A variety of rehabilitation programmes can be offered to Long COVID patients, specifically physical training. Indeed 90% of these patients reports impairments of verticalization, stability and spatial orientation, making difficult exercise in the gym. The aim of our study was to assess the effectiveness and safety of aquatic exercise techniques as part of a comprehensive rehabilitation program for patients with Long COVID. The first of a two-stage program involved development of aquatic exercises technique, which was evaluated in 12 patients with impaired upright posture control before and after exercising by "Habilect" video gait analysis system. During the second phase, effectiveness and safety of aqua exercises were tested in water pool as part of a comprehensive rehabilitation programme conducted in 23 patients with Long COVID outcomes. Physical examination, 6-minute step test, Euro-QL-5D questionnaire, Borg scale, laser Doppler flowmetry, cardiointervalography, and spirometry were performed before and after the aquatic exercises program. After the training with aquatic exercises, indices of deviations of the main body axes of the head and the body mass centre ameliorated, as well as direction of body movement vector decreased (p<0.05). This study demonstrated a statistically significant improvement in exercise tolerance in both groups, as measured by the 6-minute step test after rehabilitation. The comparison group averaged 236.7 metres [126; 380] (T=8, p=0.047) after the rehabilitation course and the intervention group averaged 233.71 metres [150; 320] (T=8.0, p=0.047). When tested with the Euro-QL-5D questionnaire, a post-treatment improvement was noted in the comparison group on the anxiety/depression subscale (3 [3;3] (T=0, p=0.043)). In the intervention group, laser Doppler flowmetry revealed a statistically significant increase in microcirculation (6.36 standard units after rehabilitation) [5.54; 8.17] (T=7.0, p=0.004), and a decrease of oxidative metabolism index of 6.89 standard units. [4.76; 6.96] (T=4.0, p=0.03). No serious adverse events were reported. In conclusion, the developed aquatic exercises technique seems to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern.

Climate change represents a global challenge that impacts the environment, traditional lifestyle and health of the Indigenous Peoples in the Arctic zone of Western Siberia and threatens their food security. Reindeer are an important food source for this population since reindeer herding products are used as traditional nutrition and effective preventive means and remedies for adapting to the cold and geomagnetic activity in the High North. Longer off-season periods, high summer and winter temperatures, melting ice, and forest and tundra fires have a significant impact on the trampling and degradation of reindeer pastures. These effects may lead to massive reindeer losses and changes in the traditional diet of the Indigenous Peoples in the Arctic, which result in increases in the prevalence of respiratory diseases, overweight and hypertension. This study applied a multidisciplinary approach based on ecological and medical research methods with the inclusion of socioeconomic analysis. The primary sources included data on the longitudinal dynamics of air temperature as a climate change indicator and reindeer livestock populations (1936–2018), consumption of reindeer products and physiological impacts on the Yamal Indigenous population collected during expeditions to the Arctic zone of Western Siberia in 2012–2018.

This article presents the challenges facing reindeer herding as being both a profitable business and part of the traditional culture of the nomadic Indigenous peoples in the Arctic zone of Western Siberia which addresses substantial needs of the local population. Reindeer herding products are used as traditional nutrition, and as effective preventive means and remedies for adapting to the cold and geomagnetic activity in the High North. Export trends of traditional reindeer products have decreased local Indigenous peoples’ access to venison and had a negative impact on their health. Due to the COVID-19 pandemic, it is especially urgent for the Indigenous peoples to have sufficient access to traditional food and be involved in policy decision-making to maintain this traditional business. We aim to analyze the dependencies of Indigenous peoples on the reindeer produce–exporting “food value chain” and explore how (1) the independence of reindeer herders could be increased in these export chains and (2) how provision of their products to local communities could be secured. The study takes a multidisciplinary approach based on policy and socioeconomic analyses with input from medical research. Primary sources include data collected from interviews and surveys of Indigenous peoples during expeditions to the Nyda settlement, the Nydinskaya tundra, the Tazovsky settlement, the Tazovskaya tundra, the Nakhodka tundra, the Gyda and Gydansky settlements, the Yavai-Salinskaya tundra, the Seyakha settlement, the Seyakhinskaya and Tambeyskaya tundras located along the southern coast of the Ob Bay, the northeast coast of the Yamal Peninsula, the Tazovsky and Gydansky Peninsulas, and the Shuryshkarsky district. Data were collected during the summers and winters of 2014–2020.

The Covid-19 pandemic could reach several million people worldwide. Presumably, 5-15% of them will need medical rehabilitation after suffering from pneumonia and acute respiratory distress syndrome. A comprehensive search was performed in the databases MEDLINE, CENTRAL, EMBASE, Web of Science and MedPilot, CyberLeninka, and eLIBRARY on-drug rehabilitation methods that prevent the development of Covid-19 complications. The goals of medical rehabilitation at the preclinical stage are to achieve the correction of diseases that contribute to the development of Covid-19 complications (COPD, bronchial asthma, rhinosinusitis, diabetes mellitus), mainly due to non-drug methods. Non-drug technologies have a number of advantages over medications that have a side effect, and such as glucocorticoids and antibiotics lead to a worse prognosis of the underlying disease. Medical rehabilitation in the intensive care unit is aimed at reducing the risk of complications and increasing the functional reserves of the body, as well as reducing the area and degree of lung damage, preventing extrapulmonary complications, including secondary infection. The main goal of medical rehabilitation in a hospital is to reduce the severity of symptoms, resorption and repair in the lesion of lung tissue, reduce the development of fibrosis, and provide bronchial drainage to prevent secondary infection. In addition, timely transfer of the patient to a specialized stage of medical rehabilitation can increase the functional reserve of the respiratory muscles and exercise tolerance. The second, specialized stage of medical rehabilitation can be carried out in the conditions of a sanatorium-resort organization. The goals of this stage are not only to reduce symptoms and increase tolerance to physical activity, but also to improve the quality of life, psychological rehabilitation, and recovery.