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The aim of the study – Is to evaluate the effectiveness and safety of the use of a functional unloading orthosis with the possibility of varus–valgus correction (FUOVVC) in patients with stage III osteoarthritis of the knee joint.Materials and methods. The study involved 10 patients with stage III osteoarthritis of the knee joint who underwent outpatient treatment at the V.A. Nasonova Federal State Medical University of the Russian Academy of Medical Sciences. All patients used the FUOVVC for 3 months. To evaluate the results, pain intensity was determined using a visual analog scale (VAS) and knee joint function according to the knee injury and osteoarthritis KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaire before using the orthosis, after 1 and 3 months. Additionally, the assessment of VAS was carried out immediately after fixation of the orthosis on the knee joint.Results. The median age of the patients was 63.5 [55.0; 74.0] years, body mass index – 29.9 [27.9; 34.0] kg/m2, pain according to VAS baseline – 40.0 [40.0; 60.0] mm, pain according to VAS 1 hour after the start of the use of The median age of the patients was 63.5 [55.0; 74.0] years, body mass index – 29.9 [27.9; 34.0] kg/m2, pain according to VAS baseline – 40.0 [40.0; 60.0] mm, pain according to VAS 1 hour after the start of the use of FUOVVC – 25.0 [10.0; 30.0] mm, pain according to VAS after 1 month – 10.0 [0.0; 20.0] mm, VAS after 3 months – 10.0 [0.0; 20.0] mm. The median score according to the KOOS questionnaire was initially 41.5 [38.0; 50.0], after 1 month – 61.0 [53.0; 63.0], after 3 months – 63.5 [58.0; 64.0]. None of the patients had any adverse events when wearing the FUOVVC. – 25.0 [10.0; 30.0] mm, pain according to VAS after 1 month – 10.0 [0.0; 20.0] mm, VAS after 3 months – 10.0 [0.0; 20.0] mm. The median score according to the KOOS questionnaire was initially 41.5 [38.0; 50.0], after 1 month – 61.0 [53.0; 63.0], after 3 months – 63.5 [58.0; 64.0]. None of the patients had any adverse events when wearing the FUOVVC.

Aim. Create and justify the algorithm of physical therapy application, which will be used at the early stage of treatment of critically ill patients treated in the transferred anesthesiology and intensive care unit. Materials and methods. The study was conducted during five months of 2023 in two medical and diagnostic centers in Kyiv, Ukraine, in the conditions of the department of anesthesiology and intensive care unit. 80 critically ill patients took part in the study, who were divided into main and control groups of 40 people each. Participants in the main group had physical therapy included in the treatment process, while the control group did not receive such treatment. The sample of patients was based on selection on the basis of indicators of critical condition and the need for treatment in the conditions of the anesthesiology and intensive care unit. Participation in the study varied from 1 to 3 weeks, with the first assessment at the meeting with the physical therapist and the last before discharge or transfer of the patient. Assessment included manual muscle testing and the Richmond Agitation/Sedation Scale, as well as observation for comorbidities. During the research, a developed algorithm for the use of physical therapy for critically ill patients was applied. Results. In the course of the study, a complex of physical therapy methods was used to influence the dynamics of the patients' state of consciousness, the functional strength of the muscles of the upper and lower limbs, as well as to study the frequency and severity of the development of accompanying complications (bedsores, contractures, swellings, deformations, wounds). Data collected from the main and control groups were subjected to comparative statistical analysis. The results of the analysis confirm that the use of the developed algorithm of physical therapy contributed to a significant improvement in the cognitive state of the participants, an increase in functional strength in the muscles of the limbs, and also effectively reduced the risk and severity of comorbidities. This indicates the importance of integrating physical therapy into a comprehensive approach to the treatment of critically ill patients. Conclusions. The proposed approach to the use of physical therapy for patients who are in critical condition and treated in the conditions of the department of anesthesiology and intensive care confirms its high efficiency in the early stages of treatment. Studies show that the use of physical therapy improves the functional state of muscles, improves the cognitive functions of patients, and also helps to prevent the development of concomitant complications that may occur during a stay in the conditions of the anesthesiology and intensive care units.

Aim: to determine the effectiveness of a physical therapy program for the elderly with sarcopenic obesity in terms of the kinesiophobia and physical functioning parameters. Materials and methods: We examined 106 elderly people, who were divided into 3 groups. The control group consisted of individuals with normal body weight and they had no sarcopenia. The main group 1 consisted of individuals with sarcopenic obesity and a weak therapeutic alliance; they were given general recommendations for modifying the diet and expanding physical activity. The main group 2 included patients with a strong therapeutic alliance. A one-year physical therapy program with the use of kinesitherapy, massage, dietary intervention, patient education, the elements of cognitive training and occupation therapy was developed for them. The dynamics were assessed by Tampa Kinesiophobia Scale, Fullerton Fitness Test, Edmonton Frail Scale. Results: Elderly people with sarcopenic obesity have a high level of kinesiophobia (Tampa Kinesiophobia Scale), their physical status (coordination, balance, strength, flexibility, endurance, agility) significantly lags behind that of their peers (Fullerton Fitness Test), they suffer from the frailty (Edmonton Frail Scale). After applying the developed physical therapy program, it was possible to state that the individuals of the main group 2 showed a statistically significant (p

Aim: to assess the effectiveness of the developed physical therapy program on locomotive syndrome parameters in elderly people with osteoarthritis of the knee and obesity. Material and methods. 93 elderly people were examined. The control group consisted of 31 people without osteoarthritis of the joints, with no obesity. The main group 1 consisted of 33 people who received rehabilitation according to the general principles of osteoarthritis correction. Representatives of the main group 2 (31 people) were engaged in a physical therapy program using functional training on the «Prosedos» platform, therapeutic exercises, Proprioceptive Neuromuscular Facilitation; massage, kinesiological taping, nutritional correction, patient education. The effectiveness of the program was evaluated according to the dynamics of the Short Physical Performance Battery, Functional Gait Assessment, Tinetti-test (Performance-Oriented Mobility Assessment), 25-question Geriatric Locomotive Function Scale. Results. Elderly patients with osteoarthritis of the knee and obesity were found to have impaired balance (Short Physical Performance Battery), altered gait stereotype (Functional Gait Assessment), risk of falling when performing activities of daily living (Tinetti-test) at the level of locomotive syndrome II degree (25- question Geriatric Locomotive Function Scale). The developed program of physical therapy in persons of the main group 2 revealed a statistically significantly better effect on the components of the locomotive syndrome compared to the initial examination in all studied parameters (p

Aim: to evaluate the effectiveness of the developed program of hand therapy on the parameters of upper limb motility in wounded military servants with the consequences of a gunshot polystructural forearm bones fracture in the post-immobilization period Materials and methods. 49 military servants with the consequences of a gunshot polystructural forearm bone fractures were examined. The control group (23 persons) underwent rehabilitation according to general polyclinic principles. The main group (26 persons) underwent rehabilitation using tools and principles of hand therapy (therapeutic exercises and functional training for the wrist and fingers, forearm, shoulder, all joints of the upper limb, exercises on the mechanotherapeutic table MAPS THERAPY; Proprioceptive Neuromuscular Facilitation, massage of the upper limbs; kinesiological taping; orthotics) lasting 1 month. The effectiveness of the program was evaluated by the functioning of the upper limb when performing the Action Research Arm Test and dexterity by the Nine-hole peg test. Results. In the injured persons with the consequences of a gunshot polystructural fracture of the bones of the forearm in the post-immobilization period, deterioration of the motility of the upper limb according to the Action Research Arm Test and dexterity according to the Nine-hole peg test, which are factors of disruption of the normal functioning of the upper limb, were determined. After the rehabilitation intervention, all examined persons showed an improvement in motility according to the Action Research Arm Test in the control group by 14.7%, in the main group by 35.4%, according to the Nine-hole peg test - by 61.8% and 22.3%, respectively. According to all studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p

Duchenne muscular dystrophy is a genetic orphan neuromuscular disease caused by a mutation in the DMD gene encoding the protein dystrophin. As a result of developing and progressive muscle damage and atrophy, children lose the ability to walk, develop respiratory and cardiac disorders. The core elements of good care standards are early diagnosis, prevention and treatment of osteoporosis, daily physical therapy, regular rehabilitation, glucocorticosteroids, and control of heart and lung function. The clinical effect of new targeted pathogenetic therapies for Duchenne muscular dystrophy, restoring synthesis of full or truncated dystrophin, depend on their appropriate combination with existing standards of care.

Introduction. Effective and available rehabilitation methods are necessary in the context of the ongoing pandemic of COVID-19 (CoronaVirus Disease 2019).The objective was to develop a personalized rehabilitation program for patients who have undergone COVID-19 based on the proven effectiveness of methods.Methods and materials. Three months after COVID-19, 855 patients were examined by the method of standardized phone interview, according to the rehabilitation routing scale (RRS). 200 patients have got through the 10-days inpatient rehabilitation course. Breathing exercises, exercise regimen designed to strengthen basic muscles groups, Nordic walking were used. The physical activity level, heart rate and saturation (SpO2) have been monitored by wearable devices (fitness-trackers) during 3 months.Results. Inpatient rehabilitation was required for 1 % of patients, outpatient – 19 %. 42 % did not need rehabilitation, but they had respiratory symptoms and decreased exercise tolerance. There was an improvement in flexibility, muscle strength; the duration of breath holding, 6-minutes walk test, exercise tolerance test; reducing the severity of shortness of breath (mMRC scale) and respiratory symptoms (САТ scale). The achieved level of daily physical activity was maintained for 3 months after the end of the rehabilitative program.Сonclusion. Using the rehabilitation routing scale in the post-COVID period allows stratifying patients according to the degree of need for rehabilitation. Clinically significant and persistent positive effect in most patients can be achieved by physiotherapy methods during 10-days course. Wearable devices of monitoring biometric data are useful additional instruments for monitoring recovery after COVID-19.

