deficits. The most common among these deficits is post-stroke spasticity. The incidence of spasticity ranges from 20 to 40 % during the early rehabilitation period, and increases to 50–60 % among patients with hemiparesis in the later stages following a stroke. It is important to emphasize that a patient’s recovery after a stroke should not be limited solely to addressing motor impairments. AIM. To evaluate the effect of a comprehensive program combining reflexology and occupational therapy on spasticity and functional mobility, with a focus on short-term outcomes and quality of life in patients with post-stroke spasticity and visual impairments. MATERIALS AND METHODS. A single-centre controlled study included 40 patients in the early recovery phase of an ischaemic stroke (up to 6 months) with spasticity rated 1–3 on the modified Ashworth scale and objectively confirmed visual impairments. The main group, in addition to standard health resort treatment, received a course of reflexotherapy (10 sessions) and occupational therapy (10 sessions). Alongside traditional scales (the Modified Ashworth Scale (MAS), the Barthel Index, the Quality of Life Assessment (EQ-5D-5L) and others), particular attention was paid to timed tests — the Timed Up Go test and the time taken to perform basic self-care tasks. The study was conducted in the premises of the National Medical Research Centre for Rehabilitation and Balneology of the Russian Ministry of Health, between 2024 and 2026. RESULTS. The intervention group demonstrated a significant reduction in spasticity (MAS from 2 [1; 3] to 1 [1; 2] points; p = 0.001) and marked improvement in temporal mobility measures: Timed Up and Go test time decreased from 25.0 [22.5; 28.0] to 22.0 [20.0; 25.0] sec (p = 0.02), while the duration of dressing and eating tasks decreased by an average of 25–30 %. Furthermore, daily living independence rose (Barthel Index from 65 to 85 points; p = 0.0004), quality of life (EQ-5D-5L) improved, and anxiety-depressive symptoms decreased (Hospital Anxiety and Depression Scale (HADS); p 0.01). No adverse events were recorded. DISCUSSION. The use of reflexology and occupational therapy is accompanied by an improvement in the quality of life, a decrease in anxiety and depression, as well as a decrease in pain, which indicates a systemic positive effect on the psycho-emotional status and quality of life of patients. Therefore, the proposed program is characterized by high safety (there were no adverse events) and good tolerability, which makes it possible to recommend it for widespread implementation in health resort institutions providing medical rehabilitation to patients after a stroke. CONCLUSION. The combined use of reflexotherapy and occupational therapy in patients with post-stroke spasticity and visual impairments is a safe and effective method that not only reduces muscle tone but also significantly improves temporal characteristics of motor activity and everyday independence. These findings justify the inclusion of this programme in the standards for health resort rehabilitation to address both motor and time-related functional impairments.
INTRODUCTION. Disorders affecting the nervous system rank among the top causes of illness and disability within the population. Military health resort facilities possess a unique potential for rehabilitating patients with central and peripheral nervous system disorders. Some prospects have been mapped out for developing the potential of military health resorts in the field of neurological rehabilitation. AIM. To evaluate the capacity of military health resorts to provide treatment for patients with disorders of the central and peripheral nervous systems, and the effectiveness of natural and physical therapies. MATERIALS AND METHODS. Medical records from the Podmoskovye and Dalnevostochny health resorts, managed by the Russian Ministry of Defence in 2024, were analyzed. The study focused on various patient categories, the distribution of diagnoses based on ICD-10 classifications. RESULTS. Among patients with neurological conditions, the majority are reservists and their family members (aged 51–88), as well as contract servicemen (aged 21–57) who were admitted following the completion of special missions. In the breakdown of conditions among patients with neurological disorders resulting from wounds, injuries, concussions and other external causes (Class XIX of the International Classification of Diseases, 10th Revision), the following predominate: T93 — sequelae of injuries to the lower limb (including sequelae of open wounds to the lower limb) (33.1 per cent); T92 — sequelae of injuries