Резюме Цель исследования-изучить влияние наружной контрпульсации (НКП) на эндотелиальную функцию и состояние микроциркуляции у пациентов после реваскуляризации миокарда (стентирование и коронарное шунтирование) с хронической сердечной недостаточностью (ХСН) II-III функционального класса (ФК). Материал и методы. Обследованы 60 больных после реваскуляризации миокарда с ХСН II-III ФК в возрасте от 50 до 75 лет. Все пациенты получали одночасовые процедуры НКП 5 раз в неделю. Курсовое лечение включало 35 процедур. Для оценки состояния микроциркуляторного русла проводили изучение капиллярного кровотока методом лазерной допплеровской флоуметрии. Результаты. Курсовое применение НКП у пациентов с ХСН II-III ФК после реваскуляризации миокарда оказывало корригирующее действие на систему микрогемодинамики. Изменения микроциркуляции были обусловлены нормализацией миогенного и нейрогенного тонуса артериол, усилением осцилляций эндотелиального диапазона. Выраженное благоприятное воздействие НКП на сердечно-сосудистую систему у обследуемых пациентов подтверждалось достоверным повышением толерантности к физической нагрузке, статистически значимым улучшением результатов теста 6-минутной ходьбы. Отмечено уменьшение ФК сердечной недостаточности. Заключение. НКП является эффективным, неинвазивным методом лечения пациентов с сердечной недостаточностью.

Worldwide, arterial hypertension (AH) is the most common cardiovascular disease. Despite the fact that today, high efficacy and persistent hypotensive effect of transcerebral pulsed electro- and magnetic therapy in patients with AG has been proven, it seems relevant to develop optimal transcerebral effects for this category of patients. The aim of this study was to select optimal transcerebral effects in patients with mild arterial hypertension, depending on hemodynamic types of central hemodynamics and microcirculation. Methods: The study included 82 patients with MAG from 45 to 79 years and the the duration of the disease from 2 to 11 years.Patients in the first group (40 patients) received MDM mesodial encephalus modulation and in the second group (42 patients) combined magnetotherapy (PeMP and PMP). Results: It was found out that patients with MAG who received MDM had a pronounced hypotensive effect due to improvement of the basic indices of central hemodynamics regardless of the type of blood circulation. As well as MDM causes positive correction of the basic parameters of capillary blood flow, regardless of the initial type of microcirculation. In patients with MAG combined magnetotherapy (PeMP and PMP) causes hypotensive effect, which is accompanied by a favorable restructuring of the basic parameters of central hemodynamics in hyperkinetic type of hemocirculation. Correction of microcirculatory disorders has been established only in patients with spastic type of hemodynamics. Conclusion: On the basis of the conducted studies it is possible to say that MDM and transcerebral combined magnetotherapy contribute to the effectiveness of treatment of patients with hypertension. Sufficiently high efficacy of applied methods allows to approach them in a differentiated way based on clinical and hemodynamic features of hypertension course.

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BACKGROUND: Total knee arthroplasty is one of the most common surgical interventions in the world and the Russian Federation. Endoprosthetics of the knee joint occupies a leading place in the structure of surgical methods for the treatment osteoarthritis. AIM: of the study was to scientifically substantiate the feasibility of the complex use of electrical stimulation and therapeutic exercises in patients after total knee arthroplasty. MATERIALS AND METHODS: We examined 60 patients who were admitted 3 months after TCS and were randomized into 2 groups. In the first group, 30 subjects received electrical stimulation of the quadriceps muscles and underwent therapeutic exercises, for a course of 10 procedures. The subjects of the second group, 30 people, had only physiotherapy exercises. RESULTS: The use of electrotherapy and physiotherapy exercises, in the complex treatment of patients after total knee arthroplasty, improves the function of joint mobility. This is confirmed by the improvement in the functional activity of the operated joint according to the KSS scale (Кnee Society Scores), the improvement in the state of microcirculation and the positive dynamics of the pain syndrome according to the VAS (Visual Analog Scale). The obtained data of the HAQ (Health Assessment Questionnaire) questionnaire testify to the expansion of the possibilities for performing most of the activities in everyday life. However, more statistically significant results were obtained in patients after a course of quadriceps electrical stimulation and therapeutic exercises compared with the use of therapeutic exercises alone. CONCLUSION: The complex of rehabilitation of patients after total knee arthroplasty presented by us, including electrostimulation and therapeutic gymnastics, is scientifically sound, effective and can be implemented into the basic scheme of outpatient and sanatorium treatment of this category of patients.

BACKGROUND: All over the world, osteoarthritis is a common disease and accounts for 10% of all diseases in the population, and therefore, the frequency of large joint arthroplasty continues to increase, which determines the need to develop new methods of complex treatment in the rehabilitation of patients after arthroplasty operations. AIM: Scientific substantiation of the expediency of the complex use of a stabilometric multifunctional platform with biofeedback and light therapy in patients after arthroplasty of the joints of the lower extremities to improve the quality of life in the late recovery period. MATERIAL AND METHODS: 60 patients were examined three months after total joint replacement of the lower limb at the age of 55 to 75 years. All patients were randomly divided into three groups of 20 people comparable in terms of clinical and functional characteristics. Patients of the main group were exposed to monochromatic polarized incoherent light and underwent physical training using a stabilometric complex with biofeedback COBS (mtd-Systems, Germany), in the comparison group, patients received therapeutic exercises on a stabilometric simulator with biofeedback, patients the control group received only a standard rehabilitation complex and drug therapy, which served as a background in the main group and the comparison group. RESULTS: Prior to the start of treatment, when analyzing the indicators of static and dynamic stabilometric studies, an uneven distribution of the load was established during tests with a preponderance towards the healthy leg. After a course of treatment, patients of all groups showed statistically significant positive results, however, a more pronounced improvement in indicators was observed in patients of the main group, less pronounced, but statistically significant results were obtained in the comparison group, and insignificant positive dynamics was noted in patients of the control group. When studying the quality of life and the effectiveness of treatment according to the EQ-5D questionnaire in the examined patients in the initial state, the indicator averaged 6.60.8 points. After the course of treatment, patients of the main group showed a statistically significant decrease in the scores of the EQ-5D questionnaire from 6.70.9 points in the initial state to 4.20.9 (p 0.001), which lasted up to 6 months. In patients of the comparison group, in all periods of observation, a decrease in the indicator was also noted, but less pronounced, in patients of the control group ― only a positive trend. The findings were supported by the results of the Hospital Anxiety and Depression Scale (HADS). CONCLUSION: The use of a comprehensive rehabilitation program with the inclusion of a stabilometric platform with biofeedback and polarized light "Bioptron" contributes to a marked improvement in the state of balance, balance and coordination abilities of patients, normalization of muscle tone, a significant reduction in anxiety and depression and can significantly improve the quality of life of patients with endoprostheses in the late recovery period.