The aim of the work is to review modern literary sources regarding the relevance of physical therapy and occupational therapy in cancer patients at the stage of palliative and hospice care. Results. The relevance of physical therapy and occupational therapy methods in palliative and hospice medicine for cancer patients was studied. It has been established that physical therapy and occupational therapy for oncological patients at the stage of palliative and hospice care has a high efficiency for various indicators, which ultimately leads to an improvement in the quality of life not only of patients but also of their family members who supervise. But on the other hand, physical therapy and occupational therapy are not used enough in this group of patients due to various reasons. Conclusion. The use of physical therapy and occupational therapy are relevant for palliative oncological patients. It is necessary to introduce it into the health care system more actively, considering the high efficiency of physical therapy and occupational therapy in the practice of interdisciplinary treatment approaches of oncological patients at the stage of palliative and hospice care.

The aim of our research is to review modern literature regarding the relevance and frequency of physical and occupational therapy in palliative and hospice medicine of neurodegenerative diseases. Results. The role of physical therapy and occupational therapy in palliative-hospice medicine for such neurodegenerative diseases as Parkinson’s disease, cognitive impairment and/or dementia, Alzheimer’s disease, amyotrophic lateral sclerosis, multiple sclerosis has been studied. It has been found, a wide variety of physical and occupational therapy is widely used in palliative hospice medicine despite the disease’s severity. These methods significantly improve the quality of life of both palliative patients and their families ultimately. Physical and occupational therapist specialists are a very important link in the multidisciplinary team of palliative-hospice medicine. Conclusions. Physical and occupational therapy play a very important role in neurodegenerative diseases patients requiring palliative-hospice care in today’s world. Palliative physical and occupational therapy of patients with neurodegenerative diseases has many benefits that help maintain or improve various bodily functions. This contributes to the quality of life improving for not only patients but also for their family members who care for them.

The aim of the work is to evaluate the impact of physical therapy and preformed physical factors in pregnant women with chronic pyelonephritis on central hemodynamic indicators. Materials and methods. The dynamics of 134 pregnant women with chronic pyelonephritis (CP) in the remission stage, who underwent a complex sanatorium rehabilitation program, were examined. The main study group consisted of 79 pregnant women with chronic pyelonephritis. In this contingent of women, the sanatorium rehabilitation complex additionally included a course of intermittent normobaric hypoxytherapy (INH). The comparison group consisted of 55 pregnant women with CP, for whom the sanatorium rehabilitation complex did not include an INH course. The control group is represented by 37 somatically healthy women with a physiological course of pregnancy. All pregnant women were examined for central hemodynamic (CH) indicators using the computer diagnostic complex REOKOM (Kharkiv). Results. Pregnancy periods of 20–30 and 31–30 weeks in women with CP are characterized by a pathological load on central hemodynamics. At the same time, the application for the INH course in the sanatorium rehabilitation complex (the main group) allows for an increase in the compensatory capabilities of the pregnant woman with CH. Thus, in the period of pregnancy of 22–30 weeks in the main group, indicators of diastolic blood pressure and heart rate were probably lower than the control values (P < 0.001), which in this group is determined by values of peripheral resistance of blood vessels close to those of the control group (P > 0.05), regardless of the timing of the study. The study of CH and the comparison of different periods of gestation and between research groups indicate an inverse relationship between indicators that reflect the intensity of cardiohemodynamics and indicators of vascular resistance, as one of the final mechanisms of maintaining blood pressure at a physiological level, or its pathological increase in chronic pyelonephritis and preeclampsia Taking into account that the ratio of cardiac index indicators and total peripheral vascular resistance in all study groups was stable and directly dependent on the level of blood pressure, it is advisable to recommend for practical application in order to assess the state of CH of pregnant women with CP indicators of stroke or cardiac indices, which characterize the intensity cardiohemodynamics and do not depend on the anthropometric data of the pregnant woman. Conclusions. The application of physical therapy and preformed physical factors, namely, intermittent normobaric hypoxytherapy in pregnant women with chronic pyelonephritis in a complex program of sanatorium rehabilitation increases the compensatory capabilities of the cardiovascular system, which is confirmed by a significant decrease in the values of the total peripheral resistance against the background of an increase in the cardiac index.

Pneumonia is one of the most common infectious diseases and the leading infectious cause of death worldwide. High rates of morbidity, frequency of complications, mortality, the emergence of new highly virulent strains of pneumonia pathogens, antibiotic resistance determine the global medical and social problem of community-acquired pneumonia. The economic consequences of pneumonia are represented not only by direct medical costs (the cost of maintaining a patient in a medical institution, the cost of medical services, the cost of medicines, laboratory and instrumental studies, other medical procedures, etc.), but also include non-material costs from pneumonia, which include pain, psycho-emotional experiences of the patient due to a decrease in the quality of life during the illness. One of the directions of increasing the effectiveness of pneumonia therapy is the widespread introduction of physical therapy (PT) and electrophysical modalities (EM) into complex treatment, which are an important part of the medical rehabilitation for pneumonia, aimed at the speedy restoration of the health and working capacity of patients. The effectiveness of EM in the treatment of pneumonia is due to the versatile therapeutic effect of physical factors that have anti-inflammatory, desensitizing, bacteriostatic, broncholytic, mucolytic, immunostimulant effects, improve blood supply to the lungs. PT contributes to the normalization of pulmonary ventilation, has an expectorant effect, strengthens the respiratory muscles, accelerates the resorption of the inflammatory focus, prevents the formation of pleural adhesions, activates blood and lymph circulation. PT and EM are relevant in the comprehensive treatment of community-acquired pneumonia since they accelerate the regression of clinical symptoms, decrease the drug load, reduce the duration of inpatient treatment, that is confirmed by the results of clinical studies. We assume that the inclusion of PT and EM in the comprehensive treatment of pneumonia can lead to minimizing the total cost of the disease while reducing the duration and volume of drug treatment.

Abstract. Cerebral palsy is one of the most widespread nervous diseases for children [1]. From data of VOOZ annually there is growth of quantity of children with disabilities, including cerebral palsy. According to the Center for Medical Statistics of Ukraine, children with disabilities make up about 2% of the child population, thus relative majority - are children who have lost mobility due to congenital and acquired diseases and injuries of the central and peripheral nervous systems [2]. The most common form of cerebral palsy is spastic diplegia (bilateral paralysis of the same parts of the body). Children with spastic diplegia and lesions of all extremities, muscle tone of the extremities is increased, which may eventually lead to contracture. In turn, these contractures lead to persistent restrictions of active and passive movements in the joints and can be prevented or eliminated in the process of physical therapy. The analysis of the scientific literature on these issues allowed us to conclude that it is necessary to further improve existing methods of physical therapy of the cerebral palsy with spastic diplegia, which determines the relevance of this research.

The review discusses the treatment methods based on physical phenomena in clinical ophthalmology. The physical nature and treatment techniques using electric current and electromagnetic field, light and laser radiation, mechanical energy and sound waves, high and low temperature in various ocular pathologies are considered. It is noted that reliable evaluation of the effectiveness of physical treatment methods for the different diseases and pathological conditions requires the implementation of protocols that include objective testing methods of the structure and functioning of the visual system. Once the clinical effectiveness of the particular physical treatment methods and techniques is confirmed, further development and improvement of the most efficient ones becomes possible.

The aim of the work to determine the dynamic characteristics of overall physical condition indicators in 11–13-year-old female weightlifters after injuries of the musculoskeletal system at the training stage of physical therapy. Materials and methods. The experimental population comprised 45 female weightlifters (aged 11–13 years, qualification ‒ I, II, III junior categories) from SСYSSOR “Spartak” of the Zaporizhzhia regional council, CYSS “Kolos” of Kamiansko-Dniprovskyi district of Zaporizhzhia region, Berdiansk CYSS of Zaporizhzhia Region City Council, and students of Kharkiv Regional Higher School of Physical Culture and Sports majoring in weightlifting. Patients after musculoskeletal injuries were divided into two groups: main (MG, n = 22) and control (CG, n = 23). Patients of the control group underwent standard treatment (generally prescribed in medical establishments). For main group patients in the training period, the program of physical therapy has been developed and implemented, with the current control of overall physical condition indicators. Research methods. Analysis of literature and sources of information presented on the Internet; clinical observations; pedagogical testing; methods of mathematical statistics. Results. Analysis of overall physical condition indicators of athletes of 11–13-year-old weightlifters of the main and control groups during the recovery and training periods allows us to state that main group athletes have higher growth rates, and dynamic characteristics of their overall physical condition are linear with constant focus on improvement. According to the indicators of “running 30 m, s” test, the following growth indicators were recorded: main group athletes (-0.48), control group athletes (-0.29), the difference (-0.19). According to the indicators of “standing long jump, cm” test, the following growth indicators were recorded: main group athletes (+14), control group athletes (+5), difference (+9). According to the results of the test “flexion-extension of the arms in the supine position, n” the following indicators were obtained: main group athletes (+4.44), control group athletes (+2.86), difference (+1.58). Conclusions. Intensification of the training process and forcing the training of junior athletes in weightlifting are the leading factors that result in injuries of the musculoskeletal system, multisystem pathologies and the development of pathomorphic phenomena. Indicators of overall physical condition of weightlifters aged 11–13 allow us to state that main group athletes have a higher difference in growth, and the tendency of their overall physical condition has a linear focus on improvement. Indicators of overall physical condition of control group athletes are nonlinear, according to “running 30 m, s” and “standing long jump, cm” the test results.

