BACKGROUND: An increasing body of evidence suggests that home-based exercise (HBE) therapy has significant therapeutic effects on knee osteoarthritis (KOA) and hip osteoarthritis (HipOA), and it has advantages such as cost savings, strong operability, and good compliance compared with hospitalization and exercise courses.
OBJECTIVE: To evaluate the efficacy of HBE in the treatment of KOA and HipOA.
METHODS: A systematic search was conducted in PubMed, Cochrane, Web of Science, and Embase to collect randomized controlled trials. The retrieval time was from database establishment until March 6, 2024. Stata 15.1 software was used for data analysis.
RESULTS: A total of 16 randomized controlled trials involving 3,015participants were included, with 1,519 participants in the intervention group and 1,496 in the control group. The meta-analysis showed that, compared to the control group, HBE can significantly improve pain [SMD=-0.38, 95% CI (-0.58, -0.18); P = 0.001], joint function      [SMD=-0.60, 95% CI (-1.01, -0.19); P = 0.004], balance ability [SMD=-0.67, 95% CI (-1.00, -0.34); P = 0.001], mobility (ADL) [SMD = 0.51, 95% CI (0.19, 0.82); P = 0.002] in patients with KOA and HipOA. There is no statistical difference in the improvement of joint stiffness [WMD = -0.80, 95% CI (-1.61, 0.01); P = 0.052]. In addition, subgroup analysis showed that HBE significantly improved pain, joint function, and balance ability in KOA patients compared with the control group. HipOA patients showed significant improvement in pain and joint function; However, HBE only improved activity ability in patients with comorbidities of KOA and HipOA.
CONCLUSIONS: HBE can effectively alleviate pain, improve joint function, and enhance physical function in patients with KOA and HipOA. However, more high-quality randomized controlled trials (RCTs) with large sample sizes and long-term interventions are needed to validate the efficacy of HBE due to limitations in the methodology and consistency of indicator outcomes in the included RCTs.
BACKGROUND: We\'ve registered with PROSPERO, and the number is CRD42023443085.

The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained values of manual muscle test (MMT) and range of motion (ROM) after rehabilitation, compared with the obtained values of FADI index and on that basis evaluate its possibility in assessing the functionality of the respondents after surgery for bimalleolar or trimalleolar fracture of the ankle. The sample included 60 subjects over the age of 18 who underwent surgery for osteosynthesis due to bimalleolar or trimalleolar fracture of the ankle. All subjects were treated with kinesitherapy as part of the postoperative rehabilitation program. The research was conducted from 2013 to 2018 at the Department of Orthopedics of Dr. Safet MujiÊ Cantonal Hospital in Mostar and Mostar University Clinical Hospital. A statistically significant correlation was found between FADI index values per group and average percentage recovery per MMT (p<0.05), as well as a statistically significant correlation between FADI score values per group and mean percentage ROM value (p<0.05). A statistically significant association was found between mean percentage recovery per ROM and MMT (p<0.05). The conducted research confirmed the working hypothesis of the conducted study. The effects of kinesitherapy after ankle surgery can be evaluated using the FADI index, as well as by manual muscle test and ROM measurement.

