Efficacy of Physical Rehabilitation after Anterior Cruciate Ligament Reconstruction: Non-Randomized Trial

Background. Anterior cruciate ligament rupture is the most common knee joint injury, especially in young people with a healthy and active lifestyle. The concept of quality of life has been dynamically developing. The scope of its application is expanding in various fields of medicine to provide a comprehensive assessment of treatment and rehabilitation efficacy.Objective — to assess the feasibility of complex individual physical rehabilitation of patients after early and delayed arthroscopic reconstruction of the anterior cruciate ligament (ACL).Methods. Open simple non-randomized trial enrolled 834 patients with the anterior cruciate ligament rupture of the knee joint. In the first group (431 patients), ACL plastic surgery was performed in the early stages — between weeks 2 and 6. In the second group (403 patients), ACL reconstruction was performed in the later stages — from week 7 to 1 year, inclusive. Each group was divided into two subgroups — the main one, in which restorative treatment and comprehensive individual rehabilitation were carried out, and the control group, with rehabilitation treatment in accordance with the standards of postoperative treatment. The study was conducted in Traumatology, Orthopedics and Medical Rehabilitation Unit of Clinical Hospital No. 1. Patients were included in the trial from 2016 to 2021. The follow-up period for each patient was one year. Statistical data processing was performed by means of Statistica 12.0 (StatSoft, Inc., USA). Independent samples were compared using non-parametric criteria: Mann — Whitney U-test and Wilcoxon T-test.Results. No statistical differences were found in the distribution according to gender, age and body mass index. A comparative analysis of scale medians of Medical Outcomes Study 36Item Short-Form Health Survey (MOSSF-36), conducted in patients before surgery, revealed no statistically significant differences ( p>0.05) between the main and control subgroups in both groups. Analyzing medians before ACL reconstruction showed a significant decrease in comparison with population studies ( p < 0.0001, Mann — Whitney U-test). The analysis of physical and mental component summaries via MOSSF-36 revealed statistically significant differences in the effectiveness of treatment of patients in 1 year after ACL plastic surgery and complex individual rehabilitation. Thus, in the main subgroups, the values of treatment efficacy medians were significantly higher than in the control ones, regardless of the timing of ACL plastic surgery ( p < 0.001, Mann — Whitney U-test). The results testify to higher median efficacy values in patients of the main subgroup of group 1 than in other subgroups ( p < 0.001, Mann — Whitney U-test). The study of correlative relationships demonstrated a stronger relationship between the medians of physical and mental component summaries in the main subgroup of the first group (correlation coefficient = 0.76), if compared to the main subgroup of the second group (coefficient = 0.67).Conclusion. The study testified to the treatment efficacy proved using the scales of physical and mental component summaries. They demonstrated more significant treatment efficacy one year after arthroscopic ACL reconstruction and individual rehabilitation in the main subgroup of group 1 than in the other subgroups

The importance of physical activity in the regulation of anti-viral immunity

The paper reviews the current data on the effect and role of varying intensity physical activity in the prevention of various respiratory virus infections, including influenza virus and SARS-CoV-2 coronavirus. The paper discusses the effect of varying intensity physical activity on antiviral immunity, cellular and cytokine responses to respiratory virus infections, physical activity influence on vaccination effectiveness and the role of regular moderate intensity physical activity in the prevention of viral infection in patients with obesity, overweight, diabetes and other metabolic disorders. The paper analyzes physical activity role in the prevention of SARS-CoV-2 infection, as well as in the conditions of self-isolation and quarantine

Efficiency of isotonic drinks for rehydration of athletes of children and youth age

TThe most important factor limiting sports performance is insufficient fluid intake by athletes and dehydration of the body, while a significant decrease in performance and sports endurance begins with a dehydration level of 2 % and above.Objective: to study the effectiveness and safety of rehydration of the body of athletes­skiers of children and youth using isotonic drinks «Izonok» and «Izonok+».Materials and methods: the main group (n = 12, 16.2 ± 1.4 years) took isotonic drinks for 30 days to compensate for fluid losses, the comparison group (n = 8, 15.7 ± 1.1 years) — drinking water. Bioimpedance body composition analysis was carried out on a KM-AR-01-”Diamant” device (RF, St.Petersburg), and central hemodynamic analysis was carried out on a «SIMONA 111» (LLC “Okulyus 2000”, RF). The content of secretory immunoglobulin A (sIgA) and lysozyme in saliva samples of athletes was carried out by the enzyme immunoassay on an ANTHOS 2010 analyzer (Austria). Statistical data processing was carried out using the Statistica 6.0 software package from Stat Soft @ Ink USA.Results: The intake of an isotonic drink is accompanied by the stimulation of the production of secretory immunoglobulin (sIgA) and lysozyme compared to the consumption of drinking water. The total volume of fluid and the volume of extracellular fluid tended to increase; the volume of intracellular fluid remained practically unchanged; the amount of total water when taking isotonic increased.Conclusion: The investigated isotonic drinks “Izonok” and “Izonok+” are effective sports drinks for maintaining optimal water-salt balance and local immunit

