Application of non-drug methods in rehabilitation programs to improve the quality of life of patients after lower limb joint endoprosthetics

Abstract

BACKGROUND: All over the world, osteoarthritis is a common disease and accounts for 10% of all diseases in the population, and therefore, the frequency of large joint arthroplasty continues to increase, which determines the need to develop new methods of complex treatment in the rehabilitation of patients after arthroplasty operations.

AIM: Scientific substantiation of the expediency of the complex use of a stabilometric multifunctional platform with biofeedback and light therapy in patients after arthroplasty of the joints of the lower extremities to improve the quality of life in the late recovery period.

MATERIAL AND METHODS: 60 patients were examined three months after total joint replacement of the lower limb at the age of 55 to 75 years. All patients were randomly divided into three groups of 20 people comparable in terms of clinical and functional characteristics. Patients of the main group were exposed to monochromatic polarized incoherent light and underwent physical training using a stabilometric complex with biofeedback COBS (mtd-Systems, Germany), in the comparison group, patients received therapeutic exercises on a stabilometric simulator with biofeedback, patients the control group received only a standard rehabilitation complex and drug therapy, which served as a background in the main group and the comparison group.

RESULTS: Prior to the start of treatment, when analyzing the indicators of static and dynamic stabilometric studies, an uneven distribution of the load was established during tests with a preponderance towards the healthy leg. After a course of treatment, patients of all groups showed statistically significant positive results, however, a more pronounced improvement in indicators was observed in patients of the main group, less pronounced, but statistically significant results were obtained in the comparison group, and insignificant positive dynamics was noted in patients of the control group. When studying the quality of life and the effectiveness of treatment according to the EQ-5D questionnaire in the examined patients in the initial state, the indicator averaged 6.6±0.8 points. After the course of treatment, patients of the main group showed a statistically significant decrease in the scores of the EQ-5D questionnaire from 6.7±0.9 points in the initial state to 4.2±0.9 (p <0.001), which lasted up to 6 months. In patients of the comparison group, in all periods of observation, a decrease in the indicator was also noted, but less pronounced, in patients of the control group ― only a positive trend. The findings were supported by the results of the Hospital Anxiety and Depression Scale (HADS).

CONCLUSION: The use of a comprehensive rehabilitation program with the inclusion of a stabilometric platform with biofeedback and polarized light "Bioptron" contributes to a marked improvement in the state of balance, balance and coordination abilities of patients, normalization of muscle tone, a significant reduction in anxiety and depression and can significantly improve the quality of life of patients with endoprostheses in the late recovery period.

Keywords

medical rehabilitation / total knee replacement / balance / training associated with biofeedback

References

[1] Abuseva GR, Antipenko PV, Arkov VV, et al. Interregional Scientific Society of Physical and Rehabilitation Medicine. Association of Medical Societies for Quality. Physical and rehabilitation medicine: A national guide. Moscow: GEOTAR-Media; 2020. 688 р. (In Russ).

[2] Абусева Г.Р., Антипенко П.В., Арьков В.В., и др. Межрегиональное научное общество физической и реабилитационной медицины. Ассоциация медицинских обществ по качеству. Физическая и реабилитационная медицина: национальное руководство. Москва: ГЭОТАР-Медиа, 2020. 688 с.

[3] Epifanov VA, Korchazhkina NB, Epifanov AV. Medical and social rehabilitation of patients with various pathologies. In 2 parts. Ed. by S.V. Yablonsky. Vоl. 2. Moscow: GEOTAR-Media; 2019. 560 р. (In Russ).

[4] Епифанов В.А., Корчажкина Н.Б., Епифанов А.В. Медико-социальная реабилитация пациентов с различной патологией. В 2 частях / под ред. С.В. Яблонского. Т. 2. Москва: ГЭОТАР-Медиа, 2019. 560 с.

[5] Epifanov AV, Epifanov VA, Galanova ES, et al. Medical rehabilitation: A textbook. Moscow: GEOTAR-Media; 2022. 664 p. doi: 10.33029/9704-6688-9-MRE-2022-1-664

[6] Epifanov A.V., Epifanov V.A., Galsanova E.S., et al. Medical rehabilitation: Textbook. Москва: ГЭОТАР-Медиа, 2022. 664 p. doi: 10.33029/9704-6688-9-MRE-2022-1-664

[7] Amosova NA, Arutyunov GP, Aukhadeev EI, et al. Therapeutic physical culture in the system of medical rehabilitation: National guidelines. Moscow: GEOTAR-Media; 2022. 896 р. (In Russ).

[8] Амосова Н.А., Арутюнов Г.П., Аухадеев Э.И., и др. Лечебная физическая культура в системе медицинской реабилитации: национальное руководство. Москва: ГЭОТАР-Медиа, 2022. 896 с.

[9] Epifanov VA, Epifanov AV, Petrova MS, et al. Rehabilitation in traumatology and orthopedics: A guide. 3rd revised and updated. Moscow: GEOTAR-Media; 2021. 560 p. (In Russ). doi: 10.33029/9704-7147-0-TPE-2022-1-896

[10] Епифанов В.А., Епифанов А.В., Петрова М.С., и др. Реабилитация в травматологии и ортопедии: руководство. 3-е изд., переработанное и дополненное. Москва: ГЭОТАР-Медиа, 2021. 560 с. doi: 10.33029/9704-7147-0-TPE-2022-1-896

[11] Kotenko KV, Epifanov VA, Epifanov AV, Korchazhkina NB. Joint pain. Moscow: GEOTAR-Media; 2018. 560 p. (In Russ).

