Russian Journal of Physiotherapy, Balneology and Rehabilitation
Peer-review bimonthly medical journal.
Editor-in-chief
- Nataly B. Korchazhkina, MD, Dr. Sci. (Medicine), Professor
ORCID iD: 0000-0002-9804-7725
Journal founders
- Izdatelstvo "Meditsyna"
- Eco-Vector Publishing Group
Publisher
- Eco-Vector Publishing Group (WEB: https://eco-vector.com/)
About
Types of accepted articles
- reviews
- systematic reviews and metaanalyses
- original research
- clinical case reports and series
- letters to the editor
- short communications
- clinical practice guidelines
Publications
- in English and Russian
- bimonthly, 6 issues per year
- continuously in Online First
- with Article Submission Charge (ASC)
- distribution in hybrid mode - by subscription and/or Open Access
(OA articles with the Creative Commons Attribution 4.0 International License (CC BY-NC-ND 4.0))
Indexation
- Russian Science Citation Index (Web of Science)
- Russian Science Electronic Library (eLibrary.ru)
- Google Scholar
- Ulrich's Periodicals directory
- WorldCat
- Crossref
Current Issue
Open Access
Access granted
Subscription Access
Vol 24, No 6 (2025)
Review
Physical therapy in comprehensive treatment of peripheral artery disease and diabetes mellitus
Abstract
Peripheral artery disease (PAD) and diabetes mellitus (DM) are serious medical and social issues that pose a significant risk of cardiovascular complications, amputations, and disability. The coexistence of these conditions worsens both survival and limb preservation, increases the severity of lower limb ischemia, and promotes trophic tissue disorders of the foot, including diabetic foot. The modern management of patients with PAD and DM relies on a multidisciplinary strategy, with physical therapists playing a key role. Their expertise encompasses improving physical activity, preventing complications, managing chronic wounds, and providing rehabilitation after vascular reconstructive surgery. This review summarizes current physical therapy approaches, including supervised exercise therapy (SET) for intermittent claudication, preoperative conditioning, early mobilization protocols, and restoration of motor activity following amputation or ulcer healing. Special emphasis is placed on offloading strategies for affected foot regions, physiotherapeutic techniques (laser therapy, magnetotherapy), and personalized exercise therapy programs for patients with DM. Furthermore, the review discusses barriers to SET implementation, including limited accessibility of programs, shortage of trained specialists, and patient referral challenges, as well as the need for educational and certification programs in chronic wound care for physical therapy and rehabilitation professionals. Clinical evidence suggests that integrating physical therapy into comprehensive treatment of patients with PAD and DM can improve limb function, reduce complication rates, and enhance quality of life.
407-421
Body weight changes in men after lower limb amputation
Abstract
Lower limb amputation (LLA) leads to body weight changes, induces vascular remodeling, hypokinesia, stress, and significant postural and locomotor dysfunction, and has a profound impact on systemic homeostasis. Functional reserves of the cardiorespiratory system decrease, metabolic processes become disrupted, and exercise tolerance declines. We analyzed publications in Russian and international journals indexed in the Russian Science Citation Index (RSCI), PubMed, Embase, CINAHL, Web of Science, Wan Fang Data, Cochrane CENTRAL, and Scopus. During the first two years of follow-up, the mean calculated percentage weight gain in men with amputation was significantly higher than in non-amputee men. Weight gain in amputees peaked in the second year, followed by partial weight loss without reverting to baseline values. More than 45% of men who underwent transtibial (TTA) or transfemoral (TFA) amputation gained 10% of body weight by the end of the second year, compared with 9.2% among non-amputees and 22.7% among those with partial foot amputation (PFA). By the end of the third year, there was a modest increase in the proportion of individuals who had lost 5% of their baseline body weight (18.5% among non-amputees vs. 19.7%, 13.0%, and 22.5% among those with PFA, TTA, and TFA, respectively). Men with bilateral amputations and those with higher baseline body weight were more likely to experience weight loss (12%, 20 of 166; p < 0.01). Individuals with non–blast-related traumatic amputations more often maintained stable body weight (67%, 101 of 706; p = 0.03), as did those with delayed amputations (79%, 170 of 216; p < 0.01). Men younger than 20 years were more likely to gain weight (44%, 17 of 39), whereas those older than 20 years tended to maintain stable body weight (p = 0.01). Assessment of body fat composition in men after lower limb amputation demonstrated a consistent increase in fat mass proportional to the level of amputation. The increase in total fat mass was mainly attributed to subcutaneous fat accumulation. Metabolic disturbances and alterations in cardiovascular function adversely affect the effectiveness of rehabilitation measures, hinder prosthetic fitting and gait training, and ultimately reduce the overall rehabilitation potential.