Seasonal variation of quality of life of women

In clause the results of estimation of quality of life in women. 60 practically healthy women student's aged 17-20 years are surveyed. The estimation quality of life students was spent by the MOS 36-item short-form health survey (SF-36). Is established, that parameters quality of life had seasonal rhythms. Thus, the peak RF, SF and MH are observed in the winter, VT and RE - in spring, PF - in summer, HG and BP - in autumn

Оценка эффективности реабилитации после артроскопической реконструкции передней крестообразной связки

Целью исследования явилось изучение эффективности лечения пациентов после артроскопической реконструкции передней крестообразной связки с применением индивидуальной физической реабилитации. Материалы и методы. В исследование включены 834 пациента в возрасте 18–55 лет (464 мужчины и 370 женщин) с диагнозом «разрыв передней крестообразной связки коленного сустава». Пациенты были распределены на две группы: контрольную – 530 человек (302 мужчины и 228 женщин), которые получали стандартное послеоперационное лечение; основную – 304 человека (162 мужчины и 142 женщины), которые помимо стандартного послеоперационного лечения получали комплексную индивидуальную реабилитацию. Эффективность лечения оценивали с помощью субъективных ортопедических опросников в ходе динамического наблюдения (до операции и через 1 год после операции и реабилитации). Результаты. Спустя 1 год после артроскопической реконструкции передней крестообразной связки и физической реабилитации у пациентов основной группы установлены статистически значимо более высокие медианы эффективности лечения по данным ортопедических опросников, чем у контрольной. Важно также отметить, что пациенты основной группы статистически значимо чаще демонстрировали высокие показатели эффективности лечения по сравнению с представителями контрольной группы. Таким образом, исследование подтвердило, что применение комплексной индивидуальной реабилитации у пациентов, перенесших хирургическое вмешательство после разрыва передней крестообразной связки, значимо улучшает их физическое и психическое состояние

Seasonal variation lipid levels in the patients with dyslipidaemia

The article is devoted to study seasonal variation in blood lipid levels in the patients with dyslipidaemia IIa type. The 185 men with dyslipidaemia IIa and 173 healthy men volunteers aged 28 to 50 years were examined four times during the year: in winter (December-February), spring (March-May), summer (June-August) and autumn (September-November). Is established, that in the patients the shift acrophases of seasonal rhythms total cholesterol, LDL cholesterol, VLDL cholesterol and apoВ to the autumn, triglycerides - to winter was observed, and HDL cholesterol and apolipoproteinА-1 - to spring in comparison with healthy, that testifies to higher probability of development in them of atherosclerosis. Thus the maximal meanings index of atherogenesis and ratio of apoВ/apoА-1 were observed in the autumn and in the healthy - in winter. Is shown, that the peak C-reactive protein in the patients with dyslipidaemia was observed in the summer and in the healthy - in spring. Thus the shift acrophases of seasonal rhythms lipid spectrum in the patients with dyslipidaemia IIa type as to the autumn raises risk of development in them cardiovascular patholog

LIFE QUALITY INCREASING AND DYNAMICS OF COGNITIVE PROCESSES AS THE RESULT OF EDUCATION AT THE “THIRD AGE”

Longitudinal data obtained in the study of the influence of education at the third age on cognitive functioning and psychological status of elderly persons is analyzed in the article. The project started in October 2014 and will continue until December 2016. All the participants (N=21) are non-working pensioners with higher non-psychological education; in the project they are studying in the program “Practical psychology”, the duration of education is 2.5 years. As a result of the training the participants have become more confident in the sphere of social relations, they have become more self-confident, the future has stopped to seem meaningless for them. The students have become more confident in their cognitive abilities, their indices of cognitive consciousness and life satisfaction have increased significantly. As a result of the conducted research, it was revealed that learning in elderly years influences significantly the psychological well-being of elderly students. The improvement of cognitive functioning by the end of the first semester (six months after the beginning) was revealed as well. It is assumed that the improvement of cognitive functioning is due to changes in neuronal structures, as more time is necessary for these qualitative and quantitative changes