Abstract Spinal dysraphism (SD) or spina bifida (SB) is a congenital deformity that results from embryonic neural tube closure failure during fetal devel- opment. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. This paper aims to evaluate the role of the physical and rehabilitation medicine (prM) physician and prM practice for children and adults with spinal dys- raphism. a systematic literature review and a consensus procedure involved all European countries delegates represented in the uEMs prM sec- tion through a delphi process. the systematic literature review is reported together with thirty-two recommendations resulting from the delphi procedure. The professional role of the PRM physician requires specific expertise in the treatment of patients with SD to plan, lead and monitor the rehabilitation process in an interdisciplinary setting and to participate in the assessment of the needs of these patients in the transitional phase from childhood to adulthood, with particular attention to the activity limitation and participation restriction.

(Cite this article as: petronic Markovic i, Nikolic d, stahl M, tederko p, hdyrya o, Negrini s, et al. Evidence-based position paper of the uEMs prM on the role of physical and rehabilitation Medicine (prM) physician in the management of children and adults with spinal dysraphism. Eur J phys rehabil Med 2022;58:511-9. doi: 10.23736/s1973-9087.22.07536-0)

Key words: spinal dysraphism; rehabilitation; physical and rehabilitation medicine; Guideline adherence; consensus.

Abstract  

Background. The article deals with the effect of physical therapy on students with vertebral artery functional compression syndrome. Constant stable flexion of the cervical spine is one of the functional factors that can cause deformation of the vertebral arteries and, as a consequence, to reduce blood flow through these arteries

The purpose of the research is to define the effect of physical therapy on vertebral artery functional compression syndrome caused by a violation of biomechanics in the cervical spine.

Material and methods. The research involved 24 students aged 18 to 23 years old. The research used the following methods: theoretical analysis and generalization of reference sources on the topic of scientific research, clinical evaluation of vegetative disorders with a questionnaire for determining signs of vegetative changes by O. M. Vein, comprehensive ultrasound examination of the head and neck blood vessels, goniometry of the cervical spine and mathematical statistics.

Results. Physical therapy helped to restore the volume of active movements in the cervical spine (p<0.05). The disappearance of the main symptoms was noted by an average of 74% of respondents, and the rest noted their decreased character. Peak systolic blood flow velocity in the vertebral arteries when performing functional tests increased (p <0.05).

Discussion. The positive results were achieved, probably due to the normalization of anatomical and functional interconnections in the cervical spine, stimulation of its reparative capabilities via manual therapy, namely post-isometric muscle relaxation.

Conclusions. The research results show that the use of physical therapy for patients with vertebral artery functional compression syndrome helps to reduce the clinical manifestations of the disease, restore proper spinal biomechanics and improve blood flow in vertebral arteries.

Key words: physical therapy, vertebral artery functional compression syndrome, post-isometric muscle relaxation, biomechanics of the cervical spine, goniometry of the cervical spine, ultrasound examination of the vertebral arteries.  

УДК 534.05:616-008.842/.848

The ever-increasing harmful effect of endo- (products of inflammatory processes of genital tissues) and exogenous factors (environmental conditions) on the body of women and animals (cows) leads to a substantial decrease in ova fertilisation during mating and artificial insemination. Therefore, the purpose of this study was to identify changes in the signs of physical condition (colour, consistency, fluidity, impurities, etc.) and ratios (homeostasis) of H2O mass, organic (OS) and inorganic (IS) substances of uterine-vaginal mucus (UVM) should be used to assess their harmful effect on the fertilisation of cows after their first insemination. The following methods were used for this study: ocular estimate of the physical condition of freshly obtained mucus; gravimetric assessment of the features of changed mass parameters of its dry residue (DR) components; mathematical and statistical analysis of certain indicators. Determined by the gravimetric method, the features of the imbalance of mass (g, mg), its distribution (%) and ratios (Im:1, Ic:1) in the system of the “medium — substance” type due to the harmful effects of endogenous factors (products of inflammatory processes) indicate that the secretions of the genitals released during oestrus are characterised not only by changes in signs, but also ±2-4 times different from the norm (control) indicators of the mass of components. Under such circumstances, the distribution of substances in the DR samples of the experimental group is expressed by the series, where the mass OS1˃IS˃OS2, but in the control group — OS1˃IS˃OS2. This means that the products of inflammatory processes released by the genitals of cows change the norm of homeostasis of the mass (distribution of components) of OS and IS of the biological system of the “medium — substance” type. Indicators of the obtained mass ratios between component pairs H2O: DR; H2O: OS2, H2O: OS1,H2O: IS (control group — 63:1, 586:1, 231:1, 109:1; experiment group — 42:1, 310:1, 87:1, 112:1), except for the H2O: IS pair (P˂0.05), indicate the presence of probable changes in the homeostasis of OS and IS in the “H2O — components” system. The high probability (P˂0.02; ˂0.001) of the detected changes is inherent in the “DR –components” system, namely: if the average ratio indicators of pairs DR: OS2; DR: OS1; DR: IS samples of the control group are 9:1, 4:1, 2:1, then the same indicators in the experimental group are 7:1, 3:1, 2:1, respectively

 Introduction. Almost all patients, who have experienced acute manifestations of COVID-19, regardless of the severity of the acute phase of the disease, are only at the beginning of a long way to recovery. According to experts, SARS-CoV-2 infection should affect almost 80% of the world's population, so all these patients to a greater or lesser extent will need a rehabilitation of certain manifestations of postcovid syndrome.

