This work aimed to study the recovery of consciousness during forced awakening from slow-wave sleep (SWS) and rapid eye movement sleep (REM) in healthy volunteers. To track the changes in the degree of awareness of the stimuli during the transition to wakefulness, event-related potentials (ERPs) and motor responses (MR) in the auditory local-global paradigm were analyzed. The results show that during awakening from both SWS and REM, first, alpha-activity restores in the EEG, and only 20 and 25 s (for REM and SWS awakenings, respectively) after alpha onset MR to target stimuli recovers. During REM awakening, alpha-rhythm, MR, and conscious awareness of stimuli recover faster than during SWS awakening. Moreover, pre-attentive processing of local irregularities emerges earlier, even before alpha-rhythm onset, while during SWS awakening, the local effect we registered only after alpha restoration. The P300-like response both on global and local irregularities was found only when accurate MR was restored. Thus, the appearance in EEG predominating alpha-activity is insufficient either for conscious awareness of external stimuli or for generating MR to them. This work may help to understand the pathophysiology of sleep disorders well as conditions characterized by the dissociation between behavior and various aspects of consciousness.

Objective. The purpose of this study is to evaluate the effectiveness of using the EMW MED deep electromagnetic tissue stimulation system in the comprehensive rehabilitation of patients in the early postoperative period after TEKS. Material and methods. A prospective, randomized, controlled study was conducted involving 30 patients (15 in each group) hospitalized after TKA surgery. The main group received a comprehensive rehabilitation program, including therapeutic exercise classes and a course of electromagnetic stimulation procedures on the deep «EMW MED» device (low-intensity mode: 150 Hz, 40–60 mT, 10 minutes, a course of 10 daily procedures). In addition to therapeutic gymnastics, patients in the control group received magnetic therapy using the Almag+ device (50 Hz, 20–30 mT, 15 minutes, a course of 10 daily procedures). The dynamics of the patients’ condition were assessed at three time points (the 1st, 5th, and 10th days) using the following parameters: pain syndrome — using the visual analog scale (VAS), range of motion in the knee joint using goniometry, swelling severity — measuring the limb circumference at four levels, and the safety and tolerability of the procedures were also taken into account. Statistical analysis was performed using the Mann-Whitney U-test (intergroup comparisons) and the Wilcoxon test (intragroup dynamics) with Bonferroni correction. Data are presented as medians and interquartile ranges. Results. The groups were comparable by age, gender, and comorbid status (p>0.05 for all comparisons). In the main group, the median VAS decreased from 3.6 [3.2; 3.7] points to 0.2 [0.0; 0.5] points (on the 10th day), in the control group — from 3.5 [3.3; 3.7] points to 2.3 [2.0; 2.5] points; the differences between the groups on the 5th and 10th days were statistically significant (p 0.05 for all levels and terms). Adverse events were not recorded in any of the groups. Conclusion. The use of the EMW MED system in early rehabilitation after TKA provides a more pronounced analgesic effect and faster restoration of range of motion compared to low-intensity pulsed magnetic therapy using the Almag+ device. The method is safe and well tolerated by patients. The obtained results require confirmation with a larger sample of patients.