Annotation. A differentiated strategy for the rehabilitation treatment of patients with rheumatoid arthritis is the development and implementation of a comprehensive therapeutic programme that includes the use of non-drug measures in addition to conservative therapy. The purpose of the paper is to evaluate the functional status of patients with rheumatoid arthritis as a result of the proposed physical therapy programme. Materials and methods. A total of 188 patients with rheumatoid arthritis were examined, with an average age of 44.9±7.6 years. All patients were randomly assigned to the control (n=92) and intervention (n=96) groups. Patients in the control group underwent rehabilitation in accordance with the recommendations of the regulatory document of the Ministry of Health of Ukraine. The physical therapy programme for patients of the main group is developed in accordance with the domains of the ICF, taking into account the factors that affect the level of functional impairment, health status and quality of life. The effectiveness of the proposed physical therapy programme on the functional status of patients with rheumatoid arthritis was assessed by the results of the Stanford Health Assessment Questionnaire. Results. At the beginning of the study, the total score for patients in the control group was 6.3±0.7 points and for the intervention group - 6.5±9.5 points. The greatest difficulties arose in getting dressed, including tying laces and fastening buttons, opening and closing a tap, bringing a full cup to the mouth, bending over and picking up an object from the floor. After 3 months, significantly better changes occurred in patients of the main group compared to the control group. So, in the patients of the main group, the total score decreased to 3.9±11.1 points, in the control group this score was worse and amounted to 4.7±2.3 points. After the treatment and physical therapy in 6 months, the functional status of patients in both groups improved, but the total score in the main group was significantly better and closer to normal (1.8±12.2 points) than in patients in the control group (2.9±4.1 points). Significantly better results of functional status indicators in patients of the main group indicate the effectiveness of the proposed physical therapy programme. Conclusion. Increased motor activity in the joints, muscle strength in the affected upper extremities as a result of the proposed physical therapy programme contributed to the improvement of daily activities and functional status of patients in the main group, as evidenced by the results of the Stanford Health Interview. Thus, significantly better changes occurred in the patients of the main group compared to the control group, where conventional rehabilitation treatment was performed.

The article is about medical rehabilitation of children who have suffered from the coronavirus infection COVID-19, which is an acute infectious disease caused by a new strain of the coronavirus SARS CoV-2. The authors present current information about epidemiology and clinical course of this disease in children. It is known that complications and adverse outcomes of COVID-19 in children are observed much less frequently than in adults. At the same time, the clinical experience of monitoring children who have had a new coronavirus infection showed that all patients need medical rehabilitation, including those who had the disease in asymptomatic or mild form. Data on the possibility of functional disorders not only in the respiratory organs but also in other systems of the body determines the necessity of stage-by-stage medical rehabilitation of these children. The article defines the main principles and stages of their rehabilitation, proves the necessity of indications for different stages. Medical rehabilitation of children after a new coronavirus infection at all stages is provided by specialists of a multidisciplinary rehabilitation team which includes a pediatrician, a physiotherapist, an exercise therapist, a medical rehabilitation doctor, a reflexologist, a medical psychologist, a speech therapist, an instructor-methodologist, etc. This article presents a wide range of modern techniques of apparatus physiotherapy and kinesotherapy indicated for children who have undergone COVID-19, with the description of the main therapeutic effects and the mechanism of therapeutic action of physical factors. Psychological rehabilitation is of great importance in the complex of rehabilitation measures for children with COVID-19. Special attention is paid to the issues of sanatorium-resort treatment of children after a new coronavirus infection. The spectrum of nonmedicamentous technologies for inclusion in the individual program of sanatorium-resort treatment of such patients with the use of natural healing resources (mineral waters, therapeutic mud, therapeutic climate, other natural conditions used for treatment and prevention of diseases); nonmedicamentous therapy, therapeutic exercises, massage, physiotherapy, hydrotherapy, reflexotherapy, psychotherapy is determined. The article presents criteria for evaluating the effectiveness of rehabilitation measures.

Congenital epidermolysis bullosa is known to be on the list of rare diseases for which there is no specific treatment. Determining thecontent and means of the rehabilitation program for patients with epidermolysis bullosa is not an easy task and involves a carefulselection of methods for each patient. Aim. The article analyzes the results of the use of non-drug methods in the complex rehabilitation of 90 children (from 6,5 to 18 years)with congenital epidermolysis bullosa. Material and methods. To assess the effectiveness of rehabilitation in the study before and after treatment we used methods ofclinical examination with skin state evaluation and standard psychological and pedagogical examination to determine the degree ofsocial adaptation of patients (analysis of medical and psychological and pedagogical documentation, structured conversation aboutsocial conditions of the child’s life, “Color diagnostic test of nervous and mental states and relations” (V.I. Timofeev and Y.I. Filimonenko),the method “Drawing of an unknown animal” (M.Z. Dukarevich, adaptation by A.L. Venger), “The T.V. Dembo-S.Y. Rubinstein Self-AssessmentResearch Method, the Self-Concept Scale” (E. Pierce, L. Harris, adapted by A. M. Prikhozhan), questionnaire “Assessment ofparental compliance” (D.E. Morisky, L.V. Green), questionnaire “Feeling, activity, mood” (V.A. Doskin, N.A. Lavrentieva, V.B. Sharay andM.P. Miroshnikov). The way in which diagnostics was organized varied taking into account the individual psychophysical capabilitiesof the child. Results. The effectiveness evaluation of the complex rehabilitation of children with epidermolysis bullosa showed an improvementin the clinical condition of the children (significant reduction/elimination of dryness and itching of the skin) and the indicators of wellbeing(mean value: before 30 points after 45, p ≤0.05), activity (mean value: before 25 after 34, p ≤0.05), mood (mean value: before 44,after 51, p ≤0.05) of patients (WAM questionnaire), an increase in the degree of parental commitment to treating children (Moriski-Green questionnaire) from medium to medium and high values. Conclusion. The inclusion of physical therapy and psychological and pedagogical methods of assistance in the process of rehabilitationtreatment increases its effectiveness, activates the compensatory potential of the child’s body, promotes harmonization of intrafamilyrelationships, and thus improves the quality of life of the child and his or her relatives.

Aim. To explore the possibility of using the GMFM-88 scale for the evaluation of the effectiveness of short-term (21 days) intensiverehabilitation of children with motor impairment. Material and methods. The study included a combination of statistical and analytical methods. 83 children with cerebral palsy underwentintensive physical rehabilitation at the Centre of Medical Technology and Rehabilitation (CMTR. The level of the children’sfunctioning was assessed in accordance with the Gross Motor Function Classification System (hereinafter GMFCS). The GMFM-88 scalehas been employed for the planning of the intervention and the assessment of rehabilitation effectiveness. Results. Statistical analysis of the average values on GMFM-88, before and after rehabilitation and according to the Student t-criterion,shows significant changes in functioning after rehabilitation (t = -6.493, significance level less than 0.0001). This suggests the possibility of using the scale as a tool for assessing short-term interventions. At the same time, the use of this scale justifies the assumptionabout the effectiveness of short-term intensive rehabilitation in the form of significant improvements in the functional capabilities ofchildren with motor disorders. Conclusion. The use of the standardized GMFM-88 scale in this study confirms our assumption regarding the need for periodic, intensiverehabilitation for children with movement disorders. An integrated approach to the detailed assessment of the current state ofthe child makes it possible more accurately identify current problems, determine the nearest development zones, and, consequently,identify the goals and objectives for the rehabilitation period.

The aim. To compare three respiratory physical therapy techniques and their impact on pulmonary function restoration among cardiac surgery patients in hospital settings. Materials and methods. The study involved 126 patients of both sexes who were admitted for cardiac surgery. All the procedures were performed by sternotomy with cardiopulmonary bypass and cardioplegic arrest. The patients were randomly divided (with a ratio of 1:1:1 by envelope method) into the control group (CG, n = 42), incentive spirometry group (ISG, n = 42) and іnspiratory muscle training group (IMTG, n = 42). The examined patients underwent standardized physical therapy (early mobilization; therapeutic exercises; coughing). The groups varied in respiratory therapy. Patients of the ISG group performed additional respiratory exercises using a Tri-Ball respiratory exerciser (three repetitions of 10 forced, full and rapid inspirations through the respiratory exerciser under the supervision of a physical therapist; besides, they were recommended to perform 3 repetitions with 10 inspirations each hour). Patients of the IMTG group performed additional respiratory exercises using Respironics Threshold IMT breathing exerciser, received explanations and recommendations like patients of the ISG group. The pulmonary function test (PFT) was performed for the patients of all groups before the surgery and on the 7 postoperative day. Results. PFT scores did not differ statistically between the groups of patients before the surgery. The three groups of patients had a negative dynamic of all test indicators, except Tiffeneau index. The analysis of PFT final scores did not confirm a significant difference in the studied indicators among the groups: vital capacity (P = 0.599), forced vital capacity (P = 0.393), forced expiratory volume in one second (P = 0.589), peak expiratory flow (P = 0.326), forced inspiratory vital capacity (P = 0.258), peak inspiratory flow (P = 0.569). Conclusions. Statistical analysis of PFT indicators did not reveal any significant differences among the groups of cardiac surgery patients at the preoperative examination and on the 7 postoperative day, despite the differences in postoperative respiratory physical therapy.