422-432
Original studies
Impact of training with a 3D video-reconstruction rehabilitation system on functional recovery in early postoperative period after total knee arthroplasty
Abstract
BACKGROUND: Total knee arthroplasty is the gold standard for treating stage III–IV deforming osteoarthritis; however, in early rehabilitation, up to 20% of patients report persistent limitations in joint function, gait disturbances, and decreased quality of life. An important challenge is the integration of rehabilitation technologies that support gait recovery using augmented virtual-reality systems under conditions approximating real-life situations.
AIM: To evaluate the effectiveness of the D-Wall system (DIH S.r.l., Florence, Italy) in patients in the early rehabilitation period after total knee arthroplasty using the domains of the International Classification of Functioning, Disability and Health.
METHODS: A prospective, randomized, controlled trial was conducted with 60 patients (mean age 68.2 ± 6.5 years) after primary total knee arthroplasty at the second stage of medical rehabilitation. The main group (n = 30) received training on the D-Wall rehabilitation system in addition to a standard comprehensive rehabilitation program, while the control group (n = 30) followed standard comprehensive rehabilitation program. Functional status was assessed before the start of medical rehabilitation and after completion of a 10-day rehabilitation course.
RESULTS: Ten days after completing rehabilitation, the main group demonstrated significant improvements compared with the control group: a 42% reduction in pain intensity measured by the Visual Analog Scale (4.1 ± 1.2 points in the main group and 6.3 ± 1.5 points in the control group, p < 0.01); a 25° increase in knee flexion range of motion (115 ± 8° in the main group and 90 ± 10° in the control group, p < 0.001); a 35% increase in walking speed according to C-Mill assessment (0.92 ± 0.15 m/s in the main group and 0.68 ± 0.12 m/s in the control group, p < 0.01); and a 28% improvement in social and daily-living adaptation (p < 0.05).
CONCLUSIONS: Incorporating the D-Wall rehabilitation system with 3D video-reconstruction and biological feedback into early postoperative rehabilitation after total knee arthroplasty promotes faster recovery of motor function, gait correction, and improved quality of life.
433-444
Comparative evaluation of the effectiveness of high-intensity focused electromagnetic stimulation of pelvic floor muscles and radiofrequency exposure for treatment of female sexual dysfunction across various age groups
Abstract
BACKGROUND: Female sexual dysfunction affects patients’ quality of life. Multifactorial causes include age-related, physical, and psychological characteristics.
AIM: To evaluate the effectiveness of non-pharmacological methods for restoring sexual function in women of different age groups.
METHODS: A prospective observational study included 90 women aged over 18 years with complaints of sexual dysfunction. Patients were divided into three equal groups: reproductive age (21–46 years), perimenopausal (47–53 years), and postmenopausal (54–72 years). Each patient received non-pharmacological treatment: high-intensity focused electromagnetic stimulation of pelvic floor muscles (HIFEM therapy) using the BTL Emsella device (BTL, UK), radiofrequency lifting using the BTL EXILIS device (BTL, UK), or combined non-pharmacological exposure using both methods. Medical history, clinical and instrumental data were analyzed. Female Sexual Function Index (FSFI) and Sexual Quality of Life-Female (SQOL-F) questionnaires were assessed at baseline and 1 and 3 months after treatment.