Late-stage gonarthrosis (Kellgren-Lawrence grades III-IV, Kosinskaya grade III) is a common cause of persistent pain and dysfunction in the lower extremities. Total knee arthroplasty (TKR) is an effective surgical procedure; however, rehabilitation outcomes in the early postoperative period are not always predictable. Existing prognostic models rely primarily on questionnaires and scales, while objective biomechanical parameters—gait characteristics and postural stability—remain understudied in their relationship with psychosocial status. The aim of this study was to determine the prognostic significance of the initial psychosocial status of female patients after TKR in relation to the dynamics of clinical, functional, podometric, and stabilometric parameters in the early postoperative period. Material and methods. A prospective cohort study included 29 female patients (median age 65.5 years) undergoing primary TKA for stage III–IV gonarthrosis. Entry testing was performed on the third postoperative day, and final testing was conducted after 7–12 days of inpatient rehabilitation. Quality of life (SF 36), clinical and functional status (KSS, WOMAC), spatiotemporal gait parameters on the C-Mill treadmill, and postural stability on the D-Wall platform were assessed. Statistical analysis included nonparametric tests, calculation of the summary psychosocial index (mean Z scores for subscales) and summary motor index, the Wilcoxon signed-rank test for assessing the dynamics of indicators, and partial rank correlation with control for the baseline motor level. Results. During the rehabilitation period, significant improvement was recorded in the WOMAC scale (from 39.5 to 26.5 points; p <0.001), KSS (clinical from 79.0 to 88.5 points; p <0.001), decreased stance phase asymmetry (p=0.041) and double support (p=0.024), improved postural stability with eyes open (decreased rate of shift of the center of pressure, p=0.016–0.042). The summary psychosocial index positively correlated with the final motor index (ρ=0.748; p=0.005); the relationship remained after statistically accounting for the initial motor level (partial rank correlation ρ=0.734; p=0.0065). Patients with a higher initial psychosocial index achieved significantly better motor results (p=0.009). Conclusion. The obtained results demonstrate that initial psychosocial status is an independent predictor of final motor recovery early after TKA. The identified relationships substantiate the need for preoperative psychological screening and targeted optimization of psychosocial functioning to improve the effectiveness of rehabilitation programs.

Knee osteoarthritis in its late stages (stages III–IV) is a socially significant problem leading to patient disability. Total knee arthroplasty has become the gold standard of treatment and is performed annually in large numbers worldwide and in Russian orthopedic practice. Approaches to early postoperative rehabilitation have been widely reflected in scientific and practical work; however, certain gaps remain in the study and analysis of abnormal motor patterns in patients when assessing the biomechanics of movement in the preoperative period. The aim of this study was to determine the role of biopsychosocial factors as predictors of gait disturbances in women with stages III–IV gonarthrosis during preoperative preparation for total knee arthroplasty. Material and Methods. This study, conducted at Clinical Hospital No. 1 of Medsi Group of Companies, involved 20 patients who underwent a preoperative examination, including functional testing, quality-of-life and psychological health assessment, and instrumental diagnostic methods for podometric assessment of gait stereotypes. The results obtained were statistically processed using correlation analysis. Results. The constructed correlation network revealed 30 statistically significant relationships between variables. The greatest number of correlations were found for the WOMAC overall, TUG (Turn Up and Go) and 10‑meter walk test. Among the psychosocial variables, the SF-36 physical and social functioning scales demonstrated the highest degree of centrality. Strong positive correlations were found between weight distribution asymmetry and gait timing asymmetry: with single-support asymmetry and double-support asymmetry in timing, as well as a negative correlation between gait speed and weight distribution asymmetry. These results indicate the need for a comprehensive approach to preoperative preparation of patients with gonarthrosis, including not only an assessment of functional status but also psychosocial support. Conclusion. The identified relationships substantiate the advisability of integrating psychological diagnostics, correction, and social adaptation into the «School of Endoprosthetics» program to improve the recovery period after surgery.

In recent years, there has been an increase in the number of people with transplanted organs in Russia leading an active lifestyle; however, issues related to their participation in organized sports, including football, remain insufficiently studied and systematized. The lack of unified approaches to medical support, the training process, and psychological assistance hinders the development of inclusive sports programs for this category of athletes, which determines the relevance of the present search-and-analytical study. The article presents an analysis of the current state and prospects for the development of football for individuals with transplanted organs in the Russian Federation. Particular attention is paid to the problems of medical and biological support and psychological assistance, as well as to the issues of developing specialized sports training programs, financing, and infrastructure development. Possible ways to address these problems are considered, including the development of adapted training programs, the organization of specialized tournaments, the implementation of psychological support, and the enhancement of public awareness regarding organ donation. In conclusion, the importance of developing inclusive sports programs is emphasized, and practical recommendations are presented for creating safe conditions for playing football, improving infrastructure, and training specialized professionals, which makes it possible to expand opportunities for the social integration of people with transplanted organs into active sports life.