Disabled persons, who have undergone lower limb amputation (LLA) due to obliterating atherosclerosis, are a special group among patients with coronary heart disease (CHD). In the developed countries, 25-35% of patients was performed high LLA in the first year of critical ischemia, ant the number of interventions is steadily increasing. The development of personalized medical rehabilitation programs (MR) for such patients is relevant.
OBJECTIVE: To scientifically substantiate the therapeutic effects of MR in patients with CHD and LLA.
METHODS: The research design was a prospective cohort comparative study of MR therapeutic effects. The research subject was a change of physical activity tolerance (PAT) in patients during the implementation of recommended MR programs. The study object was 102 patients aged from 45 to 74 years. All patients were distributed by the random numbers method. The examined sample of patients was divided into two clusters. The first cluster consisted of 52 patients with CHD and LLA: study group included 1 - 26 patients, who were performed MR (kinesitherapy, manual mechanokinesitherapy, breathing exercises) and comparison group consisted of 1 - 26 patients, who were performed the preparation to prosthetics). The second cluster included 50 patients with CHD (study group consisted of 2 - 25 patients, who were performed MR and pharmacotherapy, and comparison group consisted of 2 - 25 patients, who were performed only pharmacotherapy). Clinical, instrumental and laboratory methods of examination were used in the research, as well as indicators of psychophysiological status and life quality, subjected to adequate statistical analysis.
RESULTS: Dosed physical activities improve clinical and psychophysical statuses, as well as life quality of patients with CHD and LLA, increase contractility and optimize diastolic myocardial function, raise PAT, improve central and intracardial hemodynamics levels, neurohumoral regulation and lipid metabolism. The efficacy of personalized MR programs for patients with CHD and LLA is 88%, and standardized programs is 76%. The determinants of MR efficacy are base PAT values, as well as indicators of myocardial contraction and diastolic function.
CONCLUSIONS: The MR in patients with CHD and LLA forms obvious cardiotonic, vegetative correcting and lipid lowering healing effects.
Среди пациентов с ишемической болезнью сердца (ИБС) особую группу составляют инвалиды, подвергшиеся ампутации нижних конечностей (АНК) вследствие облитерирующего атеросклероза. В развитых странах мира в первый год критической ишемии у 25—35% больных выполняют высокую АНК и число выполненных вмешательств неуклонно растет. Актуальна разработка персонализированных программ медицинской реабилитации (МР) таких пациентов.
UNASSIGNED: Научное обоснование лечебных эффектов МР больных ИБС с АНК.
UNASSIGNED: Дизайн исследования — проспективное когортное сравнительное исследование лечебных эффектов МР. Предметом исследования явилось изменение толерантности к физической нагрузке (ТФН) пациентов в ходе реализации рекомендованных программ МР. Объект исследования — 102 пациента в возрасте от 45 до 74 лет. Все пациенты были распределены методом случайных чисел. Исследованная выборка больных была разделена на два кластера. Первый кластер составили 52 пациента с ИБС и АНК: группа наблюдения 1 — 26 пациентов, у которых проводили МР (кинезитерапия, ручная механокинезитерапия, дыхательная гимнастика), и группа сравнения 1— 26 пациентов, у которых выполняли подготовку к протезированию). Второй кластер включал 50 пациентов с ИБС (группа наблюдения 2 — 25 пациентов, получавших МР и медикаментозное лечение, и группа сравнения 2 — 25 пациентов, получавших только медикаментозное лечение). В работе использованы клинические, инструментальные, лабораторные методы исследования, а также показатели психофизиологического статуса и качества жизни, подвергнутые адекватному статистическому анализу.
UNASSIGNED: Дозированные физические нагрузки улучшают клинический статус и психофизический статус и качество жизни больных ИБС с АНК, повышают сократительную способность и улучшают диастолическую функцию миокарда, повышают ТФН, улучшают показатели центральной и внутрисердечной гемодинамики, нейрогуморальной регуляции, липидного обмена. Эффективность персонализированных программ МР пациентов с ИБС с АНК составляет 88%, а стандартизованных программ — 76%; детерминантами эффективности МР являются исходные показатели ТФН, а также показатели, характеризующие сократительную способность миокарда и его диастолическую функцию.
UNASSIGNED: МР у больных ИБС с АНК формирует выраженные кардиотонический, вегетокорригирующий и гиполипидемический лечебные эффекты.

Urinary incontinence (UI) is the involuntary loss of urine. It is highly prevalent in women and has a great biopsychosocial impact. Rehabilitation is established as the first-line treatment, although its use has not been protocolized.
To identify which personal risk factors and type of treatment applied are statistically related to patient improvement.
Retrospective cohort study.
Retrospective cohort study of female patients diagnosed with urinary incontinence who attended the Pelvic Floor Rehabilitation Clinic of the Río Hortega University Hospital, receiving rehabilitation treatment during the year 2021. The minimum follow-up period was 12 weeks. The presence or absence of improvement was evaluated according to seven objective and subjective variables, and improvement was established as positive evolution in at least five of the seven variables.
A total of 114 women with urinary incontinence were analyzed. The most frequent types of incontinence were stress (53%) and mixed (36%). The most important risk factors and associated pathology were episiotomy (68%), repeated urinary tract infections (61%), and constipation (40.9%). None of these factors showed a statistically significant relationship with patient improvement. The most used rehabilitative treatment was kinesitherapy+biofeedback (51%) which showed a statistically significant relationship with the improvement of these patients (P=.037) together with biofeedback+posterior tibial nerve electrostimulation (PTNS) (P=.044).
Biofeedback combined with kinesitherapy or PTNS are established as the most effective rehabilitative procedures.

