<p><strong>The aim</strong><strong>: </strong>to substantiate the structural components of the control system aimed at improving the physical therapist’s work during pulmonary rehabilitation (PR) of COPD persons.</p><p><strong>Materials and methods. </strong>Analysis and generalization of the data of the special scientific and methodological literature on the issues of physical therapy of patients with chronic obstructive pulmonary disease; method of analysis of medical records; elaboration of Internet sources, including databases of evidence based medical literature.<strong></strong></p><p><strong>Results. </strong>The control system, which is reasonable to be implemented at three stages (preliminary, current, final) of the process of physical therapy (PT) and PR of patients with COPD, is substantiated.</p><p>The control system within the competence of the physical therapist provides for rehabilitation examination (preliminary control), monitoring (current control) and final evaluation of certain indicators. There were 5 groups of main indicators: quality of life/ activity and participation, disease course, body functions, body structures, educational competence. For the selected groups of indicators, the selection of measuring instruments was made, the features of their application at different stages were outlined, the values of the minimum clinically significant difference for the selected indicators were given.</p><p><strong>Conclusions. </strong>The process of pulmonary rehabilitation of people with COPD needs to be evaluated and monitored for its effectiveness in accordance with the expected results.</p><p>The monitoring system allows to track all changes in the patient's health and functioning, regulate the intervention and its intensity, evaluate both the individual physical therapy session and the effectiveness of the entire program.</p><p>One of the criteria of the control system is the effectiveness of PT and PR, which is evaluated on the basis of the dynamics and direction of changes of the studied indicators, their compliance with the expected result and taking into account the values of the minimal clinically significant difference for the evaluated indicators.</p>

Львівський державний університет фізичної культури імені Івана Боберського, Україна 2 КНП ЛОР «Львівська обласна інфекційна клінічна лікарня, Україна

Introduction. People living with HIV (PLWH) have a great need in physical therapy (PT), but there are many barriers to accessing it. Specific recommendations on how to integrate PT into multidisciplinary teams and outpatient care programs PLWH is currently in short supply. The aim of the study. Identify factors to consider when integrating PT into the work of a multidisciplinary team in providing assistance to PLWH. Materials and methods. A descriptive sociological study consisting of interviews with health workers (n=12) and with adults living with HIV (n=13). Research results and their discussion. Guided by the principles of biopsychosocial models in the study of barriers and factors to be considered when integrating PT in multidisciplinary team for the management of PLWH, identified 8 contextual factors that may affect the integration of PT in the care of PLWH. Conclusion. The role of PT in the care of PLWH is multifactorial and patient-oriented, a special role belongs to the contextual factors. Prospects for further research. Structuring the PT mode with orientation on a specific patient; development of methods for assessing PT as an interprofessional component assistance.

Purpose: to assess the functional state of patients with human immunodeficiency virus with different levels of T-lymphocytes for use in the practice of physical therapy. Materials and methods. We examined 24 patients with human immunodeficiency virus at the stage of acquired immunodeficiency syndrome at the outpatient stage of treatment. The patients were divided into 2 groups. Group 1 included 11 patients with CD4+ T-lymphocyte levels <100 cells ml-1, and group 2 included 13 patients with CD4+ T-lymphocyte levels above 150 cells ml-1 (р<0.01). The clinical and anamnestic data, the main anthropometric parameters and physiological indices, the results of carpal dynamometry, the 6-minute walk test, characterizing the functional state of people living with the human immunodeficiency virus, were studied. The results of immunological, virological and biochemical parameters were also studied. Results. Anthropometric indicators: Group 1 – body mass index 48.9±7.4 kg m2-1, waist to hip ratio ratio 0.92±0.17 cm, leg circumference 16.6±0.8 cm; Group 2 – body mass index 23.1±2.8 kg m2 -1, waist to hip ratio ratio 1.14±0.11 cm, leg circumference 15.9±1.4 cm (р>0.05 ). Indicators of physiological indices: Reed - group 1 - 17.3±7.2%, group 2 -  18.3±11.8% (p>0.05); Hobbes - group I 70.9 ± 5.5%, group 2 - 93.6 ± 11.8% (p<0.05), Kerdo - group 1 was 26.6 ± 14.2%, group 2 - 10 .8 ± 14.7% (р<0.05). Index of functional changes group 2 - 2.44±0.2 points, group 2 - 2.59±0.3 points (p>0.05). Dynamometry indicators - group I - 17.5 ± 6.8 kg, group 2 - 28.1 ± 9.4 kg (р>0.05); strength index – group 1 35.3±-9.6%, group 2 40.5±10.4% (р>0.05); 6 min walk test in group 1 - 402.8±40.04 m, group 2 459.7±56.1 m (р<0.05). Indicators of biochemical studies were in reference values ??in patients of both groups. Conclusions. There is a decrease in the functional state and the predominance of catabolic processes in people with human immunodeficiency virus with a significant deficiency of CD4+ T-lymphocytes.

Резюме. Цілі: дослідити зв'язок втоми у людей що живуть з ВІЛ (ЛЖВ), побутової фізичної активності та факторами, які можуть на неї впливати. Матеріали і методи: Обстежено 60 ЛЖВ, 40 чоловіків і 20 жінок у віці від 23 до 61 року. Втому оцінювали за допомогою шкали FAS. Фізичну активність вивчали за допомогою щоденника фізичної активності, якість життя (ЯЖ) – опитувальником SF 36. Показник рівня CD4+ T-лімфоцитів визначали методом проточної цитофлуориметрії, вірусне навантаження (ВН) - за допомогою ПЛР. Результати дослідження та їх аналіз. Ступінь втоми у ЛЖВ коливалася від 17 до 47 балів, середнє значення – 36,4 ± 6,4 балів. До першої групи увійшло 46 пацієнтів з вираженою втомою, а до другої – 14 пацієнтів з помірною. У I групі встановлено: пряму кореляцію з вірусним навантаженням (r = 0,16, р = 0,02), позитивну кореляцію між психічним компонентом ЯЖ та тривалістю сну (r = 0,24, р = 0,06); зворотній зв'язок з фізичною побутовою активністю (r = -0,43, р = 0,0001), загальним показником ЯЖ (r = -0,16, p = 0,02), фізичним та психічним компонентами  ЯЖ – r = -0,19, р = 0,03 та r = -0,37, р = 0,13 відповідно, рівнем CD4+ T-лімфоцитами та ВН (r = -0,25, р = 0,06). У II групі встановлено: пряму кореляцію між втомою та тривалістю сну r = 0.46, р = 0.22, ВН r = 0.24, р = 0.28; зворотна кореляція була між ступенем втоми та загальним показником ЯЖ r = -0.18, р = 0.03, фізичним компонентом ЯЖ r = -0.15, р = 0.02., рівнем CD4+ Т-лімфоцитів r = -0.27, р = 0.17, фізичною побутовою активністю r = -0.35, р = 0.005, ВН r = 0.53, р = 0.28. Висновки. Побутова фізична активність може зменшити втому у ЛЖВ. Тривалість сну позитивно впливає на досліджувані нами патерни здоров’я у ЛЖВ. Встановлено, що втома пов’язана з високим ВН, низькою ЯЖ та ІМТ. Виникає потреба у розробці математичної моделі оцінки втоми.