Purpose: to study the effectiveness of rehabilitation program and the dynamics of cognitive impair- ment and manifestations of chronic fatigue syndrome in patients after coronavirus disease.

Methods: The study design included 60 patients after SARS-Cov-2 infection. Among the examined patients there were 26 (43,3%) women and 34 (56,7%) men. An average age of the patients was 43,9±1,08 years. Patients were referred to the Department of Physical Rehabilitation after corona- virus disease with chronic fatigue and cognitive disorders syndromes. Accordingly, all patients, who participated in the study, were divided into two groups: group I - 28 patients with a general condition of moderate severity at the hospital stage and 32 patients - group II, with severe course of the disease and oxygen demand at the hospital stage. Depending on the duration of rehabilitation, two observation periods were used - on the 7th and 14th day of rehabilitation program.

Results: It has been proven, that patients, who didn’t need oxygen, were complaining about anos- mia, cephalgia, cognitive impairment, increased anxiety and fatigue. Dysgeusia, dyssomnia, and depression were more common in patients, requiring oxygen therapy at the hospital stage. Rehabil- itation program eliminated cognitive dysfunction, depression, cephalgia, drowsiness and dyssom- nia on the 7th day in patients, who did not require oxygen therapy (p>0,05), and in patients, who needed oxygen therapy - on the 14th day of the rehabilitation program (p>0,05). However, 2 (6,3%) and 3 (9,4%) patients, who needed oxygen therapy, even after 14 days of rehabilitation had mani- festations of minor recurrent headache and drowsiness.

Conclusion: Thus, patients after coronavirus disease, who needed oxygen therapy at the hospital stage, need long-term rehabilitation program.  
Keywords: postcovid syndrome, anxiety, depression, drowsiness, rehabilitation 

УДК 616.311.2+616.314.17.) – 06:616.1/.4] -036

The purpose of the study was to investigate the influence of concomitant somatic pathology on periodontal tissues.
Materials and methods. 104 patients, aged 28–46 years, with diseases of periodontal tissues, who had somatic pathology, were involved in the study. The examined persons were divided into groups: 35 persons (group 1) with pathology of the hepatobiliary system, 37 persons (group 2) with pathology of the gastrointestinal tract, and 32 persons (group 3) with pathology of the cardiovascular system.
The comparison group included 30 people with periodontal tissue diseases without somatic pathology.
To determine the depth and prevalence of the inflammatory process of the gums the Svrakov’s number indicator was used. Oral hygiene was assessed according to the Silness-Loe and Stallard indices. The papillary-marginal-alveolar index (C. Parma, 1960) was determined to assess the severity of gum inflammation. 
Bleeding gums were assessed by the gum’s papilla bleeding index according to Muhllemann. Statistical processing of the research results was carried out with a computer program for variational and statistical analysis of medical and biological research data “GraphPad Prism 5”.
Results and discussion. Patients with diseases of periodontal tissues against the background of somatic pathology had the highest percentage of chronic generalized periodontitis of the II degree, in contrast patients of the comparison group had the highest percentage of chronic generalized periodontitis of the initial – I degree.
Svrakov’s number in patients with periodontal disease against the background of somatic pathology significantly (р ˂0.05) exceeded the indicators of patients of the comparison group. At the same time, there is no significant difference between the results of groups 1, 2 and 3.
The highest values of the indexes of Silness-Loe and Stallard were recorded in patients with the cardiovascular system pathology, which significantly (p<0.05) exceeded the data in the comparison group, but did not significantly differ from the results of patients with pathology of hepatobiliary system and gastrointestinal tract.
The papillary-marginal-alveolar index data were the highest in patients with hepatobiliary system pathology (64.25 ± 8.19%), which significantly (p<0.05) exceeded the results of the comparison group and in individuals of groups 2 and 3.
The highest indicator of the bleeding index is 1.98 ± 0.22 points in patients of the 1st group, which significantly exceeds the indicators in the group of people without somatic pathology and in the group of patients with pathology of gastrointestinal tract and cardiovascular system.
Conclusion. The conducted studies show that the presence of somatic pathology contributes to the development of periodontal tissue diseases, and certainly aggravates their course, which is proven by the results of the index assessment.
Keywords: periodontitis, somatic pathology, periodontal indices.