TMD is a group of pathological changes including increased tension in the masticatory muscles, pain in the muscles and/or the temporomandibular joints, abnormal range of the mandibular movement or the presence of acoustic symptoms in the joints in the form of clicking or poping. The aim of the project was to compare the effectiveness of two methods of physiotherapeutic rehabilitation, used in adolescent patients with temporomandibular disorders.
METHODS: The material consisted of 68 patients, aged 14 to 17, of both sexes, generally healthy, who came to the Dental Prosthetics Department for treatment due to pain in the masticatory muscles. Dental examination and diagnostics revealed Ia in all cases in accordance with RDC/TMD protocol. Manual therapy was performed in group I (34 people) and kinesitherapy with massage was performed in group II (34 people). Patients were allocated randomly to both groups. Contraindications were considered for both methods.
RESULTS: Within the first study, mean values of pain intensity between group I and group II were not significantly different (6.12 and 6.24 respectively). Within the second study significantly lower VAS scores in both groups have been revealed (0.92 and 0.74 respectively). Results of the first and second study differed significantly in both groups. Similar results were obtained for the maximum abduction of the mandible.
CONCLUSIONS: The results of the conducted studies indicate a beneficial effect of the assessed physiotherapeutic procedures in terms of functional rehabilitation of adolescent patients with temporomandibular disorders.

OBJECTIVE: Physical exercise has obvious effects on bone loss, pain relief, and improvement of bone metabolism indexes in patients with osteoporosis, but currently lacks sufficient evidence. The aim of this systematic review and meta-analysis was to synthesize and present the best available evidence on the effectiveness and safety of exercises in the treatment of primary osteoporosis.
METHODS: Publications pertaining to the effectiveness of exercise on bone mineral density (BMD), visual analog scores (VAS), and biochemical markers of bone metabolism in primary osteoporosis (POP) from PubMed, Cochrane Library, Embase, VIP, CNKI, and Wanfang Database were retrieved from their inception to April 2020.
RESULTS: A total of 20 studies with 1824 participants were included. The results of the meta-analysis revealed that exercise therapy for lumbar spine and femoral neck BMD is statistically different from conventional therapy (lumbar spine BMD: SMD = 0.78, 95%CI: 0.46, 1.10, P < 0.00001, I2  = 85%; femoral neck BMD (SMD = 0.80, 95%CI: 0.34, 1.27, P = 0.0007, I2  = 88%), exercise therapy can significantly increase the lumbar spine BMD of patients with OP, especially in lumbar spine2-4 BMD (SMD = 0.47; 95%CI: 0.20, 0.75; P = 0.0008; I2  = 69%). Compared with conventional treatment, kinesitherapy also has significant differences in alleviating the pain of POP patients (SMD = -1.39, 95%CI: -2.47,-0.31, P = 0.01, I2  = 97%). Compared with conventional therapy, kinesitherapy has no significant difference in improving biochemical markers of bone metabolism such as bone glaprotein (BGP) (SMD = 2.59, 95%CI:0.90, 4.28, P = 0.003, I2  = 98%), N-terminal pro peptide of type I procollagen (PINP) (SMD = 0.77, 95%CI: -0.44 to 1.98, P = 0.21, I2  = 95%), serum phosphorus (SMD = 0.04, 95%CI: -0.13, 0.22, P = 0.61, I2  = 30%), alkaline phosphatase (ALP) (SMD = -0.08, 95%CI: -0.44, 0.27, P = 0.64, I2  = 76%), and serum calcium (SMD = 0.12, 95%CI: -0.18, 0.43, P = 0.42, I2  = 63%) in POP patients.
CONCLUSIONS: Kinesitherapy significantly improved lumbar spine and femoral neck BMD, and relieve the pain of patients in the current low-quality evidence. Additional high-quality evidence is required to confirm the effect of exercise therapy on the biochemical markers of bone metabolism in POP patients.

