Elena Yuryevna Mozheyko

INTRODUCTION. Speech disorders such as aphasia and dysarthria often occur in patients after a stroke. They are considered second only to motor disorders in terms of severity. Aphasia is one of the most common speech disorders. Due to the vast size of Russia, there are remote communities without qualified speech therapists to restore lost speech function. AIM. To study the available scientific data on the effectiveness of motor aphasia recovery in patients who have suffered ischemic stroke in a remote format. MATERIALS AND METHODS. We searched for publications, including 6 meta-analyses, 39 full-text and 16 review publications in Russian and English in the eLIBRARY.RU, PubMed, and Springer Nature Link databases. The search period for publications on remote rehabilitation methods for stroke patients with complex motor aphasia was five years, from January 2020 to February 2025. The review also included a number of earlier seminal works on speech recovery in patients after stroke with complex motor aphasia. Key words in Russian and English are as follows: stroke, complex motor aphasia, rehabilitation, telemedicine, remote format. RESULTS AND DISCUSSION. Remote patient management in the rehabilitation of motor aphasia is becoming increasingly necessary. This article analyzes available data on the effective use of remote methods for the rehabilitation of patients with motor aphasia. CONCLUSION. Telemedicine technologies and mobile applications represent a promising area in remote rehabilitation of patients after ischemic stroke with motor aphasia.

INTRODUCTION. The new coronavirus infection COVID-19 has had a significant impact on the health of populations around the world, causing not only respiratory symptoms, but also a wide range of systemic disorders, including autonomic dysfunction. The autonomic nervous system plays a key role in regulating vital body functions such as heart rate, blood pressure, respiration and metabolism. Disorders of the autonomic nervous system can lead to serious health consequences, including chronic fatigue, orthostatic hypotension, tachycardia and other symptoms that can markedly impair the quality of life of patients. AIM. To analyze the available scientific data on autonomic nervous system dysfunction in long COVID patients, its possible pathophysiological mechanisms of development and potential methods of correction. MATERIALS AND METHODS. We have searched for full-text publications in Russian and English over the past four years in eLIBRARY.RU, PubMed, Web of Science databases using the keywords: autonomic dysfunction, SARS-CoV-2, orthostatic insufficiency, COVID-19, long COVID. RESULTS AND DISCUSSION. The review examines in detail the pathophysiological mechanisms of autonomic dysfunction in long COVID patients. The clinical manifestations and approaches to its correction are considered. To date, many symptoms of autonomic dysfunction have been identified in long COVID patients. CONCLUSION. The analyzed studies indicate the presence of a causal relationship between the new coronavirus infection COVID-19 and the symptoms of autonomic dysfunction. However, it is necessary to further study the pathophysiology and characteristics of the spectrum of symptoms of autonomic dysfunction associated with COVID infection, to understand its natural course, to optimize treatment and rehabilitation measures based on a personalized approach.

Objective of the Review: To summarise the data from literature sources on respiratory rehabilitation of patients with the novel coronavirus infection; to assess the current state and perspectives. Key Points. The novel coronavirus infection (COVID-19) is a highly contagious acute respiratory disease with primary involvement of upper and lower respiratory tract, organs and systems of the body. The symptoms of the disease vary from asymptomatic carrier to clinically severe viral pneumonia that requires oxygen therapy and respiratory support. Respiratory rehabilitation is vital for patient recovery. Globally, there is more and more professional information and databases on respiratory rehabilitation of COVID-19 patients, since the common methods of rehabilitation after a respiratory disease can be ineffective or unsafe. Conclusion. Respiratory rehabilitation should be an integral part of COVID-19 therapy, starting from ICU once the patient’s condition has stabilised. Rehabilitation should be personalised. Future studies will help in understanding the development path of pulmonary rehabilitation in order to improve the quality of patients’ life and to facilitate faster activity restoration. Keywords: rehabilitation, respiratory rehabilitation, coronavirus infection, COVID-19, breathing exercises.

The review assesses physical exercises as an additional non-pharmacological mean of combating the progression of primary open-angle glaucoma. The ophthalmic hypotensive effect is determined by the type of exercise, its duration and intensity. Moderate aerobic activity is preferred. Among dynamic exercises, jogging has the greatest hypotensive effect. Upper body isometric resistance training provides a more lasting decrease in ophthalmotonus. The decrease in intraocular pressure (IOP) in patients with glaucoma is several times more pronounced in comparison with healthy people and occurs regardless of the nature of the local drug antihypertensive therapy. After the termination of classes IOP returns to the previous level on average within a month. An increase in ocular perfusion pressure associated with physical activity dictates the appropriateness of physical exercise for patients with pseudo-normal pressure glaucoma. The combination of hypotensive, vascular, neuroprotective effects of physical activity with a high level of physical fi tness does not exclude a decrease in the risk of development and progression of primary open-angle glaucoma. The development of indications for the use of physical activity by patients with advanced glaucoma, including those who have undergone hypotensive surgery, remains relevant. The type, intensity, dosage and mode of performing the recommended physical exercises require an individual choice.

The International Classification of Functioning, Disability and Health (ICF) is a globally recognized classification for health components and health-related factors, which has been recommended by the World Health Organization for use in medical rehabilitation. In the practice of a rehabilitation doctor dealing with patients suffering from juvenile myoclonic epilepsy (JME), the ICF is used to establish a rehabilitation diagnosis and formulate the goal of rehabilitation, as well as to implement its basic principles. It provides better insight into a range of difficulties patients with JME might face at the level of personal health and in everyday life.

