[Rehabilitation of the patients with osteoarthritis].

Under the term "osteoarthritis" (OA) is currently meant a clinical syndrome resulting from the combined effect of articular pain and disordered functional activity leading to the deterioration of the quality of life of the patients. The principal objective of rehabilitation of the patients presenting with GA in which all patients with this condition are in need practically after each next aggravation of the pathological process is to relive pain syndrome and restore the functional ability of the joints lost or deteriorated after each exacerbation in order to eventually improve the quality of life of the patients experiencing the constantly progressing degenerative process in the musculoskeletal system. The effectiveness of pain alleviation, the degree of improvement'of the joint functional activity and the general condition of the patient are considered as the criteria for the assessment of the effectiveness of the rehabilitative treatment. These criteria have been chosen in accordance with the recommendations of the OMERACT international working group (outcome measures in rheumatology). In addition, the quality of life associated with the health status and the adverse effects of the rehabilitative measures were estimated. Bearing in mind comorbidity in the patients presenting with OA, one of the main challenges is the development of the scientifically sound rationale for the application of non-pharmacological technologies of physical therapy, remedial gymnastics and massage for the prevention and elimination of an aggravation of the secondary aseptic inflammatory process associated with OA and the subsequent rehabilitative treatment for the restoration of the lost locomotory stereotype and the quality of life of the patients. One of the effective methods of physical therapy used for the treatment and rehabilitation of the patients presenting with GA is hyperbaric gaseous cryotherapy. This method makes use of the heat rejection phenomenon to which the organism responds, either in the compensatory or/and reflectory mode, by the activation of the heat production processes in the tissues due to the stimulation of the metabolic processes as well as the vascular, neuroendocrine, and immune systems involved in the regulation of homeostasis which produces the desired therapeutic effect apparent as the cessation of secondary aseptic inflammation and progressive degeneration process associated with OA. Taking into consideration the aforesaid, the objective of the present study was the scientifically sound substantiation of the application of hyperbaric gaseous cryotherapy as a constituent of the combined rehabilitative treatment of the patients presenting with gonarthritis and a coxarthrosis. This article was designed to report the results of such combined treatment obtained in 110 patients (22 men and 88 women) with gonarthritis and a coxarthrosis of the II-III stages (based on the classification of Kellgren). The patients aged from 40 to 75 years which were randomly divided into two groups (the main and the control (comparison) groups) comprising 55 patients each. The patients of the main group, unlike those in the control one, were treated with the use of hyperbaric gaseous cryotherapy in addition to traditional physical therapy and balneotherapy, therapeutic physical exercises, and massage. The results of the treatment were evaluated making use of the Lequesne, WOMAC, Likert international indices. It allowed to identify the predictors for the use of hyperbaric gaseous cryotherapy and to increase the effectiveness of the rehabilitative treatment of the patients suffering from OA of the large joints by 33% in comparison with the control group. The highest clinical effectiveness of 90% was achieved in the cases of at a.gonarthritis; it was somewhat lower (64%) in the cases of coxarthritis.

Immunorehabilitating effect of ultrahigh frequency electromagnetic fields in immunocompromised animals.

We observed immunorehabilitation effects of ultrahigh frequency electromagnetic fields (microwaves) in immunocompromised animals. It was shown that microwave irradiation of the thyroid gland area could abolish actinomycin D- and colchicine-induced immunosuppression and did not affect immunosuppression caused by 5-fluorouracil. These findings suggest that changes in the hormonal profile of the organism during microwave exposure can stimulate the processes of transcription and mitotic activity of lymphoid cells.

[The application of physical factors for the rehabilitative treatment of vertebrogenic cerebral dyscirculation].

