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Current conditions of military service demand higher standards of servicemen health status, whose professional activity in extreme combat conditions is accompanied by the impact of many adverse environmental factors on the body. One of the priority tasks of medical service of Armed Forces of the Russian Federation in 2023 yr. is to improve the system of curative and preventive measures in medical and medical psychological rehabilitation to recover health and increase working capacity of servicemen. The article includes an overview of measures given to servicemen for medical and medical psychological rehabilitation in sanatorium-resort organizations of Ministry of Defence in the Russian Federation for the period from 2013 to 2022 yrs.

The concept of the personalized rehabilitation is based on the principle of applying physical and rehabilitative medicine techniques depending on the factors that mostly influence on rehabilitation efficacy in a particular patient - determinant of effectiveness. Current achievements in the diagnosis and treatment of breast cancer (BC) significantly increased overall patients' life expectancy, updating rehabilitative treatment stage, which is often unmet., Objective: To perform the comprehensive analysis of the efficacy of personalized rehabilitation programs in patients with BC., Material and Methods: The combined comparative multi-centre randomised trial of rehabilitation program efficacy in patients with breast cancer was done. The study included 219 patients aged from 30 to 45 years (median 39.4 year), who were divided into 2 groups. The rehabilitation by programs, that included current personalized rehabilitative techniques (RT) with proved efficiency, based on scientometrical analysis of evidential research was performed in the first group patients. In the second group aftercare was done according to the standard programs. The comprehensive evaluation of treatment efficacy was conducted in several stages: 1) performance analysis of rehabilitative programs; 2) verification of the effectiveness' determinant of rehabilitation; 3) factor analysis to assess the mechanisms of therapeutic effects in experimental groups; 4) comparative analysis of alternative strategies for selecting rehabilitation programs., Results: The use of rehabilitative programs, based on recommended RT, changes the rehabilitation structure, significantly increasing its efficacy by 17%. Furthermore, the percentage of high-efficiency usage of this type programs increases by 17% compared with standard programs. The main determinants, affecting the efficacy of rehabilitation programs, based on selected RT, are anamnestic data, parameters of exercise tolerance and physical activity and ultrasound parameters of upper limb blood flow. The therapeutic effects of personalized rehabilitation programs are realized by correction of clinical rates, increasing exercise tolerance and physical activity, as well as psychophysiological parameters., Conclusion: The use of the evaluation system of anamnestic, clinical, functional and psychophysiological features of patient (the effectiveness' determinant) in realization of personalized rehabilitation programs for women with BC, allows to predict and manage the efficacy of RT applying.

Improving the medical and psychological rehabilitation system is a priority area for restoring the military personnel's working capacity and combat capabilities after fulfilling special tasks. Changes in the psychoemotional state due to significant psychic and emotional tension can cause mental impairments, which has negative impact not only on military personnel themselves, but also on their combat working capacity. The article presents an overview of forms and methods of medical and medical-psychological rehabilitation used in sanatorium-resort organizations of the Ministry of Defence of the Russian Federation.

Treatment and rehabilitation of patients with upper limb spasticity remains a challenging task that still does not have standard, widely accepted methods. The specific instruments used to measure the impact of spasticity on everyday life occupy an important place in the measurement of treatment effectiveness. The article presents scales and tests used to access the impact of spasticity and paresis on the arm activity. LASIS has been translated into Russian by the authors. The clinical case of treatment of arm muscle spasticity with the botulinum neuro toxin and its assessment with MRCS, MAS, Tardie, LASIS, Frenchai, Bartel, Rankin scales are presented. It provides the unique algorithm for measurement of muscle spasticity in forearm and wrist.

Background: In recent decades, the volume of high-tech medical care in the field of orthopedics and traumatology, including endoprosthetic replacement of major joints (MJs) (the hip joint and/or the knee joint) in the lower extremities (LE) (LEMJ), has substantially increased. In this connection, there are an increasing number of patients in need of medical rehabilitation, to solve the problems of which needs the effective physical and rehabilitation medicine (PRM) techniques proven during researches to be introduced into practice., Objective: To analyze evidence-based studies containing sound data on the use of PRM technologies in the rehabilitation of patients after endoprosthetic replacement of LEMJs, to identify the most effective PRM technologies and to formulate recommendations for their use for practitioners, which are based on the evidence obtained during the analysis., Material and Methods: The paper is based on the scientometric analysis of 241 studies conducted in 2000 to 2018, which were devoted to the use of physical exercises and PRM technologies in the rehabilitation of patients after endoprosthetic replacement of LEMJs., Results: Over the past decade, there has been a tangible rise in the number of studies on endoprosthetic replacement of LEMJs. Some of the most studied PRM technologies having the proven effect are physical exercises in combination with neuromuscular electrical stimulation, kinesiotherapy, cryotherapy, and pressure therapy that is effective in preventing thromboembolism after surgery., Conclusion: The use of PRM technologies in the rehabilitation of patients after endoprosthetic replacement of LEMJs should be based on the results of high-quality randomized controlled clinical trials, which serve as the basis for the development of clinical recommendations. The process of analyzing the data of studies should be regular.

It presents historical aspects of the organization of sanatorium-and spa industry and the current state andof the system of sanatorium treatment of servicemen of the Armed Forces. The paper presnts the analysis of the results of the military resorts to organize and conduct spa treatment personnel. The causes of decline of satisfaction with the qualityof personnel provided services in sanatoriums. The main directions of development of the military sanatorium complex are determined.

The physico-chemical characteristic of medicinal preparations used for the treatment of various bladder diseases is provided including their electrophoretic activity and the ability to penetrate into bladder tissues, e.g. during electrophoresis. The optimal parameters of intracavitary electrophoresis are considered.

We studied the dependence of climatotherapy effectiveness in patients with chronic heart failure (functional classes 0-II) on Ca(2+)-ATPase, phospholamban, beta1-adrenoceptor, and insulin-like growth factor 1 gene polymorphisms and possible interaction of these genes during the realization of the effect of climatotherapy. The effectiveness of climatotherapy depended on polymorphism of the studied genes; the maximum effect was attained in patients with the GG polymorphism of the Ca(2+)-ATPase gene, GT polymorphism of the phospholamban gene, ArgGly polymorphism of the beta1-adrenoceptor gene, and 19/19 polymorphism of the insulin-like growth factor 1 gene. We demonstrated additive interaction of Ca(2+)-ATPase and beta1-adrenoceptor genes during the realization of the cardiotonic effect of climatotherapy.

The aim of our study was to estimate clinical effects of spa therapy (ST) at Sochi-Macesta resort in patients with heart failure (HF). Spa therapy was given to 116 patients with HF functional class (FC) 0-II by NYHA classification. It is shown that ST leads to improvement of the patients' clinical status, reduction of HF FC (from 1.32 +/- 0.09 to 0.66 +/- 0.01, p < 0.001), to increased exercise tolerance (p < 0.05) and better 6-minute walk test results (from 460.3 +/- 11.4 m to 511.2 +/- 11.8 m, p < 0.01), higher myocardial coronary reserve, favourable shifts in blood pressure. ST also has a cardiotonic effect and corrects vegetative status, there was also antiatherogenic effect and an increase in blood coagulation potential. The received data allow us to conclude that ST can be an effective tool of medical rehabilitation in patients with initial stages of heart failure.