Medical and psychological rehabilitation of patients with functional asthenia: determinants of effectiveness


Sobolev A.V., Ponomarenko G.N., Grigoriev S.G.

1) Sanatorium and resort complex “Podmoskovye”, Moscow, Russia; 2) Federal Scientific and Educational Center for Medical and Social Expertise and Rehabilitation n.a. G.A. Albrecht, St. Petersburg, Russia; 3) North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia; 4) S.M. Kirov Military Medical Academy, St. Petersburg, Russia
Background. The multicomponent pathogenesis of functional asthenia requires the selection of a set of effective rehabilitation technologies, which is possible based on an analysis of the mechanisms of their therapeutic action. It is urgent to search for technologies that determine a favorable prognosis for medical and psychological rehabilitation (MPR) of patients with functional asthenia (FA), determinants of effectiveness.
Objective. Assessment of the determinants of the effectiveness of MPR in patients with FA.
Methods. 24 patients aged 29.3 (21.5–35.0) years with FA (ICD-10 code R53) were examined. The patients were prescribed a set of physical exercises, a course of audiovisual polysensory relaxation, carbon dioxide baths, climatotherapy, therapeutic nutrition and psychotherapy. The total duration of the course was 30 days. To determine the relationship between integral health parameters and individual clinical and functional signs of maladaptation, a correlation analysis was carried out; canonical correlation analysis was used for the selection of the most informative signs; and for the prediction of adaptive potential values, regression analysis with step-by-step selection of the most significant signs (determinants) into the model was applied
Results. A decrease in signs of asthenia, an increase in the oxygen capacity of tissues, adaptation reserves, the level of somatic health and physical performance in patients with FA were revealed. Average correlations between improvements in adaptive potential and physical performance with instrumental and psychophysical indicators have been established. The effectiveness of MPR in patients with FA was 75%. Determinants of effectiveness included indicators characterizing the level of physical health, systolic blood pressure, age, strength index, post-exercise recovery rate, specific value of pulmonary capacity, and oxygen consumption level.
Conclusion. Various components of the pathogenesis of FA determine the choice of different physical treatment methods, and the combination of mechanisms of their therapeutic action determines the high efficiency of the final result of MPR in patients with FA.

About the Autors

Corresponding author: Andrey V. Sobolev, Cand. Sci. (Med.), Head of the Sanatorium and Resort Complex “Podmoskovye”, Moscow, Russia;

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