to the upper limb (19.6 per cent); T94 — sequelae of injuries involving multiple body regions and injuries of unspecified localization (32.4 per cent); T90 — sequelae of head injuries (6.0 %); T91 — sequelae of neck and trunk injuries (6.6 %); T95 — sequelae of thermal and chemical burns, frostbite (1.2 %), and other unspecified external causes (1.1 %). The overwhelming majority of this group are contract service personnel, aged between 21 and 57, who have been transferred from hospitals for medical rehabilitation following the completion of special missions (88.5 % of the total number of individuals in this group). In 92.2 % of cases of treatment in the settings of a military sanatorium, a significant improvement in the patient's condition is achieved. The use of modern physiotherapy methods and VR enabled a significant reduction or complete cessation of pharmacological treatment for pain syndrome in 45–50 % of cases. DISCUSSION. A comprehensive health resort treatment programme involving natural therapeutic agents (mineral waters, muds), hardware physiotherapy, kinesitherapy, psychotherapy and modern techniques (transcranial magnetic stimulation, ozone therapy, pharmacopuncture) enables intervention at various stages of the pathogenesis of neurological disorders. The greatest effectiveness was achieved in patients with post-traumatic neuropathies when the rehabilitation commenced early (2–6 months after the injury). There is a high demand for methods aimed at restoring motor, sensory and psycho-emotional functions. CONCLUSION. Utilizing natural and physical treatment methods in a military sanatorium plays a crucial role in improving the quality of life for patients dealing with neurological disorders. This strategy effectively diminishes both temporary disabilities and long-term impairments resulting from nervous system diseases and injuries. It highlights the importance of ensuring patients' physical, psychological, and social adaptation to new living conditions.
INTRODUCTION. Postmenopausal osteoporosis (PMO) is a common metabolic bone disease leading to fractures, reduced quality of life, and disability. Medical rehabilitation improves functional outcomes, but the effect is often unsustainable. Ibandronic acid is an effective antiresorptive agent; however, its role in maintaining rehabilitation benefits remains understudied. AIM. To evaluate the effect of treatment with oral form of ibandronic acid 150 mg on the duration of maintaining the effect of medical rehabilitation in patients with established postmenopausal osteoporosis undergoing the 2nd stage of medical rehabilitation. MATERIALS AND METHODS. The work included 70 women aged 45 years and older in the postmenopausal period of more than 1 year, admitted to hospital for the 2nd stage of medical rehabilitation for diseases of the musculoskeletal system and diagnosed with postmenopausal osteoporosis. Women were randomized into 2 groups: the main group (n = 35), where ibandronic acid, 150 mg tablets for administration once a month, was prescribed, and the comparison group (n = 35). All patients in the main and comparison groups received cholecalciferol (vitamin D3) at an average dose of 1500 IU per day. Evaluation of the effectiveness of treatment after 12 months was carried out using a “battery” of functional tests to assess the function of movement, strength of the muscles of the spine and abdomen, static and dynamic balance indicators, as well as by assessing pain on a 5-point visual analogue scale and quality of life using the SF-36 questionnaire. RESULTS. At 12 months, the main group showed significant improvements in static and dynamic endurance of back and abdominal muscles, walking speed, Timed Up and Go test, postural control (stabilometry), reduction in fall rate (from 34.3 % to 14.3 %; p 0.05), increase in spine BMD (3.5 %) and hip bone mineral density (2.5 %), a 46.6 % decrease in the resorption marker CTx, improvement in SF-36 domains, and pain reduction on VAS (from 4.0 points to 1.5 points; p 0.05). In the comparison group, positive changes were lost by 12 months. Adverse events in the main group occurred in 11.4 % (transient flu-like symptoms). DISCUSSION. Oral bisphosphonate therapy combined with rehabilitation reduces the risk of falls in postmenopausal osteoporosis. CONCLUSION. Twelve-month therapy with oral ibandronic acid (Rezoviva 150 mg once monthly) combined with medical rehabilitation and vitamin D effectively sustains and enhances functional outcomes, increases BMD, reduces pain and falls, and has a favorable safety profile. It is recommended for long-term management of PMO patients after rehabilitation.