The present study included 65 patients presenting with vertebrogenic cerebral dyscirculation and degenerative change within the cervical spine in the absence of hemodynamically and/or morphologically significant lesions in brachiocephalic arteries. During the first phase of the study, 39 randomly selected patients underwent traction of the cervical spine following collar zone massage. Moreover, they were instructed to simultaneously wear a soft cervical collar. The analysis of the results of this treatment showed that a combination of physiotherapeutic procedures produces the beneficial effect in the patients with the early manifestation of degenerative processes in the form of cerebral instability. Those suffering more severe anatomical changes in the vertebral column (spondylosis, spondyloarthrosis, spinal disk dislocation) are much less likely to benefit from the proposed treatment. The patients for the second group (n=26) were selected based on the results X-ray examination; they presented with vertebral instability requiring combined physiotherapeutic treatment including collar zone massage, orthotraction therapy, and simultaneous wearing a soft cervical collar. The results of the treatment were assessed from dynamics of clinical manifestations and the results of radioisotope studies of cerebral blood flow. No complications of combined physiotherapy were documented. The effectiveness of orthotraction therapy after preliminary collar zone massage in the patients of group 2 was estimated at 88.5%. Moreover, arterial pressure in the patients with concomitant arterial hypertension was reduced in conjunction with the improvement of venous outflow characteristics.

[The influence of pulsed infrared laser radiation on the hormone production in the thymus (an experimental study)].

Local irradiation with pulsed (1500 Hz) low-energy infrared laser light of the thymus and thyroid gland region caused well-apparent stimulation of alpha-1-thymosin production in the healthy animals and normalized its level in the stressed ones. Similar stimulation of alpha-1-timosine biosynthesis was observed in an experiment with direct laser irradiation of the cultured HTSC epitheliocytes from the human thymus.

[Optimization of the treatment of patients with osteoarthrosis using hyperbaric gaseous cryotherapy].

The authors report the results of combined rehabilitative treatment of patients presenting with gonarthrosis and coxarthrosis by means of hyperbaric cryotherapy using carbon dioxide at -78 degrees C. Estimation of the data obtained based on the internationally accepted Lequesne, WOMA, and Likert indices made it possible to objectively evaluate the clinical efficiency of this technology. Moreover, the approach employed permitted to elucidate various aspects of the mechanism of action of the physical factor, identify predictors of the possible outcome of hyperbaric gaseous cryotherapy, and improve by 33% the efficacy of rehabilitative treatment of patients with arthrosis affecting the large joints.

[Rehabilitation of patients after total endoprosthesis replacement of hip joint by the method of functional electrostimulation].

Patients after total endoprosthesis replacement of hip joint underwent method of functional electrostimulation (FES) with the purpose to recovery correct walking stereotype, to increase leisured muscle strength, to prevent secondary coxarthrosis development via stimulation or relaxation of muscles, and for analgesia of joints and pain zones at walking. Results of treatment of 143 patients received rehabilitation course of FES (15 procedures of 30 minutes) were compared with results of treatment of 54 patients received traditional methods. It is shown that FES is effective method of rehabilitation because it makes possible to improve muscle strength significantly, to eliminate or reduce motor deficit, to decrease pain syndrome, to form correct walking stereotype, and to perform early prophylaxis of secondary coxarthrosis on contralateral side. The main advantage of proposed method of nonmedicamental influence is better clinic-biomechanical result without use of drugs.

[Combined rehabilitation treatment of patients with spinal dystrophy using epidural pharmacotherapy]. / Kompleksnoe vosstanovitel'noe lechenie bol'nykh s distroficheskimi zabolevaniiami pozvonochnika s primeneniem épidural'noi farmakoterapii.

The article presents the results of treatment of 70 patients with spinal lumbosacral dystrophy complicated by dislocation of the intervertebral disks. All the patients had long-term history of the disease and exacerbation resistant to conservative treatment. Later, this treatment was changed for epidural long-term local pharmacotherapy (ELLP). The effect of this treatment was assessed by changes in pain syndrome in early and long-term periods, in MRT and CT images. ELLP proved effective as the response reached 83.2%. The maximal 95% response was achieved in combined treatment: ELLP + physio-, balneo-, kinesitherapy, massage. MRT and CT image dynamics show that pathological substrate disappears or significantly decreases in size in 83.4% cases.

[Epidural long-term local pharmacotherapy in patients with degenerative dystrophic spinal diseases during combined rehabilitation therapy]. / Epidural'naia dlitel'naia lokal'naia farmakoterapiia u bol'nykh s degenerativno-distroficheskimi zabolevaniiami pozvonochnika v komplekse vosstanovitel'noi terapii.

Epidural long-term local pharmacotherapy in degenerative-dystrophic diseases of the lumbar spine proved most effective in combination with rehabilitation procedures. Such combined treatment can be used in cases with long-standing disease resistant to conservative treatment.

