INTRODUCTION. Urinary incontinence in children is an interdisciplinary problem. The prevalence of urinary incontinence ranges from3.1% to 8.6% and decreases with age. Urinary incontinence can be caused by both organic (diseases of the genitourinary system,neurological pathology) and functional causes. One of the methods of non-drug correction of urinary incontinence is extracorporealmagnetic stimulation, used in adult patients. At the same time, the effectiveness of the method among the pediatric population hasnot been sufficiently studied.
AIM. To study the effectiveness and safety of extracorporeal magnetic stimulation in the comprehensive rehabilitation of children withneurogenic urinary incontinence.
MATERIAL AND METHODS. A prospective open randomized controlled clinical study included 75 pediatric patients (from 5 years to 16years and 6 months) with a clinical form of day and night urinary incontinence, who were divided by simple randomization into a maingroup (n=39), who received a standard rehabilitation and extracorporeal magnetic stimulation program for 21 days, and a comparisongroup (n=36), in which the standard rehabilitation program did not include the use of extracorporeal magnetic stimulation.
RESULTS AND DISCUSSION. A prospective open randomized comparative study revealed that the clinical effectiveness of theextracorporeal magnetic stimulation method in the comprehensive rehabilitation of children with neurogenic urinary incontinenceis 94.8%, which is 25.4% higher than in the comparison group. After treatment, patients in the main group had a noticeable decreasein urinary incontinence episodes, an increase in the micturition volume, and an improvement in the quality of life. Patients withvarious background neurological pathology responded to treatment, which indicates the common pathogenetic mechanisms of thedevelopment of lower urinary tract symptoms in these conditions and the independence of the final effect from the basic diagnosis.
CONCLUSION. The use of the perineal extracorporeal magnetic stimulation method in children with neurogenic urinary incontinenceincreases the effectiveness of rehabilitation and is a promising and safe direction of rehabilitation treatment.
The hydrogalvanic baths provide a tool for the combined application of warm fresh water and low frequency electric current. These procedures are suitable for both systemic and local treatments. The mechanism behind their therapeutic action is based on synergistic effect of two therapeutic agents. This article presents the literature and historical review of the method as well as the current concept of hydrohalvanic therapy. The history of its development is associated with the improvement of the technical equipment and accumulation of clinical experience. Numerous studies carried out up to the present time have demonstrated that hydrohalvanic therapy can be effectively applied for the treatment of diabetic angiopathy, rheumatoid and gouty arthritis, fibromyalgia, ankylosing spondylitis. At the same time, the high potential of this method remains underestimated. At present, one of the most promising approaches to its clinical applications is the treatment of lumbosacral radiculopathy caused by degenerative vertebral disk lesions. The hydrogalvanic baths have analgesic, anti-inflammatory, and decongestant effects, improve microcirculation, and reduce sensory impairment. It is necessary to continue clinical investigations to obtain further evidence of the effectiveness of the method under consideration for the treatment of lumbosacral radiculopathy and to evaluate its short- and long-term effects. Their results will hopefully provide an opportunity to include the hydrogalvanic baths in the programs of medical rehabilitation of the patients presenting with lumbosacral radiculopathy.
