Effectiveness of early abobotulinum toxin (Dysport<sup>®</sup>) injections in patients with upper limb spastic paresis after traumatic brain injury in real clinical practice: results of a multicenter observational non-interventional prospective study (Adults with post Traumatic Brain Injury (TBI) upper limb (UL) spasticity – APTULS)

The article reveals results of the first russian prospective observational study, aimed at evaluating of the clinical results early using injections of abobotulinumtoxinA (Abo-BTA, Dysport®) in patients with upper limb spasticity (ULS), which is one of disabling consequence traumatic's brain injuries (TBI). Currently, botulinum therapy is an integral part of the complex treatment of patients with chronic spasticity, has a high level of evidence (level IA), is included in clinical recommendations, national guidelines in a lot of countries around the world countries. The article analyzes results of studies conducted in the world in recent years, which confirm the effectiveness of Abo-BTA injections in the treatment of spasticity, which developing in early period after acute brain injury. Presented data of their own observations are allowed to authors conclude, that using of Abo-BTA injections in the complex rehabilitation of patients with ULS in the early recovery period of TBI demonstrates its good tolerability and a high safety profile, contributes to improving the effectiveness of treatment by reducing muscle tone and spasticity, increasing the volume of movements in joints. Therefore, Abo-BTA injections can be considered as a necessary addition to standard early rehabilitation programs. However, it is necessary to conduct further large-scale studies to more accurately determine the timing of the start of botulinum therapy, the doses of Abo-BTA, the most effective combinations of rehabilitation methods in the creating of individual programs.</jats:p

COMPARATIVE CHARACTERISTICS OF THE EXTERNAL BREATHING PARAMETERS OF YOUNG ATHLETES IN CYCLIC SPORTS

At present, one of the main tasks of the state is to develop and improve the system of health protection and quality of life of the younger generation. In this regard, the search for simple non-invasive methods of monitoring the health of children, and especially young athletes at various stages of their competitive activity, is of great importance. It is known that the leading place among the factors influencing sports performance is occupied by a number of authors with the peculiarities of metabolic processes of sportsmen [1, 2], hemodynamics [3, 4], neuromuscular activation [5, 6], activity of the central nervous system [7, 8]. It has been shown that systematic repetition of dosed muscle load increases not only physical endurance in sportsmen but also their body resistance to hypoxia [4]. However, to date, the literature practically lacks data from complex controlled studies on the assessment of the functional state of the body in young athletes. At the same time, it should be noted that changes in the parameters of external respiration are one of the most important markers of medical and biological control of training, both for beginners and highly qualified sportsmen [9, 10]. In our opinion, studying the features of external respiration in athletes of cyclic sports of different orientation can be useful in building schemes, choosing modes and methods of their training process. In this connection, the purpose of the present research was the comparative characteristic of the external breathing system of young sportsmen of cyclic sports of orienteers and track-and-field athletes who are at the stage of a basic training mesocycle. The study was carried out with the participation of 20 young male and female athletes engaged in athletics and sports orientation. The 1st group (10 people) included athletes engaged in track and field athletics, athletes stewards (runners for 800–3000 meters, the average distance during training from 1500 to 4000 meters, pace – about 5 minutes per 1 km.), the 2nd group (10 people) – athletes engaged in orienteering (the average distance of running from 3000 to 6000 meters, pace – about 6–7 minutes per 1 km.). The age of athletes was within 13–15 years. The external breathing apparatus is most developed for orienteering athletes who have elements of staying load in the training process, with predominance of aerobic type of energy exchange, while for athletes-athletes the most characteristic was high power of forced exhalation and values of maximum ventilation of the lungs, which is due to a high degree of adaptation of these athletes to anaerobic load of high intensity. Young orienteering athletes recorded higher values in the «tranquil breathing» test as compared to track and field athletes. Thus, YEL on the average is 11.97 % (p&lt;0.05) higher than in the group of track and field athletes, and the indicators of ROV – by 20.30 % (p&lt;0.05) higher than the values obtained from volunteers involved in athletics. The probable mechanism of such differences may be that the efficiency of the training process of athletics athletes, in contrast to orienteers, is equally related to both anaerobic and aerobic types of energy exchange, and less dependent on the functioning of the external respiratory apparatus, which is reflected in the lower values of GEL and RO in these athletes, compared to young orienteering athletes, characterized by a greater contribution of aerobic type of energy exchange. In the tests «forced exhalation» and «maximum ventilation of the lungs» the orienteers registered lower values of the studied indices (FSEL in – by 17,08 % (p&lt;0,05), OFV1 – by 24,84 % (p&lt;0,05), ratio OFV1/FSEL – by 2,67 % (p&lt;0,05), MVL – by 29,21 % (p&lt;0,05) lower than in the group of athletes), which is due to a higher degree of formation of adaptation mechanisms of oxygen debt compensation at high intensity physical activity in comparison with orienteering sportsmen, whose training process is mostly connected with long medium intensity loads.</jats:p