[12] Котенко К.В., Епифанов В.А., Епифанов А.В., Корчажкина Н.Б. Боль в суставах. Москва: ГЭОТАР-Медиа, 2018. 560 с.

[13] Certificate of state registration of the database RUS No. 2021621880/16.09.2021. The application number is 2021621880. Mikhailova AA, Kotenko KV, Korchazhkina NB, et al. Database of scientific research on the use of physical factors in surgery. (In Russ). Available from: https://www.elibrary.ru/item.asp?id=46602160. Accessed: 12.02.2022.

[14] Свидетельство о государственной регистрации базы данных RU 2021621978/16.09.2021. Номер заявки 2021621880. Михайлова А.А., Котенко К.В., Корчажкина Н.Б., и др. База данных научных исследований по применению физических факторов в хирургии. Режим доступа: https://www.elibrary.ru/item.asp?id=46602160. Дата обращения: 12.02.2022.

[15] Patent RUS No. 2302268 С2/10.07.07. Bull. No. 19. Petrov KB, Kuzmenko OV, Nalivaiko BA. A method for restoring static-dynamic function in patients undergoing total hip arthroplasty. (In Russ). Available from: https://yandex.ru/patents/doc/RU2302268C2_20070710. Accessed: 12.02.2022.

[16] Патент РФ на изобретение RU 2302268 С2/10.07.07. Бюл. № 19. Петров К.Б., Кузьменко О.В., Наливайко Б.А. Способ восстановления статико-динамической функции у больных, перенесших операцию тотального эндопротезирования тазобедренного сустава. Режим доступа: https://yandex.ru/patents/doc/RU2302268C2_20070710. Дата обращения: 12.02.2022.

[17] Kotenko KV, Korchazhkina NB, Mikhailova AA, et al. Features of the use of a stabiloplatform with biofeedback in various socially significant diseases. Physiotherapist. 2020;(4):29–35. (In Russ). doi: 10.33920/med-14-2008-03

[18] Котенко К.В., Корчажкина Н.Б., Михайлова А.А., и др. Особенности применения стабилоплатформ с биологической обратной связью при различных социально значимых заболеваниях // Физиотерапевт. 2020. № 4. С. 29–35. doi: 10.33920/med-14-2008-03

[19] Korchazhkina NB, Mikhailova AA, Kovalev SA, et al. The effectiveness of methods of early rehabilitation in programs of acce lerated recovery of patients after surgical interventions. Russian journal of the physial therapy, balneotherapy and rehabilitation. 2019;18(6):408–411. (In Russ). doi: 10.17816/1681-3456-2019-18-6-408-411

[20] Корчажкина Н.Б., Михайлова А.А., Ковалев С.А., и др. Эффективность методик ранней реабилитации в программах ускоренного выздоровления больных после хирургических вмешательств // Физиотерапия, бальнеология и реабилитация. 2019. Т. 18, № 6. С. 408–411. doi: 10.17816/1681-3456-2019-18-6-408-411

[21] Patent RUS No. 2502500 С1/27.12.13. Bull. No. 36. Zaitsev KN, Avdonchenko TS, Zaitsev NM, et al. The method of rehabilitation of patients with deforming arthrosis of the knee joints. (In Russ). Available from: https://yandex.ru/patents/doc/RU2502500C1_20131227. Accessed: 12.02.2022.

[22] Патент РФ на изобретение RU 2502500 С1/27.12.13. Бюл. № 36. Зайцев К.Н., Авдонченко Т.С., Зайцев Н.М., и др. Способ реабилитации больных деформирующим артрозом коленных суставов. Режим доступа: https://yandex.ru/patents/doc/RU2502500C1_20131227. Дата обращения: 12.02.2022.

[23] Korchazhkina NB, Dugieva MZ, Moseshvili GG. Justification of the use of polychrome incoherent radiation in gynecological diseases (literature review). Russian journal of the physial therapy, balneotherapy and rehabilitation. 2019;18(1):33–39. (In Russ). doi: 10.17816/1681-3456-2019-18-1-33-39

[24] Корчажкина Н.Б., Дугиева М.З., Мосешвили Г.Г. Обоснование применения полихромного некогерентного излучения при гинекологических заболеваниях (обзор литературы) // Физиотерапия, бальнеология и реабилитация. 2019. Т. 18, № 1. С. 33–39. doi: 10.17816/1681-3456-2019-18-1-33-39

[25] Shpagina LA, Abramovich SG, Drobyshev VA. Complex application of naphthalan and nonselective chromotherapy in the treatment of gonarthrosis in rolling stock workers. Occupational Med Industrial Ecology. 2016;(4):36–40. (In Russ).

[26] Шпагина Л.А., Абрамович С.Г., Дробышев В.А. Комплексное применение нафталана и неселективной хромотерапии в лечении гонартроза у работников подвижного состава // Медицина труда и промышленная экология. 2016. № 4. С. 36–40.

[27] Sellam J, Herrero-Beamont G, Berenbaum F. Osteoarthrosis: pathogenesis, clinical aspects and diagnosis. Arthritis Rheum. 2009;60(2):524–533.

[28] Sellam J., Herrero-Beamont G., Berenbaum F. Osteo arthro sis:pathogenesis, clinical aspects and diagnosis // Arthritis Rheum. 2009. Vol. 60, N 2. P. 524–533.

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