Методи та засоби фізичної реабілітації для постраждалих від російсько-української війни

Abstract. The article discusses issues of a comprehensive rehabilitation approach for patients with melanoma when treated with immunotherapy. By focusing on innovative treatments, the study highlights the need to integrate nutritional support, physical therapy, magnetic therapy and psychological support to improve quality of life and enhance the effectiveness of immunotherapy regimens. Purpose. The study aims to evaluate the impact of a multidisciplinary rehabilitation program on improving physiological functions, psychoemotional well-being and the impact on the overall antitumor response, which together can improve the quality of life of patients with melanoma. Materials and methods. The study included 135 patients diagnosed with melanoma who received a course of immunotherapy. In the study group (the main group), a complex of rehabilitation techniques was used (magnetic therapy, physical therapy, nutritional support, psychological support), while in the control group, patients did not undergo an accompanying comprehensive rehabilitation program. Treatment effectiveness was assessed in accordance with iRECIST 1.1 criteria. To assess the quality of life, the Russian version of the EORTC QLQ-C30 questionnaire was used. The severity of adverse events was assessed according to CTCAE 5.0 criteria. Results. Patients from the main group who received comprehensive rehabilitation support along with immunotherapy showed an improvement in their general physical condition and a decrease in the intensity of some side effects of treatment. Patients in the control group who received only standard immunotherapy also showed changes in their health status, but these changes were less pronounced compared to the main group. Adverse events during treatment occurred in 55 % of patients in the main group and in 74 % in the control group. Patients in the main group noted an improvement in quality of life by 25 %, while in patients in the control group this figure was 12 %. An 18 % improvement in general condition was noted by patients in the main group, while patients in the control group noted an 8 % improvement in general condition. Conclusion. Implementation of a multidisciplinary rehabilitation approach, including nutritional support, physical therapy exercises, magnetic therapy, and psychological support, demonstrates significant improvements in symptom management and quality of life in melanoma patients undergoing immunotherapy.

Abstract. The article discusses the importance of a comprehensive rehabilitation approach for melanoma patients when treated with immunotherapy. By focusing on innovative treatments, the study highlights the need to integrate nutritional support, physical therapy, magnetic therapy, and psychological support to improve quality of life and enhance the effectiveness of immunotherapy regimens. Purpose of the study: to evaluate the impact of the multidisciplinary rehabilitation program on physiological functions, psycho-emotional well-being, general antitumor effect, and quality of life of patients with melanoma. Materials and methods. The study included 135 patients diagnosed with melanoma who received a course of immunotherapy. In the study group (the main group), a complex of rehabilitation techniques (magnetic therapy, therapeutic exercises, nutritional support, psychological support) was used, while in the control group, the patients did not undergo the accompanying comprehensive rehabilitation program. Treatment effectiveness was assessed in accordance with iRECIST 1.1 criteria; to assess the quality of life, the Russian version of the EORTC QLQ-C30 questionnaire was used. Results. The patients of the study group showed an improvement in their general physical condition and a decrease in the intensity of some side effects of treatment. The patients in the control group also showed changes in their health status, but they were less pronounced compared to the study group. Adverse events during treatment occurred in 55 % of the patients in the study group and in 74 % of the patients in the control group. The patients in the study group noted an improvement in quality of life by 25 %, while in the patients in the control group this indicator was 12 %. An 18 % improvement in general condition was noted by the patients in the study group, while the patients in the control group noted an 8 % improvement in general well-being. Conclusion. The implementation of the multidisciplinary rehabilitation approach, including nutritional support, therapeutic exercises, magnetic therapy, and psychological support, demonstrates significant improvements in symptom management and quality of life in melanoma patients undergoing immunotherapy.

