Assessment of the role of bioclimatic conditions in the resort of the southern coast of Crimea in effective syndrome-oriented medical rehabilitation in cardiovascular and broncho-pulmonary diseases

Authors:

Mizin Vladimir Ivanovich, Grand PhD in Medical sciences, Associate Professor, head of the Research Department of Physiotherapy, Medical Climatology and Resort Factors of the Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, e-mail: yaltamizin@mail.ru; ORCID: 0000-0001-9121-8184.

Yarosh Alexander Mikhailovich, Grand PhD in Medical sciences, Associate Professor, leading researcher of the Research Department of Physiotherapy, Medical Climatology and Resort Factors, Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, tel.: (3654) 23-51-91, e-mail: niisechenova@mail.ru; ORCID: 0000-0002-1785-2571.

Ivashchenko Alexander Sergeevich, Honored Doctor of the Republic of Crimea, researcher of the Research Department of Physiotherapy, Medical Climatology and Resort Factors of the Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, tel.: (3654) 23-51-91, e-mail: niisechenova@mail.ru; ORCID: 0000-0002-8869-9359.

Yanovskiy Taras Sergeevich, PhD in Medical sciences, senior researcher of the Research Department of Physiotherapy, Medical Climatology and Resort Factors of the Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, e-mail: taras.yanovsky@yandex.ru; ORCID : 0000-0002-8516-7015.

Ezhov Vladimir Vladimirovich, Grand PhD in Medical sciences, Professor, Deputy Director for Scientific Work of the Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, e-mail mail: atamur@mail.ru; ORCID: 0000-0002-1190-967X.

Dudchenko Leyla Shamilevna, Grand PhD in Medical sciences, head of the Research Department of Pulmonology of the Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, e-mail: vistur@mail.ru; ORCID: 0000-0002-1506-4758.

Ezhova Lyudmila Valentinovna, PhD in Medical sciences, senior researcher, Research Department of Neurology and Cardiology, Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after V.I. I.M. Sechenov, 10/3 Mukhina Str., 298603 Yalta, Republic of Crimea, Russian Federation, tel.: (3654) 23-51-91, e-mail: niisechenova@mail.ru; ORCID: 0000-0002-0530-6311.

Annotation:

Introduction. The International Classification of Functioning, Disability and Health (ICF) provides an assessment of the patient’s functional state and the influence of environmental factors on him, including climate (assessed by the second level domain e225) and the meteorological factors that form it (estimated by the fourth level domains e2250-e2258).

Aim. Evaluation of the influence of bioclimatic conditions of the South Coast of Crimea (SCC) resort on the effectiveness of syndromically oriented health resort medical rehabilitation (MR) in broncho-pulmonary diseases (BPD) and cardiovascular diseases (CVD).

Materials and methods. A randomized clinical study ware conducted in groups of 197 patients with BPD, 216 patients with cerebral atherosclerosis (CA), 134 patients with arterial hypertension (AH), and 276 patients with coronary artery disease (CCD). The methods of diagnosis and treatment were used in accordance with the standards for the provision of health-resort care to patients, supplemented by psychological examination and assessment of the quality of life (tests by Reeder, Beck, Spielberger-Khanin, SF-36). The climatic and meteorological characteristics of the SCC climate were recorded according to the observations of “Krymhydromet” (station No. 4453420) in 2018-2019. The assessment according to the ICF criteria of climatic and meteorological factors of the SCC climate (6 domains were assessed) and the functional state of patients (20 domains were assessed) was carried out in accordance with the methods developed at the “Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov”.

Results and discussion. The average values of the e2250-e2258 climatic domains for the SCC resort by the seasons of the year have been obtained. Reliable correlation effects have been established and 64 reliable regression equations for the dynamics of the values of functional domains from climatic-meteorological domains have been formulated. Biotropic effects of climatic and meteorological parameters make a multidirectional contribution to the effectiveness of MR at the South SCC resort, depending on the nosological form of diseases. Regression equations make it possible to predict changes in the patient’s functional state on the basis of meteorological forecast or information about stable meteorological characteristics during the MR period.

Summary. The effects of climatic and meteorological parameters are universal; therefore, it is important to take into account the biotropic effect of climate when routing MR at all stages of medical care. The dynamics of the values of the climatic domains (e225, e2250, e2251, e2252, e2254, and e22581), typical for the SCC climate, distinguishes the conditions of the external environment of the resort from other localities of Russia, which provides a basis for the preferable MR of patients with AH and CA in health resorts on the Southern coast of Crimea, mainly in the warm season. The dynamics of climatic and meteorological parameters on the SCC provides effective MR in BPD and CAD throughout the year, but the summer season, with high air temperature, is the least indicated for patients with CAD, while cardiac health resorts must have indoor air conditioning.

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