INTRODUCTION. Myofascial Pain Syndrome (MPS) Upper is a chronic condition caused by the activation of trigger points in muscle fibers that cause neck pain and discomfort. Prolonged pain and tightness resulting in limitation of lateral flexion and cervical rotation. AIM. To determine the difference effect between Dry needling and Instrument Assisted Soft Tissue Mobilization (IASTM) on the application of Unilateral down glide on reducing pain and increasing cervical Range of Motion (ROM) in the condition of upper trapezius MPS Physiotherapy Department Students. MATERIALS AND METHODS. This study is a quasi-experimental with a randomized pre-test post-test two group design, involving 30 samples according to the criteria and randomized into 2 groups. This study was conducted at Health Polytechnic Ministry of Health Makassar, Indonesia. Data collection and intervention were carried out between February and May 2025. The first treatment group is given Dry needling and Unilateral down glide intervention, and the second treatment group is given IASTM and Unilateral down glide. Data was collected through measurement of tenderness using Numeric Rating Scale (NRS) and measurement of ROM using a goniometer. RESULTS. Based on the independent sample t-test for the NRS scale, the value of p = 0.251 (mean difference of 4.07 1st group 3.33 2nd group), and for cervical ROM, the value of p = 0.630 for rotation (mean difference of 24.13 2nd group 21.87 1st group), p = 0.661 for lateral flexion (mean difference of 13.67 2nd group 12.47 1st group). DISCUSSION. This study indicates that Dry needling intervention can produce a greater reduction in pain than IASTM, while IASTM can produce a greater increase in cervical ROM than Dry needling, although statistically there is no significant difference between both groups. CONCLUSION. There is no superior group between two groups. Dry Needling and Unilateral Down Glide interventions group have more effect on reducing pain, while IASTM and Unilateral down glide interventions group have more effect on increasing cervical ROM in upper trapezius myofascial pain syndrome.
INTRODUCTION. In the comprehensive rehabilitation of patients with coronary heart disease (CHD), spa treatment plays a key role, consolidating the results of inpatient treatment and enhancing the body's adaptive reserves without excessive medication. This article examines the impact of the temperate continental climate of the Krinitsa Sanatorium (Sanatorium) on patients with functional class (FC) 1 and 2 CHD undergoing spa treatment and recuperation. AIM. Assessment of the impact of climatic conditions at Sanatorium Krinitsa on the psychofunctional state and quality of life in patients with ischemic heart disease. MATERIALS AND METHODS. The assessment of the climate conditions in the sanatorium-resort area was based on official data from a representative meteorological station located in the vicinity of the health resort. The research instruments included validated questionnaires: a method for assessing the body's functional reserves; the WAM (well-being, activity, mood) differential self-assessment test; the Hospital Anxiety and Depression Scale (HADS); and the EQ-5D-5L quality of life questionnaire. The sample representativeness consisted of 50 patients with Functional Class I and II ischemic heart disease. RESULTS. Analysis of the psycho-functional state and quality of life in patient with coronary heart disease showed highly significant improvement in functional reserve dynamics (p 0,001 according to the Wilcoxon test), with the average value decreasing by 29,4 %. Positive dynamics were observed in the WAM test results (significance level p 0,01 according to the Wilcoxon test: well-being 4,36 ± 1,13; activity 4,14 ± 0,75; mood 5,41 ± 0,71). Depressive manifestations and anxiety symptoms demonstrated a statistically significant decrease in mean scores from 3,48 ± 3,03 to 1,96 ± 2,20 and from 4,06 ± 3,19 to 1,86 ± 2,12, respectively. DISCUSSION. Evaluation of the climatic conditions of the health resort area allowed for the identification of favorable periods for climatotherapy. The data obtained indicate a pronounced positive impact of comprehensive health resort treatment in a temperate continental climate on the physical and psychological state of patients with functional class I and II coronary heart disease. CONCLUSION. The sanatorium-resort area of the Sanatorium Krinitsa possesses favorable medical and climatic conditions for climate-based health procedures (aerotherapy, heliotherapy, and dasotherapy). An assessment of the winter climate severity indices indicates that most of the resort area (60–65 %) is classified as moderate. The study showed that the potential for climate therapy is not fully utilized due to a lack of real-time meteorological data, which hinders the proper planning of climate-based health procedures. The evaluation of the psychofunctional status and quality of life of patients with FC I and II ischemic heart disease at the health resort established high treatment efficacy. This contributed to the harmonization of the patients' emotional state, significantly reducing levels of situational anxiety and depression, which is a key factor in the prevention of cardiovascular complications.