The aim – theoretical review of the use of physical therapy in children with acute lymphoblastic leukemia. The problem of restoring the health of children with acute lymphoblastic leukemia (GLL) is due to the increased incidence of cancer, the duration of special treatment and the development of complications and comorbidities. The main complaints are fatigue, pain, muscle weakness, decreased mobility and endurance, depression, anxiety, mood swings. Pathology of the musculoskeletal system, gastrointestinal tract and endocrine system occur with equal frequency. Today, the main expected therapeutic effect in pediatric oncology should be considered not only the clinical recovery of patients, but also their return to the previous social position in the family, school and community, the restoration of physical, psychological and social health. The problem of physical therapy of children with acute lymphoblastic leukemia was studied by many scientists. According to the literature, physical exercises reduce the fatigue associated with the tumor process, improving the functional capacity of the body and increasing metabolism. There is a positive effect of exercise on muscle strength and flexibility, but there are ambiguous conclusions from different authors on the effect of exercise on cardio-respiratory function in the course of maintenance therapy in children with GLL who have cancer fatigue. Conclusions. An important area of physical therapy in oncology is the use of dosed physical activity, which, according to many researchers, increases the effectiveness of treatment. Recently, the prevailing opinion is that regular physical activity is safe and can have potential benefits for the musculoskeletal, cardiovascular, respiratory and immune systems of pediatric patients with hematological diseases.

Purpose: to evaluate the results of physical therapy of sportsmen football players with intra-articular injuries of the ankle joint at the outpatient stage when using measures of the physical therapy program using the techniques of ethnic oriental massage. Material and methods: the study analyzes the results of a study conducted in Beirut (Lebanon), the clinic of the Mir Majid Erslan Medical Center. The effectiveness of physical therapy of 36 football players with intra-articular injuries of the ankle joint at the outpatient stage was assessed according to the method of A.V. Kalashnikov and LEFS scale. Results: it was found that with positive changes in the functional state of the injured athletes of both clinical groups, reliably better results were revealed among the football players of the main group, who were offered physical therapy according to the program we developed. Conclusions: the analysis of the research results showed that in the injured athletes of the main group, with the same periods and volumes of observation, the results of the research methods were significantly higher and objectively more pronounced than in the control group.

The aim of the work is to increase the effectiveness of physical therapy of motor impairments in children with spastic form of cerebral palsy by applying a program of therapeutic training on the device developed for rehabilitation of people with musculoskeletal disorders. Materials and methods. 30 children aged 6 to 11 years with cerebral palsy-associated spastic diplegia were included in the study. Patients were divided into 2 groups. In addition to the standard rehabilitation program, all patients were prescribed therapeutic gait training using a device for rehabilitation of people with musculoskeletal disorders: group I (n = 14) – according to the dynamic method; group II (n = 16) – by static method. The spatiotemporal characteristics of gait, activity daily indicators, the level of spasticity of lower extremity muscles, functional characteristics of gait, and the methods of mathematical statistics were studied. Results. The implementation of the elaborated program of therapeutic exercises using a device for rehabilitation of people with musculoskeletal disorders had a positive effect on the level of muscle spasticity of the lower extremity, stride length, walking speed, general endurance. It also improved balance and reduced the risk of falling in children with cerebral palsy. Conclusions. The application of the elaborated therapeutic program had a positive effect on the spatiotemporal characteristics of walking, balance and functional condition of children with cerebral palsy, as well as reduced the level of spasticity. The increase in the stride length occurs during the first 4 weeks of training, and functional condition indicators showed the greatest dynamics only after 6 weeks of training. The elaboration of the rehabilitation device with the ability to move and apply the technique of exercising with partially unstable pelvic support by the abductor-lift moving along the vertical axis, positively affected the balance and reduced the risk of falling.

The study of the structure, shape and size of the skull and its individual structures is in great demand not only from the point of view of expansion of knowledge of craniology, but also modern practical medicine. This is due to the rapid development of new methods for diagnosing pathological processes and the development of less traumatic methods of surgical treatment. The purpose of this study is to establish the size of the transverse parameters of the middle cranial fossa of a mature person depending on the three extreme types of skull. The research was conducted using a study of 50 craniotomograms and 50 bone preparations of the skull of men and women of mature age. The studied material was divided into three groups from the standpoint of studying individual anatomical variability. In order to achieve the goal of the study, the transverse parameters of the middle cranial fossa of mature people at different levels and from both halves were measured. The established indicators of transverse dimensions show that all latitudinal parameters tend to increase from the anterior parts of the middle cranial fossa to the posterior parts. The results of the study also show that the total latitudes and transverse dimensions of the left and right parts of the middle cranial fossa predominate in brachicrans and gradually decrease to dolichocrans with average values in mesocrans. This coincides with the fact that the brachycrane has a short and wide skull shape, the dolichocrane has an elongated and narrow one, and the mesocrane has average skull length and width values. The results of this study significantly supplement the existing information on the individual anatomical variability of the middle cranial fossa of a mature person and also allow more detailed application of these data in practical medicine.

The aim of rehabilitation may be: the restoration of the anatomical structure of the damaged tissues and organs, restoration of the dysfunctions, development of the compensatory possibilities, normalization of psycho-emotional disorders. Principles of medical rehabilitation in pediatrics: the use of modern achievements of the medical science and technology, systematic character, sequence and staging character of rehabilitation (hospital, sanatorium and dispensary- polyclinic stages), accountability of the influence of growth and development of organism on the dynamics of the pathologic processes, complexity of the methods (physio-, kinesi-, psycho-, diet, manual and pharmacotherapy, massage and others), combination of rehabilitation with teaching, the active participation of parents in rehabilitation, its completeness (reaching of the maximum result), use of the supporting therapy. Modern methods of rehabilitation of children with the vegetovascular dystonias: a)by the hypertensive type: - endonasal electrophoresis with a mixture of Ca -Mg (2% solution, 10 min, daily or in a day, Nq8-10); - electrophoresis with Mg (2% solution MgSO4, the currents of apparatuses Amplipulse on the collar zone, 10-15 min, in a day, N8-10); - general franklinization (10-15 min, in a day, N7-8); - electric sleep at the low frequencies (5-10-15 Hz, 30-40 min, in a day, N8-10); - oxygen baths (36-37°C, 10-15 min daily or in a day N8-10); - iodine-bromine baths (36-37°C, 10-15 min, daily or in a day, N8-10); - sea bathings in the not cold water (t° is above 21 -22°C); - baths with the sea water (36-37°C, 10-15 min, daily or in a day, N8-10); b)by the hypotensive type: - electric sleep (20-40 Hz, 30-40 min, daily or in a day, N8-10); - electrophoresis with Ca on the collar zone (8-15 min, daily or in a day, N8-10); - massage of the spine and collar zone (energetic); - carbonate or pearl baths (35-36°C, 5-10 min, daily or in a day, N8-10); - circular douche with water of indifferent or cool temperature (35-36°C, 5-6 min, daily or in a day); - sea bathings in the cool water (t° is higher than 18-20°C); - cool douches and rubdown (28-32°C, 5-10 min, daily or in a day, N8-10); - electrophoresis with 0.5% solution of Mezaton to the children of school age, employing the collar procedure (5-10 min, N 6-8 in the presence of the physiotherapist). Indications to the application of INFEMF (impulse low frequency electromagnetic field) 1. Vegetative dysfunctions of permanent course in initial vagotonia, sympathicotonia or eutonia, beginning from the age of 3. 2. Vegetative dysfunctions in combination with neurosis-like syndromes. 3. Vegetative dysfunctions against the background of somatic pathology, which is accompanied by the weakly expressed pain syndrome (diseases of loco-motor apparatus, gastrointestinal tract and others). 4. The most effective INFEMF is in the children of the younger age (7-11 years old) in reduction of protective- adaptive compensating mechanisms. The advantages of INFEMF in children and adolescents with VD (vegetative dysfunction) are: good tolerance of the procedures by all patients; simplicity and convenience in carrying out the procedure (distance influence); universality and possible range width of the influence; the possibility of integration and association with other methods of rehabilitation treatment and application for prevention. Contraindications to the application of INFEMF 1. Age up to 3 years. 2. Paroxysmal course of the vegetative dysfunctions with frequent vegetative crises, expressed orthostatic hypotension, syncope in anamnesis. 3. Vegetative dysfunctions in the period of exacerbation. 4. Vegetative dysfunctions against the background of the severe disturbance of the central nervous system of traumatic, infectious-allergic nature with presence of the convulsive of syndrome in anamnesis. 5. Exacerbation and acute course of the chronic disease, which requires adequate drug (or surgical) treatment. 6. Diseases of the eyes.

