[Effect of hardware balance trainings on postural control, risk of falls and cognitive function on elderly people with chronic cerebral ischemia. (Randomized controlled trial)]. / Vliyanie apparatnykh metodik trenirovki balansa na risk padenii, postural'nyi kontrol' i kognitivnye funktsii u pozhilykh lyudei s khronicheskoi ishemiei golovnogo mozga. (Randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: As a prevention of falls in elderly people with chronic cerebral ischemia, it is necessary to carry out rehabilitation measures with the inclusion of training aimed at improving statolocomotor and cognitive functions, improving proprioceptive sensitivity and reaction speed to external stimuli. AIMS: To compare the effectiveness of inclusion of hardware balance training on Huber («LPG-Systems¼, France) and C-mill («Physiomed Elektromedizin AG¼, Germany) simulators in complex postural control rehabilitation programs for elderly patients with chronic cerebral ischemia (CCI). MATERIAL AND METHODS: The study included 48 patients (19 men, 29 women), 81% of whom had moderate cognitive impairment. The median age was 76.2±8.5 years. The median Morse scale score before rehabilitation was 50.2 (CI 74-80). The patients were divided into three groups by randomization method: the patients of the 1st comparison group (n=16) were assigned to the Huber stabilizer; the patients of the 2nd comparison group (n=16) underwent training on the track with BOS-video reconstruction of walking «C-mill¼; the patients of the control group (n=16) underwent the course of therapeutic gymnastics according to the developed method. The duration of the course in each group amounted to 8 therapeutic procedures. In the dynamics of the conducted trainings we evaluated: the risk of falls, parameters of postural disorders in statics and dynamics, as well as criteria determining cognitive dysfunction and quality of life of patients. RESULTS: A pronounced improvement of static and dynamic postural indices was observed in the first comparison group, where there was a significant improvement of stabilometric indices: «SL¼ (p=0.001), amplitude of saggital sway (p=0.014), walking speed (p=0.001) and percentage of hitting the marks (p=0.001). The second comparison group showed significant improvement in dynamic balance parameters: walking speed (p=0.001), stride width (p=0.006), percentage of hitting the marks (p=0.001). CONCLUSION: Training on rehabilitation simulators according to the applied methods contributed to the improvement of fall risk related indicators as well as the effectiveness of improving motor performance in older adults with HIM compared to the control group. However, training on the stable-platform induced more significant clinical effects on both static and dynamic balance.

[Recovery of social and everyday skills after a complex of functional spatially oriented rehabilitation in elderly patients with cerebral stroke]. / Otsenka effektivnosti vosstanovleniya sotsial'no-bytovykh navykov s ispol'zovaniem kompleksa funktsional'noi prostranstvenno-orientirovannoi reabilitatsii u pozhilykh patsientov s tserebral'nym insul'tom.

OBJECTIVE: To analyze the effectiveness of social recovery (trip to the store by bus and making purchases) in elderly patients with stroke in the right middle cerebral artery undergoing a course of specialized trainings in a complex of functional spatially oriented rehabilitation. MATERIAL AND METHODS: The study involved 44 patients with previous stroke (mean age 70.8±3.1 years) randomized into 2 equal groups: main group - basic standard of rehabilitation (exercises with instructor, mechanotherapeutic technique with cyclic simulators, massage of paretic limbs) and training of social adaptation in a complex of functional spatially oriented rehabilitation; control group - basic standard of rehabilitation alone. Duration of rehabilitation course was 14 days. To determine mean norm of timing of complex training of socially significant skill, we asked 23 volunteers without severe comorbidities to perform tasks of functional spatially oriented rehabilitation. RESULTS: After complex rehabilitation program, we found significant dynamics of time necessary for the following actions: "take a bag and hang it over shoulder", "open the pockets of the bag with a zipper (2 pockets)", "take the jacket off the hanger and put it on", "take the products from the basket and put in the pocket". Moreover, the main group was characterized by significantly lower impairment of daily activity (Barthel score 66.3±4.5 vs. baseline 45.7±4.9, p<0.05), improvement of functional independence (FIM score 76.7±1.5 vs. baseline 65.2±3.1, p>0.05). These values turned out to be significantly better than in the control group. CONCLUSION: These results indicate the effectiveness of functional spatially oriented rehabilitation in elderly patients with cerebral stroke. This approach increases personal independence in daily life and improves overall quality of life.