INTRODUCTION. Dysfunction of the calf muscle-venous pump (MVP) associated with venous obstruction contributes to ineffective venous blood emptying from the distal lower extremities and can be considered a therapeutic target in the treatment of chronic venous diseases. Physical exercise (PE) can be an effective method for increasing the hemodynamic efficiency of the MVP. AIM. A search and analytical review of research findings published in international databases, focusing on the role of MVP dysfunction in the pathogenesis of chronic venous insufficiency (CVI), as well as the effectiveness of various types of physical exercise. MATERIAL AND METHODS. Fifty-one sources were identified from databases eLibrary.RU, Scopus, PubMed, Web of Science from 1998 to 2025, of which 19 were systematic reviews, including two Cochrane reviews, five practice guidelines, and 27 randomized controlled trials. RESULTS. In patients with mild CVI, PE was found to improve venous reflux, muscle strength, ankle range of motion (AROM), and quality of life. In patients with severe CVI, PE increased ejection fraction, decreased residual volume, and improved muscle strength and AROM. Isotonic exercise was shown to improve muscle endurance, efficiency, and strength of the calf muscles, improving their contractility and overall hemodynamics in limbs with venous trophic ulcers (VTU). It was established that the effectiveness of MVP also depends on the mobility of the ankle joint and the calf muscles contractile strength. DISCUSSION. Despite the compelling evidence base for prescribing progressive strength training and aerobic activity to patients with VTU, there are no studies examining the effectiveness of isokinetic training in the comprehensive rehabilitation of patients with post-thrombotic syndrome (PTS). This underscores the need to develop modern isokinetic training protocols for patients with PTS, as they achieve improved performance through maximal muscle loading, which enhances motor learning through real-time feedback. CONCLUSION. Studying the effects of isokinetic exercise training on calf pump function, muscle strength, AROM, and quality of life in patients with PTS is a promising area of medical rehabilitation.
INTRODUCTION. To date, the main diagnostic value of echocardiography is data on the work of the left ventricle. AIM. Evaluation of an extended echocardiography protocol that is performed immediately after brief aerobic exercise and allows the detection of early (hidden) right ventricular (RV) dysfunction in highly trained athletes with overtraining syndrome (OTS). MATERIALS AND METHODS. The study was conducted on the basis of the A.I. Burnazyan Federal State Budgetary Institution of the Federal Medical and Biological Agency of Russia in the period from July 2025 to December 2025 and examined 103 high-class athletes, divided into two groups: group 1 (n = 52) — healthy athletes and group 2 (n = 51) — athletes with overtraining. The protocol included standard resting transthoracic echocardiography and a repeat study immediately after bicycle ergometry with individually matched power (reference for heart rate — ~ 130–140 beats/min) and analysis of right ventricular parameters: RV FAC (right ventricular area change fraction), S' (systolic velocity of the tricuspid annulus movement) and TAPSE (systolic excursion of the tricuspid annulus); LVEF (left ventricular ejection fraction), GLS (global longitudinal deformity of the left ventricle) were additionally recorded. RESULTS. At rest, no differences in pancreatic function between the groups were revealed. After loading, a significant decrease in the following indicators relative to the reference thresholds was recorded in the OTS group: RV FAC from 51.75 % to 31.00 %, S' from 13.45 cm/s to 7.65 cm/s, TAPSE from 20.94 mm to 14.61 mm, while in the “Healthy” group the indicators remained within the normal range. DISCUSSION. As a result of the study, the use of an extended echocardiography protocol with mandatory post-exercise registration made it possible to identify latent dysfunction of the right ventricle, which is not recorded at rest. The parameters of the left ventricle in the studied groups remained within the normal range, which confirms the selectivity of damage to the right parts of the heart in the early stages of overtraining syndrome. CONCLUSION. The data obtained confirm the diagnostic value of the post-exercise extended echocardiography protocol for the early detection of latent RV dysfunction in overtraining syndrome. The practical application of the proposed approach will make it possible to prescribe timely rehabilitation programs for the RV in the early stages of this pathology before the pronounced clinical manifestation.
