Team-based rehabilitation improves long-term aerobic capacity and health-related quality of life in patients with chronic inflammatory arthritis.

PURPOSE: To examine the effect of an interdisciplinary, out-patient rehabilitation programme for patients with chronic inflammatory arthritis on aerobic capacity and health-related quality of life (HRQOL). METHOD: One hundred and seventy-four patients, 115 with peripheral arthritis (PA) (91 women, mean age 53 years, disease duration 16 years) and 59 with spondylarthropathies (SpA), (27 women, mean age 46 years, disease duration 14 years) were consecutively enrolled in 18 days of interdisciplinary rehabilitation. We report data from evaluations at inclusion, at discharge, and at 4 and 12 months using a sub-maximal treadmill test of aerobic capacity and the Nottingham Health Profile (NHP) (t-test). RESULTS: At inclusion, less than 20% of all patients tested had aerobic capacity classified as 'average' or better. At discharge, 41% (PA) and 54% (SpA) reached the 'average' level or better with improvements maintained for 12 months. The total NHP scores improved in both groups (mean change -12 (99%CI -15, -9) for PA; mean change -13 (99%CI -19, -8) for SpA) and were maintained. CONCLUSION: Aerobic capacity and HRQOL improved significantly in this interdisciplinary out-patient rehabilitation study, and improvements were maintained for 12 months. The preserved level of aerobic capacity after 12 months indicated a change to a more physically active lifestyle among the participants.

[The rehabilitative therapy of patients with osteochondrosis of the cervical spine and manifestations of hypermobility bv means of therapeutic physical exercise]. / Vosstanovitel'naia terapiia bol'nykh osteokhondrozom sheinogo otdela pozvonochnika s iavleniiami gipermobil'nosti sredstvami lechebnoi fizicheskoi kul'tury.

The problems of cervical spine osteochondrosis with hypermobility are of great medical and social significance. Physical rehabilitation methods can improve effectiveness of basic drug therapy. These include isometric exercises, postisometric muscle relaxation, proprioceptive neuromuscular facilitation, postural exercises and special massage.

[Electromagnetic and mechanical vibrations in the therapy of myofascial pains]. / Elektromagnitnye i mekhanicheskie kolebaniia v terapii miofastsial'nykh bolei.

Low-frequency vibration effectively stimulates in a direct way or via reflexes neuromuscular apparatus in patients with muscular-tonic manifestations of spinal osteochondrosis. Long-term myofixation forms foci of denervation disorders as painful muscular consolidations with active center the irritation of which gives rise to phenomenon of reflected pain. In this case it is better to begin treatment with optic red and infrared radiation on the reflexogenic zones and muscular consolidations for reduction of trophic abnormalities. This creates favourable conditions for subsequent vibrostimulation of affected nerves and muscles.

[The use of puncture physiotherapy for optimizing the mud therapy of spinal osteochondrosis patients]. / Ispol'zovanie punkturnoi fizioterapii dlia optimizatsii griazelecheniia bol'nykh osteokhondrozom pozvonochnika.

It is shown that physical puncture effects arouse favourable reactions of human organism both in monotherapy and in combined therapy with peloids. This suggests a conclusion that indications to physiotherapy of spinal osteochondrosis can be extended and cover also acute osteochondrosis, that new complexes of physiopeloid therapy may be designed with minimal risk of balneoreactions.

[The neurological complications caused by manual therapy in spinal osteochondrosis]. / Nevrolohichni uskladnennia, obumovleni manual'noiu terapiieiu, pry osteokhondrozi khrebta.

A clinical characterization is presented of 49 observations--neurological complications having developed following manual correction of the spine in its degenerative-dystrophic diseases. The above complications are categorized with respect to each division of the vertebral column and the body as a whole.

[Surgical treatment of tuberculous spondylitis using ceramic implants]. / Operativnoe lechenie tuberkuleznogo spondilita s primeneniem keramicheskikh implantantov.

The use of osseous grafts in the treatment of tuberculous spondylitis is associated with substantial shortcomings, requiring a long-term bedside regimen, followed by fixation of the spine with a rigid corset. The application of ceramic implants allowed one to attack several tasks: to provide primary stabilization of the vertebral segment, to exclude corset fixation, to reduce a postoperative period and surgical traumatism by refusing to take an autograft. Forty nine operations were performed in patients aged 23-65 years. In the early postoperative period neurological disorders completely disappeared in 7 patients, the remaining has significant positive changes. Complete osteoceramic adhesion occurred 2-4 months later. Following 2 patients, 26 patients were stricken off the disability register. The remaining patients continued to be disabled (7 and 16 patients had disability groups 2 and 3, respectively) due to significant contaminant diseases.

[The types of traction in osteochondrosis of the lumbar spine]. / Nekotorye vidy traktsii pri osteokhondroze poiasnichnogo otdela pozvonochnika.

The effects of low-intensive tractions were evaluated clinically and electrophysiologically in 148 patients with neurological symptoms of lumbar osteochondrosis. The above tractions were combined with vibration, peloid electrophoresis and sulphide baths. Indications and contraindications for tractions are outlined. The above complexes are recommended for use in the programs of rehabilitation of patients with osteochondrosis of the lumbar spine.

[The optimization of the arrangement of physiotherapeutic procedures based on the circadian dynamics of the cardiointervalographic indices]. / Optimizatsiia rasstanovki fizioterapevticheskikh protsedur po dannym sutochnoi dinamiki øpkazatelei kardiointervalografii.

It was found that patients with neurological manifestations of spinal osteochondrosis had marked disturbances of diurnal biorhythms of cardiointervalography (CIG): wider amplitude and structural alterations. Administration of physiobalneoprocedures in the period between acrophase and batiphase brings normalization of biorhythms. If the procedures were given in the peak phase, the normalization was not achieved. Moreover, the biorhythms got worse in 75% of the patients. To optimize the regimen of physiobalneoprocedures in patients with neurological manifestations of spinal osteochondrosis it is valid to study diurnal pattern of CIG and administration of physiotherapeutic procedures in the time of change of the diurnal rhythm phases.

[The duration of the sanatorium-health resort treatment of patients with neurological manifestations of spinal osteochondrosis]. / O prodolzhitel'nosti snatorno-kurortnogo lecheniia bol'nykh s nevrologicheskimi proiavleniiami osteokhondroza pozvonochnika.

Patients with neurological symptoms of spinal osteochondrosis in exacerbation took reduced intensive courses of physiotherapy which consisted of ultraphonophoresis of 1% oil solution of polar fraction of lipids from sulfide mud (eplir). The course included 12 daily procedures. Positive functional changes and those in vertebroneurological status support high efficacy and good tolerance of such short courses.