Annotation. Rheumatoid arthritis is regarded worldwide as one of the most common pathologies and is one of the most significant medical, social and economic problems of modern society. According to modern concepts, along with drug therapy, physical therapy plays an important role in the system of health recovery for patients with rheumatoid arthritis. The purpose of the paper is to determine the effectiveness of a physical therapy programme based on the results of wrist and hand function in patients with rheumatoid arthritis. Materials and methods. A total of 188 patients with rheumatoid arthritis were examined, including 156 women (83%) and 32 men (17%). All patients were randomly assigned to the control (n=92) and intervention (n=96) groups. Patients in the control group underwent physical therapy in accordance with the recommendations of the regulatory document of the Ministry of Health of Ukraine. Patients in the main group were engaged in a developed physical therapy programme, taking into account factors affecting the level of functional impairment and quality of life. Rehabilitation measures were developed with a personalised approach to each patient, for a long-term period of 6 months. The main section of the DASH (Disability of the Arm, Shoulder and Hand Outcome Measure) questionnaire was used to assess functional impairment of the wrist and hand in patients with rheumatoid arthritis. Results. Both standard treatment and physical therapy after 3 months contributed to the recovery and improvement of the DASH questionnaire scores in both groups, but the changes in the intervention group were more pronounced than in the control group, where the scores were lower. Thus, the number of people in the main group who had a good result increased – 27.1%, in the control group only 17.5% of patients had a good result; 52.1% of patients in the main group had a satisfactory result, 50.0% in the control group; 20.8% of patients in the main group and 32.5% of patients in the control group still had an unsatisfactory result. The analysis of the results after 6 months of physical therapy showed a significant improvement in the examined patients of the main group: a good result was noted by 49.0% of patients, which is 25.0% more than in the control group – 24.0% of patients. A satisfactory result was found in 39.6% of patients in the main group and in 57.6% of patients in the control group, which is 18.0% more than in the control group. Conclusion. The above results of the DASH questionnaire in the main group, which are significantly better than those of the control group, indicate the justification of a new marker of the effectiveness of the proposed physical therapy programme for patients in the main group.

Sensory Integration (SI) is one of the therapeutic methods created and described by J. Ayres in 1972. In Poland, for a few years, more and more specialists, also rehabilitators, have followed this concept in their work. SI is a subconscious process, whereby the ordering and assignment of meaning to information acquired by the senses takes place. The three principal senses, which Ayres described are: the sense of touch, proprioception, and the vestibular system.

The purpose of the work is to evaluate the effectiveness of a comprehensive program of physical therapy in patients after surgical reconstruction of the Achilles tendon. Materials and methods. Subjects population comprises 58 patients (aged 34–57 years), including 39 (67.24 %) males and 19 (32.76 %) females, who were up to the surgical restoration of the Achilles tendon. All patients were divided into two groups: the main group (MG, n = 29) and the control one (CG, n = 29). Research methods embraced a review of scientific literature presented on the Internet; experimental research of ascertaining and formative orientation; pedagogical observation; goniometry, plantodynamometry, modified Romberg test; methods of mathematical statistics. Results. After surgery, the angle of plantar flexion was better (P < 0.01) in MG patients compared with CG patients (4 weeks): 29.1 ± 1.19° and 28.1 ± 1.13°. However, statistically significant differences between MG and CG patients in subsequent measurements were not found (P > 0.05). The percentage values of the load distribution on the operated extremity had improved by the final measurement date (16 weeks), which reduced the difference in the load distribution on the extremities to 9.20 ± 3.09 % in MG patients and up to 14.60 ± 2.98 % in CG patients (Me (25 %; 75 %) ) ‒ 8 (6; 12) % and 16 (12; 18) %). The indicators of the final performance of Romberg test were significantly better in MG patients, making 11.4 ± 2.13 s, which is 2.5 seconds better than in CG patients (P < 0.01). Conclusions. Dynamic characteristics of plantar flexion were restored by the following means: adaptive physical exercises and corrective gymnastics, different walking exercises, exercises with fitball, exercises on an exercise bike and step platforms, hydrotherapeutic exercises, orthopedic shoes, physiotherapeutic methods, and massage. The proposed comprehensive program is effective and can be used for post-surgical physical therapy in patients diagnosed with Achilles tendon rupture.

IntroductionRegardless an improgressive habit of neural disorders in cerebral palsy (CP), without a therapy the motor abnormalities’ severity rising is registered and as a result with age the physical dysfunction progressively increases.PurposeTo improve the static and dynamic motor disorders’ and activity limitations physiotherapy efficiency among the children with hemiplegic CP form via the therapeutic training program on the developed device for rehabilitation of the people with muscle-skeleton disorder.Material and methods 24 children with unilateral CP aged from 6 to 11 were enrolled into the research. The patients were randomized into 2 groups. Additionally to the standard physiotherapy complex the I group were prescribed with the walking trainings on the rehabilitation device according to the dynamic method, the II group – according to the static method. Physiotherapy program duration was 6 weeks. The gait spatiotemporal characteristics and activity limitations were monitored.Results Appling developed program influenced on the walking spatiotemporal indexes in the both groups. The biggest increase of the distance and stride length were reached exactly on the 2 week. Herewith, distance incremental amount in the I group was higher than in the II study group. TUG test’s time decreased statistically efficiently in the I group. Maximum TUG test’s index depression was observed on the 6th study weeks. As a result GMFM-66 increased in I group.Conclusions An administration of the developed therapeutic program affected positively on the CP patients’ spatiotemporal walking characteristics, balance and endurance, as a result, decreased the fall risk and activity limitations.

Introduction. The problem is actual due to the increasing of cystic fibrosis children quantity: according to neonatal screening, there were 124 children with cystic fibrosis in 2018 (72.9 % from all identified cases for the reporting year). Medical rehabilitation is the main method of the pathogenetic therapy and prevention of cystic fibrosis exacerbation. The new strategy of medical procuring for patients with orphan diseases, which is necessary to develop expert methods for diagnostics of rehabilitation potency and objectify individual rehabilitation programs, gives particular relevance to the problem.The objective was the development of new rehabilitation programs for early aged children with cystic fibrosis, the search of efficiency assessment criteria.Methods and materials. Physical and motor growth, clinical and functional parameters were estimated in 79 early aged children of main and control groups.Results. It was proved that the weight index (absolute and relative), quantity of children with harmonic growth increased due to physical methods of rehabilitation while the quantity of children with acutely disharmonic growth reduced in main group. After applying the developed rehabilitation program, the formed motor skills amounted 83 — 92 % from age norm in the main group of children and 60 — 85 % in the control group. Normotonic reaction to physical activity after the physical rehabilitation program was registered in 73.2 % of the main group and 47.8 % of the control group. In dynamics, the rehabilitation efficiency coefficient amounted (1.68±0.10) in the control group of children and (1.97±0.14) (p

The aim of the work was to evaluate the effectiveness of a physical therapy program for athletes specializing in team sports games with diaphysis fractures of the shin after intramedullary osteosynthesis. Materials and methods. Experimental studies were conducted with athletes in game sports (n = 58) with diaphyseal fractures of the tibia, who were treated in the Department of Traumatology and Orthopedics of the Clinical Hospital № 7, Kyiv, SI “Institute of Traumatology and Orthopedics NAMS of Ukraine”, sports clinic injuries of NUFVSU during 2014–2019. Methods of analysis and generalization of literature sources were used; method of anthropometric measurements to determine the comprehensiveness of a healthy and injured limb; goniometry method for measuring the available range of motion in the knee joint of a healthy and injured limb; myotonometry method to determine the tone of the quadriceps femoris; testing to calculate the symmetry index of the lower extremities (LSI ‒ Lower Extremity Symmetry Index); methods of mathematical statistics. Results. The developed complex program of physical therapy is a cycle of restorative measures that meet the achievement of previous functionality, meets the requirements for the level of motor skills, general and special physical performance of athletes, and meets their personal ideas about the quality of life. Evaluation of the effectiveness of the physical therapy program allows us to state that in BG the normative values were reached by 25 out of 29 athletes (86.21 %), in CG ‒ 19 athletes out of 29 (65.52 %), which indicates the high efficiency of the proposed physical therapy program. Conclusions. In the process of forming physical therapy programs for patients ‒ athletes with diaphysis fractures of the tibia after intramedullary osteosynthesis, therapeutic exercises should be grouped depending on the specific objectives of rehabilitation measures and their predominant focus: to restore motor function; to restore general physical fitness; to restore special physical fitness; to restore basic motor skills and abilities; to restore special motor skills and abilities in accordance with the specifics of training and competitive activities in sports games.

Objective: to improve the effectiveness of early postoperative rehabilitation of patients after arthroscopic surgery on the shoulder joint by the combined use of exercises with dynamic controlled muscle tension (DCMT) and thin-layer peloidotherapy. Materials and methods: 98 patients operated on for rotator cuff syndrome, were divided into 3 groups, comparable in age, sex and the main clinical manifestations. All patients received basic therapy, including orthopedic mode in the form of immobilization of the upper limb and curative gymnastics according to the standard method. Patients of the I and II group in addition to basic treatment were given an exercise course with dynamic controlled muscle tension during the immobilization and postimmobilization period. Patients of the II main group in the postimmobilization period received pelotherapy. Results: according to the results of goniometry in patients of I and II groups had the greater volume of movement in the shoulder joint after immobilization was stopped in comparison with patients of group III (control). Analysis of pain indicators while the shoulder joint moving on the scale of pain a month after immobilization revealed a significant advantage of the results of the II main group. Conclusions: it was shown that the inclusion of exercises with dynamic controlled muscle tension in the therapeutic complex had a more significant effect on the main clinical symptoms of the disease, the regeneration processes, and also contributed to an earlier restoration of impaired functions of the shoulder joint.

