[The dynamics of sleep quality in patients with chronic insomnia during the complex spa treatment with the inclusion of transcranial magnetic therapy]. / Dinamika kachestva sna u patsientov s khronicheskoi insomniei na fone kompleksnogo sanatorno-kurortnogo lecheniya s vklyucheniem transkranial'noi magnitoterapii.

Dissatisfaction with night sleep occurs in 45% of the population. Chronic insomnia is one of the most common sleep disorders. The incidence of insomnia is estimated at 9-15%. The clinical importance of insomnia is determined by the negative impact it has on social aspects, economic performance and human health. Taking into account the prevalence of insomnia in the population and its social importance the correct diagnosis and effective treatment of insomnia is clear. OBJECTIVE: To assess the sleep quality dynamics in patients with chronic insomnia getting the complex spa treatment with the inclusion of transcranial magnetic therapy (TCMT). MATERIAL AND METHODS: It was examined 122 patients (mean age 54.0±0.92 years) with a verified diagnosis of chronic insomnia; 68.9% were women and 31.1% were men. The patients were randomized into 2 groups: the main group included 62 patients who received a spa complex and TCMT; the comparison group included 60 patients who received an identical treatment complex without TCMT. All patients were evaluated by polysomnography (PSG) data, insomnia severity index (ISI) and subjective symptoms of daytime functioning. RESULTS: As a result of treatment program implementation the patients of both groups showed a decrease in ISI and a subjective improvement in daytime well-being. In the main group the treatment led to an increase in the number of patients with mild disorders by 51.7%, a decrease in patients with moderate disorders by 16.2%, severe disorders by 45.2%, and the formation of a group of 6 people (9.7%) without sleep disorders. In the comparison group after treatment the proportion of patients with mild disorders increased by 33.3%, with moderate disorders by 3.3%, the number of patients with severe disorders decreased by 41.6%, and 3 (5%) patients had no symptoms. The mean value of ISI in the main group decreased by 35.9% (p<0.001), in the comparison group - by 23.1% (p<0.001), the difference was 12.8% (p<0.001). From clinical perspective, patients noted an improvement in the process of falling asleep, a decrease in the number of nighttime awakenings, an increase in the duration of sleep, and an improvement in functioning while awake. After the use of therapeutic complexes in patients of both groups there was a favorable reliable dynamics in the change in PSG indicators that was more pronounced in the main group. The difference between the groups in terms of PSG was: for the wakefulness time during sleep 16.3% (p<0.005), for the number of awakenings during sleep 12.8% (p<0.001), for the latency of falling asleep 13.9% (p<0.05), for micro-activation index 14.6% (p<0.05), for sleep efficiency 4.9% (p<0.05). CONCLUSION: The inclusion of TCMT in complex spa treatment can significantly reduce ISI, the symptoms' severity of impaired daytime functioning and improve sleep quality indicators according to PSG data in patients with chronic insomnia.

[Immediate and long-term effectiveness of combined application of magnetolaser therapy and red light in complex treatment of patients with chronic nonbacterial prostatitis].

The aim of the study was to increase the efficiency of complex treatment of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with the combined effect of magnetolaser therapy (MLT) and red light. MATERIALS AND METHODS: We examined and included in the study 120 men with a verified diagnosis of CP/CPPS (III B), at the stage of exacerbation. By envelope method, patients were divided into two randomized groups. The main group consisted of 60 patients who received a basic treatment complex, including medicamentous therapy, prostate massage, diet therapy, a complex of therapeutic gymnastics, and the combined effect of MLT and red light of 10 procedures per course. The comparison group consisted of 60 patients who received only a basic therapeutic complex. Evaluation of the effectiveness of treatment was carried out in dynamics before complex treatment, immediately after the course of treatment and 6 months later for analysis of long-term results using the questionnaire "System of summary evaluation of chronic prostatitis symptoms", dopplerography of urethral arteries of the prostate, laser Doppler flowmetry in the prostate. RESULTS AND DISCUSSION: In the main group of patients with CP/CPPS immediately after complex treatment and after 6 months, a positive therapeutic effect was noted in the form of relief of pain syndrome, dysuria, improving the quality of life, improvement of blood circulation in the urethral arteries of the prostate and microcirculation. In the comparison group, the positive effects from the complex baseline treatment were less pronounced. Comparative analysis of the results of the study between the main group of patients with CP/CPPS and comparison group showed the presence of statistically significant differences in all indicators of clinical symptoms of the disease, dopplerography in the urethral arteries of the prostate and microcirculation in the prostate, both immediately after treatment and after 6 months of follow-up. CONCLUSION: The method of complex treatment of patients with CP/CPPS with the combined effect of MLT and red light has greater immediate and remote efficacy in comparison with baseline treatment.

[The effectiveness of correction of the postural problems in the patients presenting with juvenile cerebral palsy].