A review of the literature is devoted to the problem of complications after arthroscopic reconstruction of the anterior cruciate ligament. The authors covered questions of epidemiology and surgical technique, touched on important aspects of the main complications, such as graft damage, arthrofibrosis and impingement syndrome, the formation of synovial cysts, infections, the development of osteoarthritis and cartilage degeneration. Despite the prevalence of pathology, a huge number of publications and the development of arthroscopic surgery, there are many theoretical and technical problems, that have not yet found a satisfactory solution and require further development. A relevant question for the doctor is the problem of correctly choosing the method or combination methods for anterior cruciate ligament reconstruction in relation for each patient, considering the individual characteristics and possible risks of developing different complications in patient.

Regular physical activity in cyclic sports can influence the so-called “angiogenic switch”, which is considered as an imbalance between proangiogenic and anti-angiogenic molecules. Disruption of the synthesis of angiogenic molecules can be caused by local changes in tissues under the influence of excessive physical exertion and its consequences, such as chronic oxidative stress and associated hypoxia, metabolic acidosis, sports injuries, etc. A review of publications on signaling pathways that activate and inhibit angiogenesis in skeletal muscles, myocardium, lung, and nervous tissue under the influence of intense physical activity in cyclic sports. Materials: We searched PubMed, SCOPUS, Web of Science, Google Scholar, Clinical keys, and e-LIBRARY databases for full-text articles published from 2000 to 2020, using keywords and their combinations. Results: An important aspect of adaptation to training loads in cyclic sports is an increase in the number of capillaries in muscle fibers, which improves the metabolism of skeletal muscles and myocardium, as well as nervous and lung tissue. Recent studies have shown that myocardial endothelial cells not only respond to hemodynamic forces and paracrine signals from neighboring cells, but also take an active part in heart remodeling processes, stimulating the growth and contractility of cardiomyocytes or the production of extracellular matrix proteins in myofibroblasts. As myocardial vascularization plays a central role in the transition from adaptive heart hypertrophy to heart failure, further study of the signaling mechanisms involved in the regulation of angiogenesis in the myocardium is important in sports practice. The study of the “angiogenic switch” problem in the cerebrovascular and cardiovascular systems allows us to claim that the formation of new vessels is mediated by a complex interaction of all growth factors. Although the lungs are one of the limiting systems of the body in cyclic sports, their response to high-intensity loads and other environmental stresses is often overlooked. Airway epithelial cells are the predominant source of several growth factors throughout lung organogenesis and appear to be critical for normal alveolarization, rapid alveolar proliferation, and normal vascular development. There are many controversial questions about the role of growth factors in the physiology and pathology of the lungs. The presented review has demonstrated that when doing sports, it is necessary to give a careful consideration to the possible positive and negative effects of growth factors on muscles, myocardium, lung tissue, and brain. Primarily, the “angiogenic switch” is important in aerobic sports (long distance running). Conclusions: Angiogenesis is a physiological process of the formation of new blood capillaries, which play an important role in the functioning of skeletal muscles, myocardium, lung, and nervous tissue in athletes. Violation of the “angiogenic switch” as a balance between proangiogenic and anti-angiogenic molecules can lead to a decrease in the functional resources of the nervous, musculoskeletal, cardiovascular, and respiratory systems in athletes and, as a consequence, to a decrease in sports performance.

There is currently no approved list of vascular cognitive impairment biomarkers. The main problem for the practitioner in identifying cognitive impairment in patients is the differential diagnosis of Alzheimer's disease, vascular cognitive impairment, and other diseases, which are much less common. Vascular cognitive impairment includes post-stroke dementia, cognitive dysfunction in cardio-and cerebrovascular diseases. Without etiology identification, it is impossible to prescribe adequate treatment. Another challenge is identifying cognitive impairment before dementia develops. This literature review is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive impairment and the establishment of markers of moderate cognitive dysfunction. The papers were searched for in the Web of Science and PubMed databases. A list of cerebrospinal fluid, plasma, serum and genetic biomarkers was made, allowing for differential diagnosis between vascular impairment and Alzheimer's disease. The markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the pre-dementia stage, were also identified.

In spite of recent significant advances in reduction of mortality and disability, coronary heart disease (CHD) remains widespread both in Russia and around the world. Coronary bypass graft surgery (CABG) has proved to be the most effective method of CHD treatment, providing that conservative therapy is not effective enough. The aim of the present study was to reveal and correct postoperative cognitive dysfunction (POCD), developed under the conditions of cardiopulmonary bypass (CB) in patients with CHD within 12 months after CABG. A total of 87 patients were examined, all the patients underwent a course of drug therapy, 50 patients underwent a course of rehabilitation using computer-based stimulation programmes (once per day for 20 minutes within 10 days) in addition to medical therapy. A reliable improvement in results of the conducted research suggests that the proposed method provides safety and high performance in cognitive rehabilitation of patients with impairments of the higher brain functions after CABG. A relatively short course of rehabilitation (10 days) corresponded to the length of hospital stay of patients in the cardiac unit. However, even in such a short course we could obtain significant advantage in terms of efficiency of higher cortical functions recovery. Therefore, a course of rehabilitation using computer-based stimulation programmes in patients with coronary heart disease after CABG was proved to be an effective way of correcting cognitive function.