INTRODUCTION. Health preservation and active longevity are key priorities of modern medicine and public healthcare policy. The effectiveness of their implementation strongly depends on the development of sustainable healthy lifestyle (HLS) skills among the population. Health-resort organizations (HRO) existing In Russia have unique potential for implementing comprehensive preventive and educational programs. Existing programs have low population coverage and insufficient effectiveness due to organizational difficulties, limited accessibility, a formal approach, and a lack of motivation. AIM. To conduct a systematic review of domestic and international scientific data on approaches to disease prevention and the development of healthy lifestyle skills in HRO settings, as well as to analyse the effectiveness of these approaches. MATERIALS AND METHODS. A systematic review of the literature in domestic and international databases PubMed, Web of Science, Google Scholar, eLIBRARY.RU with no restrictions on the publication date was conducted on October 15, 2025. RESULTS. A total of 11 publications, 7 foreign researchers, and 4 domestic studies, were finally included in the descriptive analysis. Domestic and international experience demonstrates that integration of educational modules into spa treatment programs significantly increases medical awareness and commitment to a healthy lifestyle — in both healthy individuals and patients with various chronic diseases, which is true in both paediatric and adult settings. DISCUSSION. This approach has been shown to be effective in quality-of-life improvement, reduction of clinical symptom severity, and prevention of disease relapse. A structured program "School of Health in Health-Resort Organisations" that combines educational, interactive, preventive, and rehabilitation components and focused on improving health literacy, can be an effective tool for fostering a healthy lifestyle and preventing chronic noncommunicable diseases at the population level. CONCLUSION. The implementation of the "School of Health Health-Resort Organisations" in the work of the HRO allows us to utilize the potential of the resort environment as a platform where patients receive not only treatment but also practical knowledge about a healthy lifestyle, as well as develop skills in self-management, balanced nutrition, physical activity, and stress management.
INTRODUCTION. As a result of traumatic brain injury (TBI), patients often develop emotional disturbances, cognitive and other functional impairments, leading to a state of distress, which can be difficult to assess using clinical and psychometric methods alone. Sympathetic activation is a key component of the stress response. Recent research indicates that the assessment of sympathetic activation via electrodermal activity (EDA) parameters is a reliable method for diagnosing stress, pain and other distressing conditions. AIM. To demonstrate the current possibilities for objectifying stress states through a comprehensive assessment incorporating clinical methods, psychometric measurements and analysis of EDA parameters, using 4 clinical case studies of patients undergoing rehabilitation following TBI. DESCRIPTIONS OF CASES. Additional assessment of sympathetic activation using EDA parameters in combination with clinical and psychometric approaches made it possible to: objectively confirm the initially high level of stress overstrain caused by pain and emotional disorders, as well as its reduction due to a decrease in the intensity of the pain syndrome and stabilization of the emotional state after rehabilitation measures (1st clinical observation); objectively determine a significant degree of stress overstrain and its dynamics in the process of rehabilitation measures in a patient with severe cognitive impairment (2nd clinical observation); identify a simulation of well-being in a patient with severe emotional disorders (3rd clinical observation); promptly diagnose a sharp increase in the level of stress tension in a patient prone to aggression (4th clinical observation). CONCLUSION. The level of sympathetic activation, determined by EDA parameters, is a reliable marker of stress in patients who have suffered a TBI. The use of this methodology as part of a comprehensive assessment of patients’ condition, in combination with clinical and psychometric methods, significantly increases the efficiency of diagnosing distress states and enables monitoring of their progression during the course of rehabilitation measures.