RESULTS: Improvement in sexual function was observed in all women. HIFEM therapy demonstrated the highest effectiveness in the reproductive-age group. Radiofrequency exposure was most effective in peri- and postmenopausal women. The combined approach was more effective than each method alone. One month after therapy, FSFI > 26.55 was achieved by 18 (60%) women of reproductive age, 12 (40%) of perimenopausal age, and 5 (17%) of postmenopausal age (p = 0.003). Three months after therapy, SQOL-F > 65 was achieved by 28 (93%) women of reproductive age, 15 (50%) of perimenopausal age, and 12 (40%) of postmenopausal age, p = 0.0001. Favorable outcome factors included age <57 years, FSFI > 13.5 1 month after treatment initiation, perineometry >10.5 mmHg at 1 month, and >12.5 mmHg at 3 months.
CONCLUSIONS: HIFEM therapy has a positive effect on women’s sexual function, and its effect is maintained for three months. This course may be recommended for reproductive-age patients. Radiofrequency exposure is most effective in peri- and postmenopausal women. The combined approach was more effective than each method alone. Treatment effectiveness criteria may include age <57 years and FSFI ≥ 13.5 one month after the initiation of any type of therapy.
445-460
Changes in clinical and functional parameters in patients with vasomotor rhinitis during coblation inferior turbinate reduction combined with physical therapy
Abstract
BACKGROUND: Vasomotor rhinitis (VR) is one of the most common otorhinolaryngological disorders. Its pronounced clinical manifestations, such as nasal obstruction, cause not only physical discomfort but also psycho-emotional disturbances and social maladaptation, substantially reducing quality of life. The most effective modern treatment for VR is cold plasma surgery (coblation), which destroys the vascular network of the inferior nasal turbinate. The combined use of low-intensity laser therapy (LILT) and transcranial electrical stimulation (TES), which have a pronounced pathogenetic effect, is a promising rehabilitation technology for patients with VR after surgery.
AIM: This study aimed to evaluate the clinical efficacy of combined LILT and TES in the postoperative period following cold plasma surgery in patients with VR.
METHODS: A prospective, randomized, controlled, comparative study was conducted in 137 patients with VR who were randomly assigned to four groups. Group 1 (control, n = 34) received basic therapy (BT) alone. Group 2 (comparison 1, n = 35) underwent a course of LILT in addition to BT. Group 3 (comparison 2, n= 34) received TES in addition to BT. Group 4 (main group, n = 34) received both LILT and TES alongside BT. The efficacy of physical therapy in the postoperative period was assessed by changes in complaints, reactive inflammation, anterior active rhinomanometry parameters, and SNOT-22 score.
RESULTS: Additional physical therapy reduced the incidence of complaints in patients with VR, with the greatest improvement observed in the main group. Changes in objective parameters corroborated the changes in subjective VR symptoms. The combined use of LILT and TES resulted in the greatest improvement in anterior active rhinomanometry parameters and mucociliary transport time. Physical therapy had a positive effect on reactive postoperative inflammation of the nasal mucosa, with the greatest improvement achieved in the main group.
CONCLUSIONS: The adjunctive use of LILT and TES accelerates the regression of clinical signs of VR and improves objective functional parameters of the nasal mucosa in the postoperative period. Combination physical therapy results in a significant reduction in clinical signs and a maximum improvement in quality of life.
461-472
Gait characteristics in children with cerebral palsy
Abstract
BACKGROUND: A diagnosis of cerebral palsy presupposes the presence of motor function impairments, among which gait disturbances play a central role. The application of three-dimensional gait analysis is limited by its high cost and technical complexity. Instrumental gait analysis using inertial sensors addresses these limitations; consequently, studying the parameters derived from this method across different forms of cerebral palsy is a relevant research objective.
