[The rehabilitative treatment of the patients presenting with chronic obstructive pulmonary disease including the application of the manual handling methods]. / Vosstanovitel'noe lechenie patsientov s khronicheskoi obstruktivnoi bolezn'iu legkikh s vkliucheniem metodov manipuliatsionnogo vozdeistviia.

AIM: The objective of the present study was to identify the peculiar features and advantages of different methods for the mechanical impact on the thoracic tissues of the patients presenting with chronic obstructive pulmonary disease (COPD) and to develop specific indications for their clinical applications. MATERIAL AND METHODS: This randomized prospective comparative study included 137 patients with COPD. In accordance with the currently accepted classification (GOLD, 2013), all the patients had COPD of medium severity. The smoldering inflammatory process was diagnosed in 75 (54.7%) patients, grade I and II respiratory insufficiency in 80 (58.4%) and 57 (41.6%) patients, respectively. The external respiration function was evaluated by means of pneumotachometry techniques during the forced expiratory maneuver and by spirometry. The pulmonary hemodynamics and myocardial contractility of the right ventricle were studied with the use of rheopulmonography and central hemodynamics by tetrapolar thoracic rheography. The routine inflammatory and immune tests were employed. RESULTS: Investigations of the systemic circulation have demonstrated the prevalence of its hyperkinetic type (54,0%) over the hypokinetic and eukinetic ones (23,3% and 22,7% respectively). All the patients were divided into three group identical in terms of clinical and functional characteristics. The patients comprising group 1 (n=46) were prescribed the rehabilitative treatment in the form of classical chest massage, those of group 2 (n=47) were treated by means of intense massage of asymmetric chest zones, and the patients included in group 3 (n=44) underwent manual therapy. It was shown that intense massage produced the most pronounced beneficial effect. Classical massage also resulted in the reduction of the inflammatory manifestations but its effectiveness was significantly lower than that of the intense treatment (р<0,05-0,02). Manual therapy failed to cause any appreciable changes in the character and severity of the inflammatory process (р>0,5). CONCLUSION: The intense massage of asymmetric chest zones proved to provide the most efficient tool for the anti-inflammatory treatment of the patients presenting with chronic obstructive pulmonary disease in comparison with other known methods for the mechanical impact on the thoracic tissues. However, the application of this technique is limited in the patients with the hypokinetic type of systemic circulation and pulmonary hypertension. The most important advantage of chest massage by the conventional method is the possibility of its application for the treatment of the patients suffering from severe forms of COPD associated with pulmonary and systemic cardiohemodynamic disturbances with alveolar hypoxia. Manual therapy can be recommended in the first place to the patients with COPD in remission and the accompanying functional blockade of the vertebral segments.

[The role of climatic therapy in the combined spa and health resort-based treatment of the patients presenting with nonspecific respiratory diseases]. / Rol' klimatoterapii v kompleksnom sanatorno-kurortnom lechenii patsientov s nespetsificheskimi zabolevaniyami organov dykhaniya.

This article deals with the issues related to the role of climatic therapy in the combined spa and health resort-based treatment of the patients presenting with pathology of the respiratory system. The characteristics of climatic health resorts, the effects of various weather factors on the patients with nonspecific diseases of the respiratory organs, and the methods of climatic therapy are discussed with special reference to the physical factors influencing acclimatization and re-acclimatization as well as the prevention of meteopathic reactions. Much attention is given to the indications and contraindications for the referral of the patients with the above health problems to the local spa and health resorts facilities.

[On the usefulness of including general biolong baths in the combined therapeutic and rehabiliatative treatment of the patients presenting with obstructive diseases of the respiratory organs].

Bearing in mind the important role of oxidative stress and intensification of lipid peroxidation processes in the development and progression of obstructive pathology of the respiratory organs, we deemed it appropriate to evaluate the therapeutic effect of general baths containing biolong, an agent showing the antihypoxic and antioxidative properties. The clinical and functional studies that involved 109 patients (52 with chronic obstructive pulmonary disease (COPD) and 57 with bronchial asthma (BA)) have demonstrated the advantages of application of the hydrotherapeutic modality in the patients with bronchial asthma. The therapeutic effect was due to degradation of the allergic inflammation processes, the well apparent decrease in the activity of lipid peroxidation processes, the improvement of humoral immunity, generalized reduction of bronchial obstruction, enhanced physical working capacity, and psychoemotional adaptation.

[The rationale for the combined application of cryomassage and silvinite speleotherapy for the rehabilitative treatment of the patients with bronchial asthma].

The present study is devoted to the estimation of therapeutic and prophylactic effects of cryomassage and silvinite speleotherapy in the patients with partially controlled asthma. Advantages of the combined application of rehabilitative technologies are illustrated by their well-expressed anti-inflammatory and immunocorrecive actions, reduced obstruction and hyper-reactivity of the bronchi, improved pulmonary cardiohemodynamics, enhanced physical tolerance and better psychological adaptation.