The leading role in rehabilitation belongs to the methods of physical influence, and the further from stage to stage it advances, the more importance they acquire, ultimately forming a direction or type called "physical rehabilitation". Physical rehabilitation is a system of measures to restore or compensate for physical capabilities and intellectual abilities, improve the functional state of the body, improve physical qualities, psycho-emotional stability and adaptive reserves of the human body by means and methods of adaptive physical culture, elements of sports and sports training. Physical rehabilitation is the use of physical exercises and natural factors for therapeutic and preventive purposes in the complex process of restoring health, physical condition and working capacity of patients and disabled people. It is an integral part of medical rehabilitation and is used at all its periods and stages. Physical rehabilitation is used in social and professional rehabilitation. Its means are therapeutic physical culture, therapeutic massage, physiotherapy, mechanotherapy, occupational therapy. The purpose of physical rehabilitation means, the sequence of application of its forms and methods are determined by the nature of the disease, the general condition of the patient, the period and stage of rehabilitation, the motor regime. Physical culture is a sphere of social activity aimed at maintaining and strengthening health, developing human psychophysical capabilities in the process of conscious motor activity. Physical culture is a part of culture, which is a set of values, norms and knowledge created and used by society for the purpose of physical and intellectual development of human abilities, improving their motor activity and forming a healthy lifestyle, social adaptation through physical education, physical training and physical development. In rehabilitation for the restoration of lost capabilities of the motor function, complexes of physical exercises aimed at recovery and return of t he amplitude of movement are actively used.

Suboccipital decompression is a common procedure for patients with Chiari malformation Type I (CMI). Published studies have reported complication rates ranging from 3% to 40%, with pseudomeningocele being one of the most common complications. To date, there are no studies assessing the effect of this complication on long-term outcome. Therefore, the authors set out to assess the effect of symptomatic pseudomeningocele on patient outcomes following suboccipital decompression for CM-I. The study comprised 50 adult patients with CM-I who underwent suboccipital craniectomy and C-1 laminectomy with or without duraplasty. Clinical presentation, radiological studies, operative variables, and complications were assessed for each case. Baseline and 1-year postoperative patient-reported outcomes were assessed to determine improvement in pain, disability, and quality of life. The extent of improvement was compared for patients with and without development of a postoperative symptomatic pseudomeningocele. A symptomatic pseudomeningocele developed postoperatively in 9 patients (18%). There was no difference with regard to clinical, radiological, or operative variables for patients with or without a postoperative pseudomeningocele. Patients without a pseudomeningocele had significant improvement in all 9 patient-reported outcome measures assessed. On the other hand, patients with pseudomeningocele only had significant improvement in headache (as measured on the Numeric Rating Scale) and headache-related disability (as measured on the Headache Disability Index) but no improvement in quality of life. Twenty-nine (71%) of 41 patients without a pseudomeningocele reported improvement in health status postoperatively compared with only 3 (33%) of 9 patients with a postoperative pseudomeningocele (p = 0.05). Surgical management of CM-I in adults provides significant and sustained improvement in pain, disability, general health, and quality of life. Development of a postoperative symptomatic pseudomeningocele has lingering effects at 1 year, and it significantly diminishes the overall benefit of suboccipital decompression for CM-related symptoms. Further research is needed to accurately predict which patients may benefit from decompression alone without duraplasty.

Background and aim: Osteoarthritis (OA) is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability . Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis. Materials and Methods : In this clinical trial study, forty female patients with severe knee OA were randomly assigned to two following groups; common physiotherapy treatment and common physiotherapy treatment accompanied by knee distraction. Quality of life was evaluated pre- and post-treatment and also one month follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Results: Common physiotherapy treatment accompanied by knee distraction resulted in significantly better quality of life post-treatment and at 1month follow-up, compared to common physiotherapy treatment alone (P<0.01). Conclusion: Common physiotherapy treatment accompanied by knee distraction induces significant improvement in quality of life in patients with severe knee osteoarthritis compared to common physiotherapy treatment alone. Key words: knee, osteoarthritis, traction, quality of life .