We have studied stabilographic characteristics and their dynamics in the healthy children (n=30) and the patients suffering from juvenile cerebral palsy (JCP) in the form of spastic diplegia (n=99) after they had undergone the combined rehabilitation treatment with the use of various methods of electrical stimulation. The mean age of the children was 7.0±1.7 years. The patients with JCP included in the main group (n=45) received therapy with the application of electrical stimulation based on the AKorD apparatus while the patients with JCP comprising the group of comparison were treated with the use of the Mioritm 040 apparatus. Vertical stability of the schoolchildren was evaluated using the Stabilan-01-2 hardware system, once in the healthy children and twice (before and after the termination of rehabilitation) in the patients with JCP. A course of the rehabilitative treatment of the patients with JCP included in the main group resulted in a 24.6% and 15.8% reduction (p<0.05) of the statokinesiogram area in the tests with the open and closed eyes respectively. The visual control coefficient increased significantly. The patients of the comparison group experienced a marked reduction of the area of statokinesiogram in the tests with the open eyes (by 15,5% (р<0,05)) while the remaining characteristics of interest remained unaltered. It is concluded that the treatment of the children presenting with juvenile cerebral palsy with the use of the AKorD apparatus for electrical stimulation is more efficient for the maintenance of the vertical posture in comparison with the treatment based on the use of the Mioritm 040 apparatus.

[The efficacy of transcranial magnetic stimulation in acute ischemic stroke]. / Effektivnost' transkranial'noi magnitnoi stimulyatsii v ostrom periode ishemicheskogo insul'ta.

OBJECTIVE: To study an effect of the course treatment with transcranial magnetic stimulation (TMS) on cognitive functions, movement deficit, daily activity and cerebral hemodynamics in the acute ischemic stroke. MATERIAL AND METHODS: Ninety-two patients, including 32 patients treated with TMS (the main group), 30 patients who received placebo (comparison group 1) and 30 patients who received low intensity magnetic stimulation and basic complex therapy during 10 days once a day (the comparison group 2), were examined. RESULTS AND CONCLUSION: A significant improvement of cognitive processes, restoration of motor functions, increase in daily activities, normalization of the cerebral hemodynamics were observed. Based on these RESULTS: the inclusion of TMS in the complex rehabilitation system of post-stroke patients is recommended.

[Dynamics of the cognitive function in the school-age children presenting with a natal injury to the cervical spine in the course of the combined spa and health resort-based treatment with the use of manual therapy].

AIM: The objective of the present work was to study dynamics of the cognitive function in the school-age children presenting with a natal injury in the cervical region of the spine in the course of the combined spa and health resort-based treatment with the use of manual therapy based at a health resort facility. THE PATIENTS AND METHODS: A total of 110 schoolchildren at the age from 8 to 15 years (mean age 13.0 ± 0.4 years) were examined during the residual period of a natal injury in the cervical region of the spine. All the participants of the study were divided into to randomized groups. The main group was comprised of 55 school-age children (mean age 13.0 ± 0.4 years) given the comprehensive spa and health resort-based treatment with the application of manual therapy and the group of comparison that contained the remaining 55 schoolchildren (mean age 13.0 ± 0.4 years) who received the same balneotherapeutic treatment but without manual therapy. We analyzed the indicators of cognitive function after the application of manual therapy in 55 children and adolescents aged from 8 to 15 years who underwent the natal trauma to the cervical spine associatedwith the symptoms of postural disorders of varying severity. RESULTS AND DISCUSSION: The article presents the results of the analysis of cognitive function dynamics in the children and adolescents under the influence of the combined spa and health resort-based treatment with the use of manual therapy of functional blocks. It was shown that the combined spa and health resort-based rehabilitative treatment with the use of the manual therapeutic techniques makes it possible to significantly improve the condition of the cervical spine and exerts the positive influence on the dynamics of the cognitive function, has beneficial effect on the mental and motor functions, increases the flexibility and backup capabilities of the nervous system, and may be instrumental in resolving the problems arising from school disadaptation.

[The comparative effectiveness of the application of various methods for electrical muscle stimulation in the patients presenting with juvenile cerebral palsy].

We studied the clinical effectiveness of rehabilitation of 168 patients presenting with juvenile cerebral palsy in the form of spastic diplegia who received the comprehensive rehabilitative treatment including therapeutic physical exercises, paraffin applications, general hydromassage baths, manual massage and electrical stimulation of weakened muscles with the use of the following devices: for group 1 of the patients (n=38), for group 2 (n=43), for group 3 (n=45), and for group 4 (n=38). The study yielded the significantly higher scores in the test for groups 1,2, and 3 compared with group 4 (p<0.05). In all the groups, with the exception of group 4, a significant (p<0.05) increase in the range of ankle joint motions was observed in conjunction with the lowering of the spastic calf muscle tone. After a course of rehabilitation, the overall clinical effectiveness did not differ significantly between the groups, viz. it was documented in 36 (94.7%) patients of group 1, in 39 (92.8%) patients of group 2, in 43 (95.6%) patients of group 3, and in 38 (88.3%) patients of group 4. However, the estimates of devices for the combined rehabilitation of the patients suffering from juvenile cerebral palsy in the form of spastic diplegia.