[The combined laser therapy of rheumatoid arthritis]. / Kombinirovannaia lazernaia terapiia revmatoidnogo artrita.

Low-intensity infrared laser radiation to the tympanic vessels was studied as one of the hemophysiotherapeutic methods and as a component of combined treatment in which it accompanies local transcutaneous laser radiation of the affected joints. It is shown that immunomodulation is feasible under noninvasive interauricular laser effect on hemostasis. Indications for both laser regimens are formulated. Joint exposure to transcutaneous laser radiation is contraindicated if the affected joints have an exudative component of inflammation.

[The interauricular laser therapy of rheumatoid arthritis]. / Interaurikuliarnaia lazernaia terapiia revmatoidnogo artrita.

Investigations have proved the ability of interauricular low-intensity infrared laser therapy (0.89 nm, 7.6 J/cm) to produce anti-inflammatory, immunomodulating action in patients with rheumatoid arthritis. The method has selective, pathogenetically directed immunomodulating effect the mechanism of which is similar to that of basic antirheumatic drugs and of intravenous laser radiation of blood. This laser therapy can be used as an alternative to intravenous blood radiation being superior as a noninvasive method. Interauricular laser therapy can potentiate the effects of nonsteroid anti-inflammatory drugs, cytostatics and diminish their side effects.

[The combined action of an ultrahigh-frequency electrical field bitemporally and decimeter waves on the thymus area in the combined therapy of rheumatoid arthritis patients]. / Sochetannoe vozdeistvie élektricheskogo polia ul'travysokoi chastoty bitemporal'no i detsimetrovykh voln na oblast' timus v kompleksnoi terapii bol'nykh revmatoidnym artritom.

The thymus of rheumatoid arthritis (RA) patients was exposed to combined action of bitemporal UHF electric field and decimeter waves to study immunomodulating effect of the combination. Biochemical, immunological and endocrinological findings during the patients follow-up gave evidence for conclusion on activation of the hypothalamic-hypophyseal-thymic axis. A response was achieved in RA seronegative variant with concomitant synovitis. This may be due to genetic factors.

[The functional changes in the hypothalamus under the influence of an ultrahigh-frequency electrical field]. / Funktsional'nye izmeneniia gipotalamusa pod vliianiem élektricheskogo polia ul'travysokoi chastoty.

The experimental study was performed to clarify the advance of the biological effect of UHF bitemporal therapy. Realization of the effect proceeds at the expense of alterations in the patency of neuromediator and endogenic opioid systems of the brain. In addition, the study covered modulations of peripheral endocrine glands by hypophysis, glucocorticoids and catecholamines by the adrenals, proliferation of the lymphoid tissue, functional activity of humoral immunity.

[The immunomodulating effect of microwaves and of an ultrahigh-frequency electrical field in patients with systemic lupus erythematosus]. / Immunomoduliruiushchii éffekt mikrovoln i élektricheskogo polia ul'travysokoi chastoty u bol'nykh sistemnoi krasnoi volchankoi.

Bitemporal exposure of the adrenals to UHF electric field and decimeter waves was studied as a component of combined therapy for stage I-II chronic SLE. The best therapeutic response was achieved at bitemporal employment of UHF electric field directed to the system hypothalamus-hypophysis. This may be due to enhanced glucocorticoid activity of the adrenals and immunomodulating effect: a rise in the T-lymphocytes number, humoral immunity suppression. Antiinflammatory action was seen from a positive trend in clinical symptoms. Less therapeutic response to the direct stimulation of the adrenals with decimeter waves stems from the deficient function of the latter consequent to long-term corticosteroid therapy.

[Immunobiological effect of bitemporal exposure of rabbits to microwaves]. / Immunobiologicheskii éffekt mikrovoln u krolikov pri bitemporal'nom vozdeistvii.

The immunobiological effect of electromagnetic microwaves applied to parietotemporal area was studied. It was shown that the exposure of parietotemporal area to microwaves produced an immunodepressive effect manifested in the decreased number of natural (background) antibody-forming cells. The exposure of parietotemporal area to microwaves was accompanied by glucocorticoid function stimulation in the adrenal cortex and thyroid function depression.