Военно-медицинская академия им. С. м. кирова, Санкт-петербург, Россия 2 Ставропольский государственный медицинский университет, Россия 3 Северо-Западный государственный медицинский университет им. И. И. мечникова, Санкт-петербург, Россия 4 Федеральное бюро медико-социальной экспертизы, москва, Россия muscle acTiViTY in paTienTs WiTh dYsfuncTion of The TismaTmouralmaliTY: The role of unifferenTiaTed connecTiVe Tissue diplasion Blinov m. s. 1 , Borodulina i. i. 1 , grebnev g. a. 1 , sirak s. V. 2 , ivanov a. s. 1 , fadeev r. a. 3 , Kozlov s. i. 4 , Kovalevsky a. m. 1 1 s. m. Kirov military medical academy, saint petersburg, russia 2 stavropol state medical university, russia 3 i. i. mechnikov north-Western state medical university, saint petersburg, russia 4 federal Bureau of medical and social expertise, moscow, russia
ТОМ 7 VOL. 7Нервно-мышечные Б О Л Е З Н И Neuromuscular DISEASES
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Оригинальные исследованияВведение Возможности терапевтического применения энер-гии магнитного поля -предмет практического инте-реса на протяжении нескольких столетий. Начало этому пути положили эксперименты Л. Гальвани, ко-торый в XVIII веке сформулировал теорию животного электричества и создал базу для развития электрофи-зиологии. С этого времени началось более глубокое изучение электромагнитного взаимодействия. Откры-тие явления электромагнитной индукции М. Фараде-ем в середине XIX века позволило установить, что в от-вет на переменное магнитное поле (ПМП) в проводящей среде возникает электрический ток. На этом постулате физики в последующем базировал-ся механизм воздействия магнитного импульса на жи-вую ткань. В противоположность электрической сти-муляции
The use of instrumental diagnosis methods is a way to form an individual strategy of rehabilitation treatment and effectiveness monitoring. However, there is a lack of methods for objective assessment of the muscle groups’ functional state in both patients with dorsopathy and healthy individuals, as well as incorrect use of existing diagnostic tools due to the lack of the regulatory framework. The subjects had no complaints on low back pain, and there was no history of pain episodes associated with spinal pathology. All the volunteers were comparable in height and weight before being included in the study. The study was conducted in accordance with the terms of the Helsinki Declaration, all subjects signed an informed consent before the start of diagnostic activities.
Aim. To determine the normative values of the strength of the flexor muscle group (FM) and extensor muscles (EM) of the lumbosacral spine and to establish the ratio of the obtained results to the automatic hardware norm.
Material and methods. The present clinical study included 22 healthy volunteers aged 23 to 61 years (the average age was 38.4±12.8 years), including 14 women (63.6%) and 8 men (36.4%).
Results and discussion. The results obtained demonstrate that the real normative indicators for MS and MR in healthy individuals can vary in the range from the hardware norm value calculated automatically by the device to a value of 20% lower. Exceeding this parameter is not a pathological deviation. When assessing the muscle strength, a decrease in this indicator is of physiological and clinical significance, since it reflects the dysfunction of this area and is a predictor of the pain syndrome chronicity.
Conclusion. The standard values findings allow us to assess correctly the initial clinical condition and use this instrumental method with biofeedback for patients with degenerative spinal lesion and non-specific pain in the lumbosacral region and patients who have undergone spinal surgery to develop individual rehabilitation programs. As a further prospect for the use of diagnostic systems with biofeedback, it is suggested that the examination plan should include the determination of the ratio of the FM strength to the EM strength, as well as the strength of the muscles involved in the lateral slopes of the trunk.
This paper presents interdisciplinary consensus on the use of protocols of high-intensity magnetic stimulation for the treatment of pelvic floor muscles dysfunction with anal incontinence in Russia.AIM: to highlight the discussion and the decision-making on the basis of an interdisciplinary consensus on the use of a new algorithm of peripheral and transcranial magnetic stimulation in the treatment of pelvic floor muscles dysfunction with the clinic of anal incontinence.RESULTS: the adoption of this consensus can serve as a basis for further research of this problem and optimize the results of treatment of patients with pelvic floor muscle dysfunction with anal incontinence. The data may be interesting for a wide range of medical specialists: general practitioners, gastroenterologists, coloproctologists, surgeons, neurosurgeons, gynecologists, urologists — anyone who encounter with manifestations of this disorder in a routine practice and chooses diagnostic and treatment options.CONCLUSION: protocols for the treatment of anal incontinence using high-intensity magnetic stimulation aimed at improving the quality of treatment of patients with anal incontinence are based on the Russian experience of using the methods discussed and the analysis of the results obtained are validated.
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