(1) Background: Osteoarthritis (OA) significantly impacts patients' quality of life and negatively affects public healthcare costs. The aim of this systematic review is to identify the effectiveness of pulsed electromagnetic fields (PEMFs) in OA treatment across different anatomical districts, determining pain reduction and overall improvement in the patient's quality of life. (2) Methods: In this systematic review following PRISMA guidelines, PubMed and Google Scholar were searched for randomized controlled trials involving patients with osteoarthritis undergoing PEMF therapy. Seventeen studies (1197 patients) were included. (3) Results: PEMF therapy demonstrated positive outcomes across various anatomical districts, primarily in knee osteoarthritis. Pain reduction, assessed through VAS and WOMAC scores, showed significant improvement (60% decrease in VAS, 42% improvement in WOMAC). The treatment duration varied (15 to 90 days), with diverse PEMF devices used. Secondary outcomes included improvements in quality of life, reduced medication usage, and enhanced physical function. (4) Conclusions: Diverse PEMF applications revealed promising results, emphasizing pain reduction and improvement in the quality of life of patients. The variability in the treatment duration and device types calls for further investigation. This review informs future research directions and potential advancements in optimizing PEMF therapies for diverse osteoarthritic manifestations.

BackgroundFirst-line rehabilitative strategies to improve motor deficits are based on functional training (physical or occupational therapy), which has been demonstrated to facilitate neural reorganisation. Accumulating evidence suggests that non-invasive brain stimulation techniques, such as repetitive TMS (rTMS), may enhance neuroplasticity, thereby facilitating neural reorganisation and recovery from Parkinson’s disease. Evidence also shows that intermittent theta-burst stimulation (iTBS) can improve motor function and quality of life in patients by promoting the excitability and neural remodelling of cerebral cortex. We aimed to combine iTBS stimulation with physiotherapy to improve the rehabilitation effect compared to physiotherapy alone in patients with Parkinson’s disease.MethodsThis randomised, double-blind clinical trial will enrol 50 Parkinson’s disease patients aged 45–70 years with Hoehn and Yahr scale scores of 1–3. Patients are randomly assigned to either the iTBS + physiotherapy or sham-iTBS + physiotherapy group. The trial consists of a 2-week double-blind treatment period and a 24-week follow-up period. iTBS and sham-iTBS will be administered twice daily for 10 days based on physiotherapy. The primary outcome will be the third part of Movement Disorders–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III) from the baseline to the first 2 days following completion hospitalised intervention. The secondary outcome will be 39-item Parkinson’s Disease Questionnaire (PDQ-39) at 4 weeks, 12 weeks and 24 weeks after intervention. Tertiary outcomes are clinical evaluations and mechanism study outcomes such as NMSS, 6MWD, 10MT, TUG, BBS, MRI, and EEG, the length of time between the drug needs to be adjusted when symptoms fluctuate.DiscussionThe aim of this study is to demonstrate that iTBS can promote overall function and quality of life in Parkinson’s disease patients using physiotherapy and that this efficacy may be associated with altered neuroplasticity in exercise-related brain regions. The iTBS combined with physiotherapy training model will be evaluated during a 6-month follow-up period. With significant improvement in quality of life and motor function, iTBS combined with physiotherapy can be considered as a first-line rehabilitation option for Parkinson’s disease. The potential of iTBS to enhance neuroplasticity in the brain should have a more positive impact in increasing the generality and efficiency of physiotherapy, improving the quality of life and overall functional status of patients with Parkinson’s disease.Trial registrationChinese Clinical Trial Registry ChiCTR2200056581. Registered on 8 February 2022.

The health benefits of regular recreational physical activity are well known in reducing secondary health consequences of a sedentary lifestyle in the general population. However, individuals with physical disabilities participate less frequently in recreational activity compared with those without disabilities. Although evidence on the impact of recreational physical activity on quality of life in this population is in its infancy, regular recreational and sports activity participation has shown to have a positive association with improvements in quality of life, life satisfaction, community reintegration, mood, and employment in those with disabilities. Facilitators of participating in adaptive sports include a desire to improve social support, physical fitness, health, and fun. Unfortunately, those with disabilities face numerous barriers to participate in adaptive sports including accessibility, transportation, awareness, finances, and physical and cognitive impairments. Further studies are needed to investigate facilitators and barriers to participating in adaptive sports to capitalize on the physical and psychosocial benefits of regular recreational activity. The aim of this article is to review the available literature on the effects of adaptive sports participation on quality of life.

Impact d’un programme d’éducation thérapeutique du patient sur la qualité de vie d’enfants avec TDAH et celle de leurs parents

Objective To determine the availability of data on overall survival and quality of life benefits of cancer drugs approved in Europe.Design Retrospective cohort study.Setting Publicly accessible regulatory and scientific reports...