AIM: To investigate gait characteristics in children with different spastic forms of cerebral palsy by instrumental gait analysis using inertial sensors and to identify key pathological patterns.
METHODS: This was an observational, single-center, retrospective, census study. This study analyzed 88 gait analysis protocols from patients with confirmed cerebral palsy, collected during initial examination at the Department of Pediatric Medical Rehabilitation of the Russian Children’s Clinical Hospital between July 2021 and November 2024.
RESULTS: Instrumental gait analysis using inertial sensors identified the most significant markers of pathological gait depending on the spastic form of cerebral palsy (hemiplegia, diplegia, and tetraplegia), including compensatory changes in the non-paretic limb in hemiplegia.
CONCLUSIONS: The identified key pathological patterns are among the most important for determining priority rehabilitation targets for individuals with different spastic forms of cerebral palsy.
473-487
Changes in psychophysiological and autonomic manifestations of occupational burnout syndrome in healthcare personnel during binaural therapy
Abstract
BACKGROUND: Occupational burnout is caused by chronic work-related stress, which leads to negative consequences for physical and mental health. The most vulnerable professional group for the development of occupational burnout is healthcare personnel, whose work is associated with a high level of stress. The most promising approach to this problem is the use of non-pharmacological technologies, particularly binaural therapy, which has a positive effect on brain function by improving its functional activity.
AIM: To evaluate the effectiveness of a course of binaural stimulation in correcting clinical-functional and psychological manifestations of occupational burnout syndrome in healthcare specialists.
METHODS: A prospective, controlled, comparative, randomized study involved 80 healthcare professionals diagnosed with occupational burnout syndrome. Basic therapy, provided to all patients, included a course of physical exercises and psychological counseling. Using simple fixed randomization, all patients were divided into two groups. The first group (control group, n = 40) received basic therapy only. The second group (main group, n = 40) received a course of binaural therapy using the PRAK audiovisual complex in alpha- and theta-stimulation modes additionally to basic therapy. The efficacy of the intervention for occupational burnout symptoms was assessed based on changes in the scores of the Maslach Burnout Inventory (MBI), the Spielberger–Hanin test, and heart rate variability.
RESULTS: Treatment course was accompanied by positive changes in the evaluated indicators, the severity of which differed substantially between the groups. However, the comparative analysis demonstrated significantly greater improvement in the main group. With the course use of binaural therapy, further regression in MBI values, manifestations of state and trait anxiety on the Spielberger–Hanin test. It also induced changes in heart rate variability parameters, which clearly indicated enhanced activity of stress-limiting mechanisms. This was evidenced by normalization of the vagosympathetic interaction index and the regulatory systems activity index.
CONCLUSIONS: The course use of binaural rhythms contributes to a statistically significantly more pronounced regression in clinical-functional and psychophysiological manifestations of occupational burnout. The high therapeutic potential of binaural therapy is based on the ability of the physical factor to exert multimodal corrective action on the key pathogenic mechanisms of burnout syndrome. This action combines anti-stress and anxiolytic effects with the ability to restore vagosympathetic balance, thereby normalizing the regulatory capacity of the autonomic nervous system.
488-498
Prevention of cardiac overload in basketball players with minor cardiac anomalies using abdominal decompression: a non-randomized controlled clinical trial
Abstract
BACKGROUND: Basketball players in connection with the specifics of selection are most susceptible to overvoltage of the heart. In this regard, special attention should be paid to the development and introduction of methods into the training process that increase the adaptive capabilities of the cardiovascular system.
AIM: Establish the efficiency of using the abdominal decompression method in the training process of athletes of basketball players with small heart developmental abnormalities to reduce the risk of heart overvoltage.