The purpose of the work is to investigate the effectiveness of the use of physical condition control of students of special medical groups for the development of physical therapy programs. Materials and methods. 40 students of 1st and 2nd year students of National University “Lviv Polytechnic” and Zaporizhzhya State Medical University participated in the experimental studies, which on the basis of the medical examinations were assigned to a special medical group for the presence of diseases of the musculoskeletal system (scoliosis I, II and III degrees). The following methods were used in the research process: analysis and generalization of scientific literature and Internet data; analysis of medical records of students; instrumental methods of morphometric and psychophysiological studies; pedagogical observations; pedagogical experiment of ascertaining orientation; methods of mathematical statistics. The results of the study show that the application of theoretical and methodological provisions and recommendations of corrective measures in the system of test control of physical conditions in students of a special medical group in the practical work, on the basis of integration of specially selected means of physical therapy, enables to activate compensatory mechanisms, mobilize reserve mechanisms ability of the body to increase the competence to perform motor actions, helps to accelerate the formation of knowledge, skills, and elimination of defects motive sphere, eliminating the difference in indicators of psychophysical development between students of the main, preparatory and special medical group. Conclusions. The control of morphofunctional and psychophysiological indicators is an effective mechanism of correction of the physical condition of students of a special medical group with functional disorders of the musculoskeletal system and a necessary prerequisite for the development of complex programs of rehabilitation based on the use of therapeutic exercises.

Purpose. The study of clinical features of the course of bronchial asthma and the study of the effectiveness of the use of therapeutic measures with the involvement of physical therapy in children living in Zaporizhzhia and from the Zaporizhzhia region, taking into account their physical development and indices of the initial vegetative tonus and vegetative provision. Materials and Methods. According to the set task, the first group of observation included 87 children with bronchial asthma (BA) living in Zaporizhzhia, 57 of which were boys and 30 girls, and the second group consisted of 40 children with BA from the Zaporizhzhia region, 24 of which were boys and 16 girls. As a comparison, 56 practically healthy children (31 boys and 25 girls) who formed the control groups (CGs) were examined. Thus, 29 of them (16 boys and 13 girls) from Zaporizhzhia made the CGI and 27 children (15 boys and 12 girls) from Zaporizhzhia region were included in CGII. The average age of the examined children was 11.40 ± 3.68 years. To evaluate the effectiveness of physical therapy in children with bronchial asthma, their catamnestic observation has been conducted for at least 2 years. Statistical data processing was performed by commonly used methods of variation statistics of the licensed software package Statistica for Windows 13 (StatSoft Inc., № JPZ804I382130ARCN10-J). Results. Bronchial asthma in children, irrespective of place of residence, clinical course and severity, was characterized by a mild and moderate persistent course in 50.57% and 40.23 % of urban and 47.50 % and 45.00 % of regional patients with obstructive type of violation of bronchial conduction. Physical development of children with bronchial asthma, grown up in the conditions of district centers, had more often harmonious physical development (85.00 %) than patients from the city (56.32 %) (P < 0.05), and, on the contrary, disharmonious prevailed in urban patients (43.68 %) and was less common in regional (15.00 %) patients, mainly in boys (59.65 % vs. 16.67 %, P < 0.05). In all patients with bronchial asthma, unlike healthy children from control group, eutonia (34.48 % and 42.50 %) was rarely recorded but more often sympathicotonia (33.33 % and 32.50 %) and vagotonia (32.18 % and 25.00 %) with a significant difference with the control group of the regional children with asthma for the hypersympathicotonic version of vegetative provision and in urban areas for sympathoasthenic, asthenosympathetic and hyperdiastolic variants. Conclusions. The use of physical therapy in the treatment of children with bronchial asthma has significantly reduced complaints, disease symptoms, accelerated remission and increased its duration to 24 months and reduced the risk of transformation of the disease into more severe forms.

Relevance. A rise in the life expectancy of the planet’s population, lack of exercise and growth in the number of people suffering from overweight lead to an increase in the number of patients suffering from diseases of the musculoskeletal system, including osteoarthritis. Given the absence of specific pharmacological treatment of osteoarthritis, as well as the increase in the number of patients with co-morbid pathology, it became necessary to search for the proven technologies of physical and rehabilitation medicine (PRM). The purpose of the study was to identify the most effective PRM technologies in the treatment of patients with osteoarthritis and to formulate recommendations on their use for practitioners, based on the proof obtained through the analysis of evidence-based high quality studies on the application of PRM technology. Materials and Methods. Over the past decade, there has been a significant increase in the number of studies on non-pharmacological methods of osteoarthritis treatment. The most studied of the PRM technologies with the proven effect were the following: physical exercises combined with traditional healthy gymnastics, acupuncture, peloid therapy, balneo therapy, as well as low-frequency electrotherapy, ultrasound therapy and infrared laser therapy. Conclusion. The use of PRM technologies in the treatment of patients with osteoarthritis should be based on the results of high-quality randomized controlled clinical trials which serve as the basis for the development of clinical recommendations. The process of the obtained data analysis should be conducted on the regular basis.

Purpose: study of the reaction of the cardiovascular system to dosed physical activity of patients with metabolic syndrome in the process of applying a physical therapy program. Material & Methods: 28 young women with metabolic syndrome took part in the study, CG – 14 women, MG – 14 women. The mean age of the patients with MG was 31,49±0,71 years, and the CG was 31,06±0,57 years. In order to determine and assess the tolerance of the cardiovascular system to dosed physical activity in the examined patients, the Martine-Kushelevsky test was used. Results: analyzed and summarized the results of a study of the reaction of the cardiovascular system to dosed physical activity according to the Martin-Kushelevsky test. According to the initial examination in the main and control groups, the indicator of the quality of the reaction according to the Martine-Kushelevsky test was less than normal, which indicates an unsatisfactory reaction of the cardiovascular system of patients to physical activity. After applying the physical therapy program, LRP increased in the main group from 0,40±0,17 to 0,54±0,01 c. u. (by 35,0%), in the control – from 0,41±0,17 to 0,49±0,12 c. u. (by 19,5%). Conclusions: the analysis of the reaction quality indicators in patients of the main and control groups showed that they were better at repeated examination in the main group of patients after applying the author's physical rehabilitation program.

Purpose: based on the generalization of the results of modern domestic and foreign scientific and methodological literature to develop a physical therapy program for adolescents with autonomic dysfunction. Material & Methods: under our supervision there were 30 children 15–17 years old with a diagnosis of vegetative-vascular dystonia. According to the purpose and objectives of the study, anthropometric methods were used, the condition of the musculoskeletal system was studied using the stoop index and REEDCO posture assessment, the static balancing was determined using the Bondarevsky test, the Kerdo index was calculated, and mathematical statistics methods were used. Results: a physical therapy program was developed, which included kinesiotherapy, elements of psychotherapy and auto-training, post-isometric relaxation. After applying the physical therapy program in adolescents, complaints of headache and dizziness decreased. The dynamics of the assessment of posture and stoop index indicated a significant improvement in all the studied parameters from the cardiovascular system; a decrease in the rate of cardiovascular contractions, an increase in the numbers of systolic blood pressure and the Kerdo index were observed. Conclusions: the physical therapy program was developed taking into account the principles of physical therapy, the effectiveness of the program is confirmed by improving empirical parameters, indicators of the musculoskeletal system, cardiovascular system and quality of life, reduced as a result of autonomic dysfunction.

Purpose: to determine the effectiveness of the developed program for the restoration of upper limb function in traumatic and compression-ischemic injuries of the peripheral nerves. Material & Methods: the study involved 173 patients who were divided into 2 main rehabilitation groups: group I – patients with acute traumatic damage to the peripheral nerve or plexus (132 people), group II – patients with compression-ischemic (tunnel) neuropathies and plexopathies (41 people). The study was conducted on the basis of the Institute of Neurosurgery acad. A. P. Romodanova of the National Academy of Medical Sciences of Ukraine” (2015–2018) and on the basis of neurological departments No. 1 and No. 2 of the Kiev City Clinical Hospital No. 4 (2017–2019). To assess impaired motor function of the nerve and sensitivity, a 6-point scale was used according to the method of R. B. Zachary, W. Holmes, N. Millesi. The Boston Questionnaire (Boston Carpal Tunnel Questionnaire) was used to assess the severity of symptoms, activity, and participation in daily life. Results: during the initial examination, we found that in the majority of patients of the 1st rehabilitation group, motor disorders on a 6-point scale were at the level of M1-M2 in 27,3% and 31,8% of individuals, respectively, and M3 in 15,9% of patients. In patients of the rehabilitation group II, the indicators of motor disorders were not so pronounced: patients with impaired motor function at the level of M2-M3 prevailed (34,1% and 24,4% of patients, respectively). According to the scale of functional disorders of the Boston questionnaire, the patients with the studied groups experienced the greatest difficulties when bathing and putting on clothes – 17,4%, doing homework – 13,6% of people, fastening buttons on clothes – 15,2%. In patients of the rehabilitation group II, approximately the same results were observed. In the main group, we used the program of rehabilitation measures that we developed, in the comparison group, the program that is used in the hospital for this category of patients. The therapy lasted 3 months. Upon repeated examination in patients of the main І rehabilitation group, motor disorders decreased under the influence of physical therapy, which were used in them. In the main group, a greater number of patients (12,3%) showed normal strength in the affected limb (M5), in the control group this indicator was lower (7,5%). Movements with overcoming the weight of the limb (M3) and movements with overcoming the resistance (M4) were observed in 24,6% and 30,8% of patients in the main group, which significantly exceeds similar indicators of the control group. Conclusions: as shown by the results of studies, physical therapy and occupational therapy in the complex treatment of people with traumatic and compression-ischemic neuropathies of the upper limb contributed to a more intensive restoration of arm functions and increased results of motor therapy. The following rehabilitation measures are most effective for this category of patients: kinesiotherapy, taping, massage, physiotherapy, mechanotherapy and hydrotherapy.