Lung cancer is a leading cause of cancer-related mortality worldwide. Depression is also a common concern for lung cancer patients and is of concern because it negatively impacts overall well-being. This study summarizes the existing literature on the impact of exercise interventions on quality of life and depression in patients diagnosed with lung cancer. A systematic search of electronic databases was performed to identify relevant randomized controlled trials (RCTs) investigating the effects of exercise interventions on depression and quality of life in patients with lung cancer. Two evaluators collected information from the chosen studies utilizing a standardized data extraction form. The quality of the studies was evaluated using the Cochrane risk of bias tool. Nine RCTs were included in the meta-analysis, with 798 participants. The pooled standardized mean difference (SMD) for the effect of exercise interventions on depression was -0.60, representing a statistically significant reduction in depression levels following exercise interventions (p < 0.001). The pooled SMD for the effect of exercise interventions on quality of life was 0.61, indicating a statistically significant association between quality of life and exercise interventions (p < 0.001). There is evidence that exercise may benefit the mental health of individuals with lung cancer, including improvements in depression symptoms and quality of life, based on the intervention studies reviewed here. Given the heterogeneity in findings, however, additional randomized controlled trials are needed to augment the existing findings. Nevertheless, there appears to be sufficient evidence for now to encourage primary care physicians to recommend exercise for patients with lung cancer, while offering guidelines on how to gradually and safely increase physical activity depending on the patient's health status.

To verify the effect of in-home rehabilitation on quality of life and activities of daily living in elderly clients. In this non-randomized controlled intervention trial, elderly participants were separated into a rehabilitation or a non-rehabilitation group (n = 100 each). The non-rehabilitation group received basic in-home nursing care, including assistance with cooking, cleaning, toileting, meals and medication. The rehabilitation group received a physical treatment program provided by a licensed professional once a week and basic nursing care in the home. For each group, quality of life and activities of daily living were assessed approximately every 3 months over a 1-year period. Quality of life was evaluated using the Philadelphia Geriatric Center Morale Scale, and activities of daily living were evaluated based on the Functional Independence Measure. The rehabilitation group showed statistically significant improvements in both quality of life and activities of daily living. In contrast, the non-rehabilitation group, although showing slight improvement in quality of life at 9 months, showed almost no effects at the other time-points and no significant changes in activities of daily living over the course of the study. The results of the present study suggest that long-term continuous in-home rehabilitation might improve quality of life and activities of daily living in elderly clients. Geriatr Gerontol Int 2017; 17: 1866-1872.

AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.

Quality of Life after Laparoscopic and Open Abdominal Myomectomy

Pulmonary rehabilitation (PR) is a supervised exercise program for patients with chronic lung disease. Among patients with pulmonary hypertension (PH), PR has been shown to improve both quality of life and exercise capacity. The purpose of this study was to assess the prevalence of PR participation among PH patients, patient perspectives regarding PR, and to identify potential barriers to PR participation. We performed a cross-sectional survey of patients with self-reported PH who attended the Pulmonary Hypertension Association (PHA) conference in June 2022 in Atlanta, Georgia, and patients within the PHA listserv. A total of 429 participants completed the survey and were enrolled in the study. The average age of participants was 61 ± 14 years with 83% of participants identifying as female, 51% of patients self-reported as having group 1 PH. Among patients who completed the survey, 41% had previously attended a PR program. Of those who had completed a PR program, 83% reported being satisfied or very satisfied with the program and 86% reported that they would recommend PR to other PH patients. After completion of a PR program, 76% of patients reported an improvement in their quality of life and 88% reported improvement in exercise capacity. Among the patients who had not previously participated in PR (n = 254), 63% reported an interest in participation while 64% cited a lack of discussion from their treatment team as the primary reason for the lack of PR participation. Limitations of the study include sampling and response bias. According to this cross-sectional survey, the majority of PH patients who have participated in PR report improvement in both quality of life and exercise capacity and would recommend PR to other PH patients. The majority of PH patients who have not participated in PR were interested in participation and cited a lack of discussion with their treatment team as one of the primary reasons for the lack of participation. PR is associated with self-reported improvements in quality of life and exercise capacity but remains underutilized among patients with PH.