METHODS: A study of the state of the cardiovascular system of 53 athletes, basketball players who are training at the FGBOU base at the National State University of Physical Culture, Sports and Health named after P.F. Lesgaft and the center of Olympic training in basketball named after V.P. Kondrashin. Together criteria: basketball players, men, acting athletes, age of 18–25 years, sports experience of at least 5 years, candidates for masters of sports. The criteria of non-inclusion are the lack of small anomalies of heart development, potentially dangerous arrhythmias at the time of the first study. Exception criteria are poor tolerance of abdominal decompression, passing of abdominal decompression procedures. Small anomalies in the development of the heart were diagnosed according to the results of echocardiography. Throughout the year, athletes of the main group (n=12) were held 6 courses of abdominal decompression. In the control group (n=12), abdominal decompression was not carried out. At the beginning of the general preparatory and beginning of the transition period, the basketball players of the control and main groups were examined, including Holter Daily ECG monitoring, the determination of myocardial antigen in the blood, the determination of cortisol and testosterone with the subsequent calculation of the anabolism index, the determination of the general and effective albumin with the calculation of the toxicity index, and the toxicity. Determination of oxidized lipoproteins.
RESULTS: Small anomalies of heart development were diagnosed in 24 (45.3%) basketball players. The high efficiency of the abdominal decompression method has been established to prevent heart overvoltage in basketball players with small heart developmental abnormalities. The main effect of abdominal decompression to increase the adaptive capabilities of the cardiovascular system and the prevention of overvoltage in basketball players is associated with a decrease in endogenous intoxication and to a lesser extent with the normalization of metabolic processes. We have not established the influence of abdominal decompression on the severity of oxidative stress. Unwanted reactions to abdominal decompression were not detected in athletes.
CONCLUSION: Abdominal decompression has the most pronounced potential for use by athletes with small anomalies of heart development to reduce endogenous intoxication and normalize the ratio of catabolic and anabolic processes. Against this background, there is an increase in the adaptation of the cardiovascular system of basketball players to training and competitive loads, expressed in a decrease in the risk of heart overvoltage.
499-508
Rationale for the use of a fifth-generation multisymbiotic in medical rehabilitation of patients with post-acute COVID-19 syndrome
Abstract
BACKGROUND: Post-acute COVID-19 syndrome poses a major healthcare challenge, affecting 20–55% of COVID-19 convalescents. Persistent post-infectious dysfunction of multiple organ systems has demonstrated strong association with gut dysbiosis, which results both from the direct cytopathic effects of the virus and from the iatrogenic pharmacotherapy impact on the gut microbiota. Therefore, the use of probiotics to modulate the composition and function of the gut microbiota may be an important component of rehabilitation, aimed at minimizing disease severity and accelerating the regression of clinical manifestations.
AIM: To establish the clinical and laboratory rationale for incorporating the fifth-generation multisymbiotic VedaBiotic into comprehensive medical rehabilitation for patients with post-acute COVID-19 syndrome.
METHODS: This was a clinical, open-label, prospective, comparative randomized controlled study, involving 128 patients with post-acute COVID-19 syndrome. The rehabilitation program for patients in the control group (group I, n = 64) included therapeutic exercise, classic manual thoracic massage, dry carbon dioxide baths, pulsed electrostatic therapy to the chest using the Hivamat device, and biofeedback (BFB)-assisted respiratory training, performed as 9 daily sessions. Patients in the main group (group II, n = 32) additionally received oral fifth-generation multisymbiotic VedaBiotic, 2 capsules once daily after breakfast. Medical rehabilitation efficacy was assessed by changes in clinical symptoms and relevant laboratory inflammatory markers.
RESULTS: The study demonstrated that adding an oral fifth-generation multisymbiotic into the rehabilitation program results in a pronounced anti-inflammatory and antithrombotic effect, optimizes lipid peroxidation and antioxidant defense systems, and ensures a significant regression of clinical manifestations.
CONCLUSIONS: The developed and scientifically substantiated rehabilitation technology for individuals with post-acute COVID-19 syndrome has demonstrated high safety and efficacy. Its future application could extend beyond this specific syndrome to other acute infections that can induce post-infectious dysfunction of various organ systems.
509-518