Purpose: to develop an algorithm of rehabilitation measures in people with compression-ischemic neuropathies of the upper limb. Material & Methods: the study involved 67 patients with compression-ischemic neuropathy of the upper limb, among whom were 43 (64.2%) men and 24 (35.8%) women. The duration of the disease ranged from 3 to 18 months. The age of the examined varied from 18 to 67 years, on average 42,3±9,4 years. The study was conducted on the basis of the neurological department and the physiotherapy department of the Kiev city clinical hospital No. 4 of Kyiv in the period from 2017 to 2019. We used the following research methods: analysis and synthesis of literature data, content analysis of medical records, rehabilitation examination. Results: an important condition for the treatment of tunnel neuropathies is an integrated approach, which should have the following components: a comprehensive rehabilitation examination to determine the main rehabilitation problems; statement of tasks with prediction of the final result; selection of appropriate individual and optimal physical therapy means for each patient. An algorithm of physiotherapeutic intervention has been developed, including the use of the following measures: kinesitherapy with neurodynamic mobilization, taping, stimulating massage, instrumental physiotherapy, mechanotherapy and hydrotherapy. The proposed algorithm of physical therapy measures differed from standard programs in that it allowed to formulate the goals of the rehabilitation process taking into account a differentiated approach to solving the problem of rehabilitation of patients with compression-ischemic neuropathies of the upper limb with varying severity of motor function disorders; had a comprehensive, multidisciplinary approach to solving the problems of patients with this pathology. Conclusions: the development of an algorithm of physiotherapeutic intervention for people with compression-ischemic neuropathies of the upper limb is an urgent problem due to the fact that compression-ischemic neuropathies of the upper limb often lead to a decrease in the patient's quality of life and long-term disability. When developing an algorithm of rehabilitation measures, it is necessary to take into account: individual features of the functional state of patients with this pathology, the presence and severity of motor and sensory disturbances, which depend on which particular nerve of the arm is affected (median, ulnar or radiation), the nature of the lesion, age, professional activity and patient needs.

The aim of modern therapy for chronic obstructive pulmonary disease (COPD) is to reduce the severity of symptoms and prevent the development of relapse exacerbations, maintain pulmonary function at an optimal level and improve the quality of life of patients. The solution to these problems is pulmonary rehabilitation. Search for effective ways of providing an educational component, assessing the impact of various training programs and implementing a self-management strategy continues. Purpose: to analyze modern approaches, advantages and disadvantages of educational programs on self-management of people with COPD and establish the role of a physical therapy specialist in providing them. Material & Methods: the search was conducted on the resource of the US National Center for Biotechnological Information PubMed and in the database of scientific evidence on physical therapy PEDro. According to the results of the search in the databases, 329 links were obtained, of which, after excluding those that did NOT meet the necessary criteria, 14 publications were selected for subsequent analysis. Results: 29 educational topics related to self-management education were identified, which in different combinations are recommended for study in educational programs for patients with COPD. Training topics were grouped into four training modules that took into account the goals and objectives of the self-management strategy and ensure their solution. The most often competent in implementing educational programs for patients with COPD are a pulmonologist, physical therapist, nurse, pharmacist, occupational therapist, and social worker. The content, results, advantages and limitations of various self-management training programs are analyzed. Conclusions: today there are not enough practical recommendations and clear criteria that training programs on self-management for patients with COPD should meet. The analysis of modern clinical studies on the introduction of self-management training is the basis for the development of Ukrainian-language training programs.

Purpose: to develop and prove the effectiveness of a comprehensive physical therapy program for children with systemic visual and musculoskeletal lesions based on the undifferentiated connective tissue dysplasia. Material and methods: the study involved 24 children of 6 years old. The study was conducted at the special educational complex. Research methods: medical histories review; clinical examination by the criteria of T. Milkovsky-Dimitrov and A. Karkashov; definition of the joint hypermobility degree by the Carter-Wilkinson criteria in the modification of Beiton; assessment of the back extensor muscles’ and abdominal press’ strength endurance (by A.M. Reisman and F.I. Bagrov tests); visometry. Results: During a preliminary study a tendency of an increase in the joint hypermobility degree in accordance with the myopia degree was established: children with mild myopia had mild form of joint hypermobility; children with moderate myopia had mild and moderate degrees of joint hypermobility; joint hypermobility at children with a high degree of myopia varied from mild to severe (generalized). A tendency of an increase in the number of children with impaired posture in accordance with an increase in the myopia degree was also established. A comprehensive physical therapy program was developed and implemented. It included modern technologies and recovery tools: therapeutic exercises for the eye muscles (solarization, palming); musculosceletal system training on the BOSU platform; balanced daily diet; self-massage of the circular eye muscles and eyelids; art therapy (fairy tale therapy); Su-Jok therapy. This methods made up the essence of the author’s program named «Sleepy Kittens». This program affected the visual analyzer and the musculoskeletal system positively. Conclusions: As a result of physical therapy measures in the main group, a number of children with high degree of myopia decreased; strength endurance of the back extensor muscles and abdominals increased; a number of children with joint hypermobility of moderate degree decreased; joint hypermobility of high degree was absent.

Back pain (BP) is an important link in neurological pathology and one of the most common complaints in general medicine practice. The purpose of the research was: scientifically and strategically substantiate and develop a comprehensive physical rehabilitation program of persons with dorsalgia in the thoracic spine and to prove its effectiveness according to the data of the electrospondilography. Materials and methods. The study was conducted on the basis of the sports and rehabilitation club “Fifth Element” in Kyiv, 67 patients (25 men and 42 women) were taking part in our research, of the working-age with BP on the thoracic level. Results. Based on the results of previous studies, we have developed a complex physical rehabilitation program for patients with BP on the thoracic spine, which included various tools and forms of physical rehabilitation, elements of modern fitness techniques, soft tissue and connective tissue manipulative techniques, and a cognitive method -conductive therapy. Conclusion. The effectiveness of the developed program of patients with BP in the thoracic department was evaluated after the completion of the course – after 12 weeks. According to the data of ESG, the positive dynamics of indicators K1, K2, K3, К4 was observed in both the MG and CG. However, only in the MG of changes in K3 and K4 indicators were statistically significant.

The purpose of the paper is to determine the effectiveness of the physical therapy programme on the dynamometry and power index of the upper extremities of patients with rheumatoid arthritis. Materials and methods. A total of 188 patients with rheumatoid arthritis were examined, including 156 women (83%) and 32 men (17%), with an average age of 45 years. All patients were randomly assigned to the control (n=92) and intervention (n=96) groups. Patients in the control group underwent rehabilitation in accordance with the recommendations of the regulatory document of the Ministry of Health of Ukraine. The subjects of the main group were engaged in the proposed technology of rehabilitation measures with a personalised approach to each patient, in accordance with the domains of the ICF, taking into account the factors influencing the level of functional impairment. Dynamometry was used to determine the strength of the hand flexor muscles of the affected upper extremities. The strength index of the hand muscles (relative strength index) was calculated in percentage, which is important for assessing the functional ability of the affected limb. The difference in means was considered significant at p

Purpose: to determine the effectiveness of the physical therapy program for obese patients by the dynamics of the components of the metabolic syndrome. Material & Methods: 214 people of the second adulthood with obesity I and II degree were examined. In terms of compliance, they were divided into a comparison group (low level) and a main group (high level). The control group consisted of 63 people without signs of obesity. The components of the metabolic syndrome were evaluated by anthropometric indicators (body mass index, waist and hip circumference, their ratio) and biochemical parameters (blood glucose, cholesterol, triglycerides, high density lipoproteins, leptin), and the visceral obesity index was calculated. The examination was carried out before and after the introduction of the annual program of physical therapy, which included maintaining a high level of compliance, increasing physical activity, changing the diet, reflexology, massage, and psychocorrection. Results: in all obese individuals were determined by abdominal obesity, fasting hyperglycemia and impaired glucose tolerance, high levels of total cholesterol, triglycerides, leptin, low levels of low-density lipoproteins. The visceral obesity index exceeded those of people with normal body weight (р

Compression-ischemic neuropathy of the upper limb is a common disease of the peripheral nervous system, accompanied by impaired motor, sensory spheres and a decrease in the quality of life in people of working age. Purpose: to reveal the structure of rehabilitation examination in people with compression-ischemic neuropathy of the upper limb. Material & Methods: analysis and synthesis of data from scientific and methodological literature and the Internet information network; interrogation, history taking, palpation, tests, mathematical methods. The study was conducted on the basis of the neurological departments No. 1 and No. 2 of the Kiev City Clinical Hospital No. 4, Kiev, from 2017 to 2019. The examination involved 48 patients with compression-ischemic neuropathy of the upper limb. Results: a scheme (algorithm) of rehabilitation examination was proposed, which included: a survey, history taking, determining the level of damage, the degree of neurological deficit, motor and sensory disturbances, muscle hypotrophy and atrophy, joint and muscle contracture. During the initial examination of patients with compression-ischemic neuropathy of the upper limb, the predominance of male patients was revealed, namely 89.6%. Damage to the peripheral nerves of the upper limb was more often observed in patients of able-bodied young and middle age – 77,1%. The vast majority were patients with radiation injuries – 52,1% and ulnar nerves – 35,4%. In 60,4% of individuals, pains of moderate intensity were observed (4–6 points on a 10-point visual-analogue scale for assessing pain intensity (VAS)). Conclusions: an initial examination was carried out indicating the presence of disorders of the motor and sensory function of the affected limb in individuals with this pathology. To restore the functional state and preserve the function of the affected limb, it is necessary to comply with the developed scheme (algorithm) of the rehabilitation examination, and will contribute to the development of an effective physical therapy program.