The article is devoted to the issues of medical rehabilitation of children with consequences of perinatal affection of the central nervous system (CNS). An important and principal aspect of the medical rehabilitation of children with perinatal pathology is the minimization of drugs, in this regard, in children in the first year of life, the leading role is given to non-drug methods of exposure. Among the important challenges of the medical rehabilitation of children with perinatal pathology are: improvement of blood supply and metabolic processes in the brain tissue, normalization of the central and peripheral regulation of muscle tone, improvement of neuromuscular conduction, stimulation of psychomotor development. In this case, kinesitherapy technologies are of leading importance: massotherapy, therapeutic exercises, reflex kinesitherapy according to V. Vojta; fitball gymnastics, method of fine finger training, dry floatation, etc. Along with physical rehabilitation methods, physiotherapy methods are actively used, which makes it possible to increase the effectiveness of treatment. The analysis of the literature showed that the use of modern non-drug technologies in children with perinatal CNS pathology, and their introduction into practice can significantly increase the effectiveness of medical rehabilitation of such children.
Статья посвящена вопросам медицинской реабилитации детей с последствиями перинатального поражения центральной нервной системы (ЦНС). Важным и принципиальным аспектом медицинской реабилитации детей с перинатальной патологией является минимизация лекарственных средств, в связи с этим у детей на первом году жизни ведущая роль отводится немедикаментозным методам воздействия. К числу важных задач медицинской реабилитации детей с перинатальной патологией относятся: улучшение кровоснабжения и обменных процессов в мозговой ткани, нормализация центральной и периферической регуляции мышечного тонуса, улучшение нервно-мышечной проводимости, стимуляция психомоторного развития. При этом ведущее значение имеют технологии кинезотерапии: лечебный массаж, лечебная гимнастика, рефлекторная кинезотерапия по методу В. Войта, фитбол-гимнастика, метод тонкого пальцевого тренинга, сухая иммерсия и др. Наряду с методами физической реабилитации активно применяются методы физиотерапии, что позволяет повысить эффективность лечения. Проведенный анализ литературы показал, что применение современных немедикаментозных технологий у детей с перинатальной патологией ЦНС, внедрение их в практику работы позволяют значительно повысить эффективность медицинской реабилитации таких детей.

The search for new methods of symptomatic therapy of dilated cardiomyopathy (DCM) remains a relevant objective of modern cardiology. This is due to the low and short-term existing methods effectiveness of conservative and surgical treatment, including drug therapy.
OBJECTIVE: Efficacy evaluation of the combined use of kinesio- and laser therapy for the correction of regional hemodynamics in patients with DCM against the background of maintenance drug therapy.
METHODS: 100 patients with DCM were examined. All patients received differential maintenance drug therapy (beta-blockers, ACE inhibitors, with intolerance to the latter - angiotensin II receptor blockers, aldosterone receptor antagonists, diuretics, cardiac glycosides, antiarrhythmic drugs). Patients were divided into 2 groups at least 3 months after the selection of drug therapy. Intravenous laser blood irradiation (ILBI) and the selection of unloading therapeutic exercises were performed for patients of the main group during therapy. Patients in the control group received only drug therapy. The main research method was venous occlusion plethysmography. It was used to assess regional hemodynamics with the determination of recirculating blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) against a functional stress test.
RESULTS: Data obtained in the dynamic observation process (after 1, 3, 6, 9 and 12 months) in the main group indicate a significant increase in Qr and QH, a decrease in Rr and RH, Vt. Significant positive dynamics in the control group was not observed. The regional hemodynamics indices after 9 and 12 months of observation significantly worsened.
CONCLUSIONS: Thus, according to venous-occlusal plethysmography, the use of unloading therapeutic exercises in combination with ILBI against the background of rationally selected differentiated drug therapy in patients with DCM significantly improves the regional hemodynamics. The developed symptomatic therapy methods can be applied in the practice of cardiologists, general practitioners, therapeutists, rehabilitation physicians to optimize the treatment of patients with DCM.
Поиск новых методов симптоматической терапии дилатационной кардиомиопатии (ДКМП) остается актуальной задачей современной кардиологии. Это связано с низкой и кратковременной эффективностью имеющихся методов консервативного и хирургического лечения, включая медикаментозную терапию.
UNASSIGNED: Оценка эффективности сочетанного применения кинезо- и лазеротерапии для коррекции нарушений регионарной гемодинамики у больных ДКМП на фоне поддерживающей медикаментозной терапии.
UNASSIGNED: Обследованы 100 пациентов с ДКМП. Все больные принимали дифференцированную медикаментозную поддерживающую терапию (β-адреноблокаторы, ингибиторы АПФ, при непереносимости последних — блокаторы рецепторов ангиотензина II, антагонисты альдостерона, диуретики, сердечные гликозиды, антиаритмические средства). Не менее чем через 3 мес после подбора медикаментозной терапии больные были разделены на две группы. Пациентам основной группы на фоне терапии проводили внутривенное лазерное облучение крови (ВЛОК) и подбор разгрузочной лечебной гимнастики. Пациенты контрольной группы получали только медикаментозную терапию. Основным методом исследования являлась венозно-окклюзионная плетизмография для оценки показателей регионарной гемодинамики с определением кровотока (Qr) и регионарного сосудистого сопротивления (Rr) в покое, венозного тонуса (Vt), резервного кровотока (QH) и регионарного сосудистого сопротивления (RH) на фоне функциональной нагрузочной пробы.
UNASSIGNED: Полученные в процессе динамического наблюдения (через 1, 3, 6, 9 и 12 мес) данные в основной группе свидетельствуют о достоверном увеличении Qr и QH, уменьшении Rr и RH, Vt. В контрольной группе достоверной положительной динамики отмечено не было, показатели регионарной гемодинамики через 9 и 12 мес наблюдения достоверно ухудшились.
UNASSIGNED: Таким образом, у больных с ДКМП, по данным венозно-окклюзионной плетизмографии, применение разгрузочной лечебной гимнастики в сочетании с ВЛОК на фоне рационально подобранной дифференцированной медикаментозной терапии достоверно улучшает показатели регионарной гемодинамики. Разработанные способы симптоматической терапии могут быть применены в работе кардиологами, врачами общей практики, терапевтами, врачами физической и реабилитационной медицины для оптимизации лечения больных ДКМП.

