The study is held in order to estimate the efficiency of applying the methods of manual therapy on pregnant women during the second and third trimesters of their pregnancy to relieve pain caused by dorsopathy. During the period from October 2015 until March 2017 was defined a “study” group (n = 25) and the “control” group (n = 25) of pregnant women with the diagnosis of “dorsopathy” (mostly osteochondrosis 66%, scoliosis 18%, intervertebral hernia 16%). The age of pregnant women is ranged from 22 up to 39 years with the gestational term from 18 to 38 weeks. During the study the following methods are used: cranio-sacral technique, traction technique, myofascial release, post-isometric relaxation, and soft tissue techniques. The number of therapy sessions for pregnant women with dorsopathy is ranged from 1 to 4. To assess the quality of life and, separately, of the pain syndrome was used McGill questionnaire, visual analogue scale (VAS), verbal rating scale, questionnaire EuroQol-5D, Oswestry questionnaire, as well as medical and social characteristics of pregnant women with this pathology. Decrease of pain syndrome was noted in patients already after the first session. Preliminary results were already evaluated and allow us to speak about the effectiveness of applying manual therapy for pregnant women at their II and III trimesters of pregnancy. The data obtained not only prove the reduction but also the complete elimination of the back pain syndrome caused by dorsopathy.

The research was aimed on the study of motor capabilities on the Motor Function Measure (MFM) scale in ambulant and non-ambulant patients with Duchenne muscular dystrophy, and to conduct a correlation analysis between the results of the MFM scale and Magnetic Resonance Imaging (MRI) data. A total of 46 boys who had genetically confirmed Duchenne muscular dystrophy (age from 2.1 to 16.7 years) and were in clinical rehabilitation were investigated. An assessment was performed according to the Motor Function Measure scale (subsections D1, D2, D3, and the total score), an MRI obtaining T1-VI of the muscles of the pelvic girdle was conducted, and the thighs and lower legs were further assessed in terms of the severity of fibrous-fat degeneration according to the Mercuri scale. In ambulant patients, the ability to stand up and move (D1) was 74.4%, axial and proximal motor functions (D2)—97.6%, distal motor functions (D3)—96.2%, and total score was 87.9%. In non-ambulant patients, the ability to stand up and move (D1) was 1.7%, axial and proximal motor functions (D2)—47%, distal motor functions (D3)—67.5%, and the total score—33.1%. A high inverse correlation (r = −0.7, p < 0.05) of the MRI data of the pelvic girdle and thighs with tasks D1, as well as a noticeable inverse correlation with tasks D2 (r = −0.6, p < 0.05) of the scale MFM, were revealed in the ambulant group of patients. In the non-ambulant group of patients, the MRI data of the lower legs muscles were characterized by a high inverse correlation (r = −0.7, p < 0.05) with tasks D3 and a noticeable inverse correlation (r = −0.6, p < 0.05) with tasks D1 of the MFM scale. Conclusion: The Motor Function Measure scale allows effective assessment of the motor capabilities of patients with Duchenne muscular dystrophy at different stages of the disease, which is confirmed by visualization of fibro-fatty muscle replacement.