Back pain treatment is one of the most common problems in medical practice. The paper presents the theoretical and practical bases of physical therapy for people experiencing pain in the back and neck, considers in detail the main kinesiotherapy techniques used in modern rehabilitation, analyzes the principles of their selection for the most effective recovery of locomotor activity and for reduction of the severity of pain syndrome, and discusses the modes of motor activity. Hardware techniques that facilitate the implementation of complex therapeutic movements are considered separately. A rationale is provided for the importance of increasing motor activity and muscular strength and normalizing muscle tone, by restoring blood circulation and by reducing inflammation and pathological impulses from the affected spine. The possibilities of kinesiotherapy for acute and chronic nonspecific back pain, discogenic radiculopathy, and lumbar stenosis are discussed.

Purpose: to study the effectiveness of physical therapy in the complex treatment of patients with deforming coxarthrosis of 2–3 degrees. Material & Methods: a comparative analysis of the use of traditional basic drug therapy and complex drug and physical therapy for 2 months in 30 patients (main and control group) with coxarthrosis of 2–3 degrees, functional insufficiency (FI) of 2 degrees using goniometry, visual analogue pain scale (VAS), Leiken index. Results: results of the analysis of goniometry indices, VAS and Leiken indices showed with statistical certainty the advantage of using physical therapy in the complex rehabilitation treatment of patients with coxarthrosis of 2–3 degrees, which was expressed in improving the dynamic function of the hip joint. Conclusion: a program of physical therapy for patients with coxarthrosis of grade 2–3 was developed and put into practice, including a set of ideomotor exercises, post-isometric muscle relaxation, gymnastic exercises with projectiles and objects, movement coordination exercises, breathing exercises with gravitational weights, exercises on block simulators and an exercise bike , as well as self-study at home.

Carpal tunnel syndrome is a neuropathy of the upper limb. It occurs in the wrist. To present the different physiotherapeutic methods for the treatment of carpal tunnel syndrome. Physiotherapeutic methods can be divided into methods of kinesitherapy and physiotherapy. Techniques include kinesiotherapeutic neuromobilization, taping rehabilitation. While the physiotherapy: sonotherapy, laser and transcutaneous electrical nerve stimulation. The effectiveness of these treatments in the carpal tunnel syndrome has been supported by research.

Rheumatoid arthritis is an autoimmune disease of unknown etiology, characterised by pain, stiffness, and swelling in the joints of the hands and feet, but the disease can also affect other joints. The disease is quite common among rheumatological pathologies and is observed in an average of 1% of the population. A thorough examination of a patient with rheumatoid arthritis, early detection of the main radiological signs of the disease, the level of functional and organic disorders, and the establishment of a rehabilitation diagnosis are essential, which is the basis for building a further personalised physical rehabilitation programme. The purpose of the paper is to determine the severity of the disease in patients with rheumatoid arthritis using instrumental and anthropometric methods of research to form an individual approach to rehabilitation. Materials and methods: the study was conducted on the basis of the Rheumatology Department and the Department of Rehabilitation Treatment with Traditional and Alternative Methods of the Rivne Regional Clinical Hospital named after Yuriy Semenyuk. The study involved 216 patients with rheumatoid arthritis, including 178 women (82%) and 38 men (18%). The patients were aged 25 to 59 years (mean age – 46±0.24). The following research methods were used: questionnaire, history taking, objective examination, instrumental methods of research (radiography), anthropometric methods (Ketle index), statistical methods. Results. Clinical and radiological stage I was diagnosed in 50 (23 %) patients, stage II – in 102 (47 %) patients, and stage III – in 64 patients (30 %). It was found that most patients had radiological stage II with characteristic radiological symptoms (periarticular osteoporosis with minor destruction of the subchondral bone; slight narrowing of the joint gaps, single usurps). Average body mass index values indicate that patients are generally overweight, which is a negative factor in the onset and progression of rheumatoid arthritis. Body mass index is an important indicator in determining the indications for treatment and rehabilitation. Conclusion. As a result of the examination, we found that most patients with rheumatoid arthritis were diagnosed with clinical and radiological stage II. The average BMI values indicate that, in general, patients are overweight, which is a negative factor in the progression of rheumatoid arthritis. The above data give grounds for the development and implementation of the concept of physical rehabilitation of patients with rheumatoid arthritis aimed at reducing clinical symptoms of the disease, reducing body mass index and improving the quality of life of patients.

The purpose, main tasks and principles of the author's concept are defined, conceptual approaches to the problems of physical therapy of patients with rheumatoid arthritis are analyzed. The main approaches to the prerequisites for the development of the author's concept of restoring the quality of life of patients with rheumatoid arthritis are considered, which include: biological, social and personal prerequisites. A system of restoration and improvement of the quality of life of patients with rheumatoid arthritis has been developed, which consists in the integrated application of rehabilitation measures, taking into account the individual and interdisciplinary approach to each patient in each of the recovery periods. The methodological approaches in accordance with the domains of the International classification of functioning, taking into account the factors that affect the level of functional impairment and quality of life of the patient, are taken into account. It is emphasised that the proposed concept was holistic in nature, based on the targeted use of a comprehensive psychological, pedagogical, medical and rehabilitation approach, physical therapy programmes were individually selected for each patient, taking into account functional joint disability, rheumatoid arthritis activity, quality of life and health status of patients. The article presents the technology of rehabilitation measures to improve the effectiveness of rehabilitation treatment of patients with rheumatoid arthritis, achieve clinical remission, reduce pain, improve joint motor function, prevent deformities and contractures, maintain performance and improve quality of life. It was noted that the realization of the restorative effect in accordance with the tasks of physical therapy varied. Each patient was given a personalized approach to rehabilitation intervention, taking into account the degree of functional joint disability, participation in work life and psychosocial issues.

The aim of this study was comparison of local cryotherapy and sonotherapy effectiveness in the treatment of gonarthrosis symptoms. Material and methods: The studies on the comparison of local cryotherapy and sonotherapy effectiveness were conducted in a research group of one hundred people singled out from the patients staying at the Wieniec Zdrój Sanatorium in Wieniec Zdrój. Before the series of sonotherapy and cryotherapy treatments and after their completion, all patients were assessed using: Centimeter tape, Goniometer, VAS (Visual Analog Scale), Laitinen Questionnaire and Sit-up Test. Results: After the rehabilitation, the intensity of pain was determined at 4.45 points, on a scale from 0 to 8 points. The intensity of pain in the VAS scale among respondents decreased significantly by 1.750 points. The average pain intensity was 1.40 points (SD = 0.778), which resulted in a significant change in the form of pain relief (p = 0.580). The frequency of pain ranges from 0 to 4 points (M = 1.35). The frequency of its occurrence decreased significantly (p = 0.670). After rehabilitation, the frequency of analgesics was on average 0.66 points, and the limit on physical activity was 1.40 points (p = 0.520). The limitation of physical activity was determined on average at the level of 1.04 points, which reduced its limit by 0.560 points. After rehabilitation, the range of motion in the knee joint increased to 99.60 °. On average, the range of movement of patients in the knee joint after rehabilitation increased by -1.429 °. After rehabilitation, knee circumference of the kneecap was between 30 cm and 76 cm. The average result was 42.375 cm and decreased significantly by 0.1676 cm. The circumference of the knee joint above the kneecap oscillated between 28 - 80.5 cm (D = 44.335 cm), which gave the effect of reducing the edema by 0.320 cm. The treatments performed varied only the results in the frequency of analgesics (p = 0.45). Better effects occurred in patients undergoing sonotherapy (M = 0.048) than in cryotherapy (M = 0.84). Conclusions: Local cryotherapy and sonotherapy reduces the severity and frequency of pain and reduces swelling in the knee joints. Positive effects of therapy reduce the amount of analgesics used. However, better results are obtained in patients undergoing sonotherapy than in cryotherapy. In addition, the range of flexion movements of the knee joints is increased under the influence of treatments. There are significant differences in the improvement of the range of motion among patients treated with sonotherapy than cryotherapy.