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.