[Efficiency of balance training with stabilizing platform in early postoperative rehabilitation of patients after arthroplasty]. / Effektivnost' vklyucheniya balans-treninga s ispol'zovaniem stabiloplatformy v kompleksnye programmy rannei posleoperatsionnoi reabilitatsii patsientov posle endoprotezirovaniya.

OBJECTIVE: To evaluate the effectiveness of balance training on stabilizing platform (HUBER360) in early postoperative rehabilitation of patients after total knee arthroplasty. MATERIAL AND METHODS: We examined 60 patients after total knee arthroplasty. Mean age of patients was 69.1±9.8 years, mean postoperative period - 3.6±1.4 days. All patients were divided into 2 groups (main group (n=30) and control group (n=30)). All patients received a standard course of treatment, including therapeutic exercises, massage of affected lower in electro-static field limb using a drainage technique, magnetotherapy, mechanotherapy of affected limb in passive motor mode (Artromot device). Duration of rehabilitation course in a round-the-clock hospital was 7 days. In the main group, patients additionally received balance-training procedures on the HUBER 360 multiaxial platform in baseline sitting position. RESULTS: Treatment was followed by positive dynamics in all patients that correlated with significant regression of pain syndrome, edema, improvement of quality of life and 10-meter walk test with external support on crutches. However, additional balance training provided more effective regression of pain, as well as improvement of quality of life and walking after the first procedures. CONCLUSION: We can recommend balance training on stabilizing platform for early rehabilitation after total knee arthroplasty.

[The role of systemic ozone therapy in the rehabilitation of patients after COVID-19]. / Rol' sistemnoi ozonoterapii v reabilitatsii patsientov, perenesshikh COVID-19.

OBJECTIVE: To evaluate the effectiveness and safety of ozone therapy in rehabilitation of patients with previous COVID-19. MATERIAL AND METHODS: A randomized controlled clinical trial included 51 patients aged 29 - 78 years with SARS-CoV-2 pneumonia (J12.8). Patients were divided into 3 comparable groups depending on the complex of rehabilitation. In the first (control) group (n=17), a 10-day course included daily breathing exercises and physiotherapy for the lungs (drug electrophoresis and low-frequency magnetotherapy). In the second (main) group (n=18), rehabilitation was combined with daily intravenous infusions of ozonized saline with ozone concentration of 2.0 mg/l within 5 days with subsequent standard rehabilitation. In the third group (n=16), patients received 5 ozone therapy procedures every other day. To determine the effectiveness and safety of systemic ozone therapy in rehabilitation of patients with previous COVID-19, we analyzed oxygen saturation, laboratory data (D-dimer and C-reactive protein), need for oxygen support before and after rehabilitation course. Complaints and quality of life throughout the rehabilitation program were assessed using the EQ-5D questionnaire. RESULTS: All patients had positive changes of all parameters. There were no adverse reactions throughout the rehabilitation program and 2 months later. We observed higher effectiveness of rehabilitation with systemic ozone therapy. Moreover, daily ozone therapy had a better effect on laboratory parameters compared to ozone therapy every other day. CONCLUSION: Ozone therapy is safe and effective in complex rehabilitation of patients with previous COVID-19. Further studies of large samples are needed to determine indications and appropriate criteria for this rehabilitation program.

[Effectiveness of physical therapy after total hip arthroplasty at the third stage of rehabilitation using a telemedicine program]. / Effektivnost' provedeniya lechebnoi gimnastiki u patsientov posle endoprotezirovaniya na tret'em etape reabilitatsii v forme telemeditsinskikh uslug.

OBJECTIVE: To assess the quality of life and efficacy of telemedicine technologies for rehabilitation after total hip replacement. MATERIAL AND METHODS: The study included 60 patients aged 40-75 years after total hip replacement. All patients were divided into two groups by simple randomization. All patients underwent a 7-day course of complex in-hospital postoperative rehabilitation. At discharge, patients of the main group received an access to telemedicine program for 3-month physical exercises (3 times a week for 30 minutes). In the control group, patients received routine recommendations for rehabilitation procedures and orthopedic recommendations. RESULTS: A course of rehabilitation with telemedicine technologies after total hip replacement was accompanied by significant clinical effect according to EQ5D, SF-36 and STAI questionnaires. CONCLUSION. T: Elemedicine technologies in postoperative rehabilitation after total hip replacement are accompanied by QoL improvement. It is an effective form of medical rehabilitation.