[The effectiveness of early rehabilitation of the patients presenting with ischemic stroke].

In this paper we evaluate the clinical effectiveness of rehabilitation of 92 patients who survived after acute ischemic stroke and received the combined treatment with the use of transcranial magnetic stimulation (the study group, n=32). The first control group (n=30) included the patients given transcranial magnetic stimulation in the function of placebo (n=30) and the second control group was comprised of the patients who received low-frequency magnetic therapy (n=30). The course of transcranial magnetic stimulation (TMS) resulted in the significant regression of the locomotor deficiency in the patients of the study group compared with those in both control groups (χ2>3,8). In addition, a significant decrease in anxiety and depression was documented in the patients of the study group. Dynamics of these characteristics in the patients of the control groups group was significantly less pronounced (χ2>3,8). The well apparent improvement of the cognitive function evaluated with the help of the MMSE test was observed in the patients of the study group and control group 2, but this effect of transcranial magnetic stimulation was significantly more pronounced than that of low-frequency magnetic therapy (χ2>3,8). Transcranial magnetic stimulation significantly normalized cerebral hemodynamics on the side of the stroke-affected hemisphere and improved the daily activities of the patients. Studying the long-term results within 6 months after the onset of rehabilitation in the hospital environment, most patients rated their health with improving. The evaluation of long-term results of the treatment during the 6 month rehabilitation period demonstrated that the majority of the patients reported the marked improvement of their health status.

[Rehabilitation of the patients presenting with combined pathology: dyscirculatory encephalopathy and climacteric syndrome].

The present paper reports the data on rehabilitation of women presenting with combined pathology: dyscirculatory encephalopathy and climacteric syndrome. It is shown that the introduction of ozonotherapy and klimadynon, a herbal medicine possessed of the estrogen-like action, into combined rehabilitative treatment ensures the significant improvement of the parameters of interest, such as climacteric symptoms, short-term memory, lipid profile, endothelial function, cerebral circulation, and quality of life.

[The role of physical exercises in the improvement of cognitive functions in patients who survived stroke, in the early rehabilitative period].

The objective of this work was to evaluate the efficacy of a complex of physical therapy exercises "Brain gymnastics" in post-stroke patients. Eighty three such patients enrolled in the study were randomly allocated to two groups. The program of physical rehabilitation for patients comprising one group (n = 41) included regular exercises with elements of "brain gymnastics" whereas patients of the other group (n = 41) received standard rehabilitative treatment. Patients of group 1 enjoyed improvement of cognitive functions, mood, and quality of life. Disturbances of short-term memory and voluntary attention were partly corrected, astheno-neurotic reactions and manifestations of advantage by illness became less apparent than in the control group while the level of self-assessment increased. None of the patients in group 1 exhibited undesirable reactions to the offered treatment.

[Efficacy of general magnetotherapy in conservative therapy of uterine myoma in women of reproductive age].

Sixty women of the reproductive age with uterine myoma were divided into two groups. Thirty patients of the study group received combined therapy plus general magnetotherapy (GMT). Patients of the control group received only combined treatment. Ultrasound investigation registered a reduction in the size of myoma nodes by 16.7% in the study group, while in the controls myoma size did not change (p < 0.05). 1-year follow-up data for the study group demonstrated no cases of the myoma growth while 16.6% of the controls showed growth of myoma nodes, in 6.6% of them supravaginal myoma amputation was made for rapidly growing myoma.

[Effect of electromagnetic irradiation of the millimetric range on hemodynamics in patients with arterial hypertension]. / Vliianie élektromagnitnogo izlucheniia millimetrovogo diapazona na gemodinamiky u bol'nykh arterial'noi gipertoniei.

The study of efficacy of combined therapy including exposure to millimetric electromagnetic radiation (MER) in hypertensive patients has found a corrective hemodynamic effect of such treatment which appeared more potent than pharmacotherapy alone or combinations with sinusoidal modulated currents and placebo electromagnetic radiation. In hypokinetic and eukinetic types of hemodynamics MER raises cardiac output, lowers peripheral vascular resistance; in the hyperkinetic type there was a fall in the stroke and cardiac indices, compensatory rise of vascular resistance. The above changes in the course of treatment result in decline of both systolic and diastolic pressure and conversion of "extreme" types of hemodynamics in eukinetic in 11% patients. In hypertensive patients with eukinetic and hyperkinetic type of hemodynamics the best hemodynamic efficacy was achieved in combined therapy with 5.6 mm radiation.