INTRODUCTION. Each year, the number of methods and techniques used in sanatorium-resort treatment increases due to scientific research, development and implementation of new medical equipment. However, a unified opinion of the scientific community on the principles of forming their unified classification has not yet been established. In order to systematize the technologies, methods and techniques of sanatorium-resort treatment, it is proposed to use the sanatorium-resort treatment directory. AIM. Justification of the methodology of systematization of data on technologies, methods and techniques of sanatorium-resort treatment of the structure and possibilities of application of the sanatorium-resort treatment directory. MATERIALS AND METHODS. During the work, a review of existing sources of information on the selected topic was conducted in the Federal Register of Regulatory and Reference Information in the Field of Healthcare, in the databases eLIBRARY.RU, PubMed, ConsultantPlus. The following sources were selected for the review: scientific articles, guidelines, legal acts in force in the Russian Federation, and publications by professional medical communities. The authors' ideas regarding the structure and usability of the sanatorium-resort treatment directory are presented in the form of a descriptive analysis of the guidebook. The period of the study is 10 years (from 2016 to 2025). RESULTS. The presented structure the sanatorium-resort treatment directory includes the following blocks: medical technologies, groups of methods with indication of the impact factor, methods, and techniques. The list of the main technologies, methods, and techniques used in sanatorium treatment contains 9 technologies, 31 groups, and 299 techniques of sanatorium-resort treatment. DISCUSSION. The techniques are matched with the corresponding medical interventions according to the nomenclature of medical services. It is planned to create a digital information resource to support management and medical decision-making based on artificial intelligence, which will include the sanatorium-resort treatment directory. CONCLUSION. The sanatorium-resort treatment directory, created according to the presented methodology, will allow for a standardized approach to the selection of methods and techniques for sanatorium-resort treatment when creating individual treatment programs. The digital information resource developed on its basis will allow medical professionals to create individualized programs of sanatorium-resort treatment that include the most effective methods and techniques. It will also help researchers identify potential topics for their research projects. Managers will be able to study the requirements for managing a sanatorium-resort organization, considering the availability of specific medical resources. Citizens will have access to information about the approaches to sanatorium-resort treatment for their specific conditions.
INTRODUCTION. Quantitative analysis of gait biomechanics is a clinically significant tool for assessing human locomotion patterns in health and disease. It is used to prescribe and evaluate the effectiveness of treatment and rehabilitation measures for patients with various medical conditions. The wide variety of instrumental methods for studying gait biomechanics, the lack of standardized measurement protocols, and the consequent high degree of data variability impede the comparison of findings obtained in various medical centers. AIM. To analyze of standardization of gait biomechanics research in accordance with modern approaches to gait assessment methodology in patients with orthopedic conditions. MAIN CONTENT OF THE REVIEW. The analysis draws on scientific papers of varying levels of evidence (randomized controlled trials, systematic reviews, cohort studies, non-systematic reviews, consensus documents) searched in the PubMed, Mendeley, ScienceDirect, eLIBRARY.RU, GoogleScholar, and Cyberleninka databases for the period 1977–2025 (521 in total). Current approaches to the clinical and instrumental assessment of gait biomechanics are examined, along with the main reasons for the lack of uniformity in terminology, a set of mandatory assessment parameters, and their reference values. The generally accepted clinical analysis of gait biomechanics includes a large number of spatiotemporal, kinetic, kinematic, and dynamic parameters. However, both domestic and international literature continue to exhibit terminological diversity in the description of gait parameters and a lack of systematization of normative values. CONCLUSION. Standardized protocols for clinical gait analysis of orthopedic patients can include gait parameters with established clinically significant differences that have proven their clinical significance. Otherwise, choosing a biomechanical indicator as a convincing indicator of functional recovery is difficult, despite its widespread use in clinical practice.
