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Comparative analysis of the effectiveness of different methods of physical therapy including hydrokinesitherapy and therapeutic gymnastics with the use of exercises on an unstable support (stabiloplatform) was made for a group of 72 patients suffering from pain in the spine of vertebrogenic genesis who had repeatedly received standard medical therapy, physiotherapy (magnetotherapy, laser therapy), and massage therapy before the onset of the study. The effectiveness of therapy was assessed based on the VAS scale, using the Schober’s test, Tomaier test, and Ott test as well as the summary index of health status. The pain intensity estimated based on the VAS scale was significantly reduced in all the patients after the completion of the treatment. Especially good results were obtained for the group of men making exercises on the stabiloplatform and in the group of women given hydrokinesitherapy in the water pool. The results of the present study of the psychoemotional state, vertebroneurological status, and spinal pain intensity in the patients presenting with dorsopathies lead to the conclusion that men and women respond differently to the rehabilitative treatment with the use of the static and dynamic methods of physical therapy.
The effect of complex rehabilitation in patients with post-stroke syndrome after complex treatment, including operative treatment, chemotherapy and radiation therapy, was studied. Electrosleep in combination with normobaric hypoxic therapy significantly improved the condition of patients and can be a method of choosing the tactics of treatment of patients of this profile. The effectiveness of the treatment was 91%. The method contributes to a more prolonged remission of the disease and gives grounds to talk about the need for repeated courses of therapy with a frequency of no more than 2 times a year.
Introduction Methadone can be used to wean opiates and reduce length of mechanical ventilation (MV) in critical care and burn patients. The objective of this study was to assess the impact of methadone use on ventilator-free days and clinical outcomes in burned patients requiring MV. Methods This was a retrospective study of adult patients admitted to a burn center for initial management of burn injuries who required MV for at least 48 hours between September 2013 and November 2019. Patients were excluded from the study if they had prior methadone use, total body surface area (TBSA) of less than 5%, or expired within the first 28 days of admission. The primary endpoint was the difference in ventilator-free days among those who received methadone compared to those who did not. Secondary endpoints include length of stay, mortality, sedative agent and average daily dose, analgesic agent and average daily dose, and incidence of delirium. Baseline demographics were compared using descriptive statistics. Nominal data was compared using Chi-square test. Continuous data was analyzed using student’s t-test or Mann-Whitney U test, as appropriate. Multivariate regression was used to identify variables for possible association with MV duration. Results A total of 83 patients were included in the study; 52 received methadone and 31 were controls. Patients were generally well-matched between groups, however patients receiving methadone were younger (45.3 vs 56.2 years, p = 0.002) and had a larger TBSA (30.4 vs 19.1%, p = 0.001). Patients who received methadone had fewer ventilator free days of the first 28 (9.5 vs 15.0 days, p = 0.009) and a longer ICU stay (57.2 vs 35.8 days, p = 0.025). There was no difference between groups in terms of mortality, reintubations, and incidence of delirium. Patients who received methadone had longer duration of analgesia (20.7 vs 12.0 days, p = 0.011) and sedation (19.0 vs 12.4 days, p = 0.026) while on MV. Conclusions This study found that methadone use contributed to fewer ventilator-free days and longer ICU stays, which was unexpected but worth discussing. There are several limitations to this study. This study occurred during a time period in which the pain management and sedation strategies of this burn unit were evolving, and strategies may not have been consistent between providers. The study included a small sample size and baseline demographics demonstrated significant differences in age and TBSA between the two groups. Additionally, pain scores were not collected as part of this study, which would have provided better insight into the effectiveness of pain management. The use of methadone as an adjunct for pain control remains undetermined.
The issue of compression ischemic syndromes, in particular, carpal tunnel syndrome, is currently extremely relevant. Prolonged compression of the nerve leads to irreversible consequences and degeneration of its fibers, followed by neurogenic muscle atrophy and permanent loss of function. Standard medical and physical therapy methods of treatment do not always achieve a positive effect. The paper considers the results of the use of phonophoresis of hydrocortisone and fermenkol in 35 patients with carpal tunnel syndrome. Positive dynamics was noted in both groups, which increases the possibility of treatment tactics selection for patients of this profile.
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