OBJECTIVE: The study aims to analyse the efficacy of massage therapy and kinesitherapy applied by parents of premature infants admitted to hospital.
BACKGROUND: Premature newborns suffer early somatic deprivation that has adverse effects on their growth and development and that also has a negative impact on the emotional state of their parents. Massage therapy and kinesitherapy is beneficial in alleviating somatic deficit and facilitates the bond between parents and newborns.
METHODS: A quasi-experimental community intervention trial will be conducted in a neonatology unit.
METHODS: This study will compare the benefits of a 15-min massage protocol applied by parents with the usual medical and nursing care given by neonatal units for premature babies. The evaluation of neuromotor development will take place through the Spanish Premie-Neuro scale. The determination of weight, size, and head circumference will be based on the unit\'s usual procedures.
CONCLUSIONS: If the implementation of a massage therapy and kinesitherapy protocol is effective in promoting the growth and development of hospitalized premature infants, the results of this study could give an impetus for the inclusion of somatic stimulation in the usual nursing care given for preterm infants.
CONCLUSIONS: Prematurity and its associated morbidity pose a major global public health problem. Somatic and kinaesthetic stimulation has beneficial effects on anthropometric and neuromotor development in preterm infants. The results will have a positive impact on premature neonates and their families, both during the hospitalization, and a positive socio-economic effect throughout their lives (education, work, disability).
BACKGROUND: NCT03704012.
目的: 本研究旨在分析医院内早产儿由家长进行推拿疗法和运动疗法的效果。 背景: 早产新生儿过早离开母体将不利于其生长发育,也会对父母的情绪状态造成负面影响。 推拿疗法和运动疗法有益于促进身体发育,增强父母与新生儿之间的纽带。 设计: 准实验性社区干预试验将在新生儿科进行。 方法: 这项研究将比较由父母采用的15分钟按摩方案的效果与新生儿病房为早产儿提供的常规医疗和护理的效果。神经运动发育的评估将通过西班牙PREMIE神经量表进行。早产新生儿的重量、尺寸和头围将基于设备的常规程序进行测量。 讨论: 如果实施推拿疗法和运动疗法方案能够有效地促进住院早产儿的生长发育,本研究的结果将推动将躯体刺激纳入早产儿的常规护理中。 影响: 早产及其相关的发育不良是全球公共卫生问题中的一个主要问题。躯体和运动刺激有益于早产儿的人体测量和运动神经的发育。这一研究的结果将有益于住院期间的早产儿及其家庭产生,并对其一生(教育、工作、残疾)产生积极的社会经济影响。 试验注册号: NCT03704012.

Vascular lesions of the central nervous system are one of the most important and topical problems in modern neuro-pathology. Bulgaria is among the first in morbidity and mortality from cerebrovascular diseases. Because of the significant medical and social importance of this pathology resulting in severe disabling of most survivors, we aimed to explore the effectiveness of kinesitherapeutic methodology applied in the recovery of a patient with ischemic stroke. We present a case of a 69-old patient admitted in the Neurological Ward of \"St. George Hospital in Plovdiv in 2015, Bulgaria with right hemiparesis due to ischemic stroke in the basin of the left middle cerebral artery. The applied Kinesi-therapeutic methodology included various techniques like Kabat\'s Bobath\'s methods as well as training in equilibrium and walking. The patient obtained satisfactory results in terms of movement of the body and preserving the equilibrium, improvement of voluntary movement of the upper and lower right limb achieved via the help of some compensatory mechanisms. Despite the applied Kinesitherapy, the patient failed to gain independence in daily activities. We ascribe this satisfactory recovery only to the short period of application of kinesitherapeutic methodology. For a better recovery of patients with cerebrovascular disease, a continuous multidisciplinary approach is needed.