Duchenne muscular dystrophy (DMD) is one of the most common forms of hereditary muscular dystrophies in childhood and is characterized by steady progression and early disability. It is known that physical therapy can slow down the rate of progression of the disease. According to global recommendations, pool exercises, along with stretching, are preferable for children with DMD, as these types of activities have a balanced effect on skeletal muscles and allow simultaneous breathing exercises. The present study aimed to evaluate the effectiveness of regular pool exercises in patients with Duchenne muscular dystrophy who are capable of independent movement during 4 months of training. 28 patients with genetically confirmed Duchenne muscular dystrophy, who were aged 6.9 ± 0.2 years, were examined. A 6-min distance walking test and timed tests, namely, rising from the floor, 10-meter running, and stair climbing and descending, muscle strength of the upper and lower extremities were assessed on the baseline and during dynamic observation at 2 and 4 months. Hydrorehabilitation course lasted 4 months and was divided into two stages: preparatory and training (depend on individual functional heart reserve (IFHR)). Set of exercises included pool dynamic aerobic exercises. Quantitative muscle MRI of the pelvic girdle and thigh was performed six times: before training (further BT) and after training (further AT) during all course. According to the results of the study, a statistically significant improvement was identified in a 6-min walking test, with 462.7 ± 6.2 m on the baseline and 492.0 ± 6.4 m after 4 months (p &lt; 0.001). The results from the timed functional tests were as follows: rising from the floor test, 4.5 ± 0.3 s on the baseline and 3.8 ± 0.2 s after 4 months (p &lt; 0.001); 10 meter distance running test, 4.9 ± 0.1 s on the baseline and 4.3 ± 0.1 s after 4 months (p &lt; 0.001); 4-stair climbing test, 3.7 ± 0.2 s on the baseline and 3.2 ± 0.2 s after 4 months (p &lt; 0.001); and 4-stair descent test, 3.9 ± 0.1 s on the baseline and 3.2 ± 0.1 s after 4 months (p &lt; 0.001). Skeletal muscle quantitative MRI was performed in the pelvis and the thighs in order to assess the impact of the procedures on the muscle structure. Muscle water T2, a biomarker of disease activity, did not show any change during the training period, suggesting the absence of deleterious effects and negative impact on disease activity. Thus, a set of dynamic aerobic exercises in water can be regarded as effective and safe for patients with DMD.

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1 ГБоу ВПо «санкт-Петербургский государственный педиатрический медицинский университет» минздрава России; 2 сПб ГБуЗ «Городская поликлиника № 106» Поступила в редакцию: 22.03.2016 Принята к печати: 05.06.2016Резюме. В течение последних пяти лет отмечается увеличение количества недоношенных детей, родившихся со сро-ком гестации от 26 недель и весом от 800 г, с тяжелой сочетанной патологией, поступающих после первого этапа вы-хаживания в поликлинику по месту жительства на педиатрический участок. Возникает много вопросов, с чего и как начинать реабилитацию данного ребенка. Анализируя развитие недоношенных детей, мы видим, что необходим комплексный подход к реабилитации таких детей. Учитывая, что детская поликлиника наблюдает детей до 18 лет, имеется возможность наблюдения и оказания помощи данной категории детей длительный период. Крайне важно также осознавать, что без надлежащей помощи негативные последствия для недоношенных детей становятся необ-ратимыми. Рождение недоношенного ребенка является тяжелым психологическим стрессом для обоих родителей. Часто не вполне осознавая этого, семья начинает жить в условиях повышенной эмоциональной нагрузки, оставаясь наедине со своей проблемой в течение длительного периода времени. Именно поэтому в отделении медицинской реабилитации должны работать с родителями недоношенного ребенка для того, чтобы помочь им адаптироваться к новым условиям жизни. Задачу дифференцированной медико-психологической реабилитации может выполнить районная поликлиника, в которой ребенок будет наблюдаться до 18 лет. В статье рассматриваются особенности со-временной реабилитации недоношенных детей в условиях амбулаторно-поликлинической службы.Ключевые слова: недоношенные дети; дети-инвалиды; реабилитация; реабилитационные учреждения. Abstract. During last five years there was increasing preterm infants, these children were born with a gestational age of 26 weeks and weighing 800 g, with severe combined pathology. Preterm infants came to the nearest polyclinics after the first stage of rehabilitation in hospitals. There are many questions how and when specialists should begin rehabilitation of such children. Specialists observes that is required an integrated approach to the rehabilitation of premature babies by analyzing the development of these children. Considering that children's polyclinic allows monitoring children till 18 years of age, there is a possibility of observing and assisting these children during longer period. It is also very essential to realize that without an adequate intensive nursery care the negative consequences become irreversible for premature infants. Birth of a premature infant is a severe psychological stress for both parents. Often without completely realizing it, the family begins to live in conditions of high emotional stress. The department of medical rehabilitation must operate with the parents of a premature baby, in ABOUT THE SYSTEM OF REHABIL ITATION OF PRETERM INFANTS