PATHOBIOMECHANICAL DISORDERS AND METHODS OF CORRECTION IN PRIMARY GONARTHRITIS IN THE ELDERLY
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i4.9735Keywords:
muscular dysfunction, volumetric pneumopressing, osteoarthritis, pathobiomechanical disorders, rehabilitationAbstract
In the elderly, the problem of osteoarthritis (OA) becomes very important in connection with concomitant diseases and involutive changes in the body. Pathology of knee joints causes changes in the functioning of the entire musculoskeletal system, primarily the spine. Selection for patients with OA rehabilitation complex programs that will restore the static-dynamic properties of the bone and muscular system, and will have both anti-inflammatory, analgesic and anti-spasmolytic action remains an urgent task. All this is a motive for finding ways to correct pathobiomechanical disorders during rehabilitation of patients with OA knee joints in the elderly.
The aim of the study – pathogenetic substantiation of the application of the rehabilitation complex with the inclusion of techniques for correction of pathobiomechanical disorders in patients with primary gonarthritis in the elderly at the outpatient stage of rehabilitation.
Material and Methods. The study involved 42 patients with primary gonarthrosis with non-specific pain syndrome in the lumbar spine, who were in the outpatient stage of rehabilitation. The average age was (65.13±0.31) years, the duration of the disease (9.24±0.42) years. Patients were divided into 2 groups, rehabilitation complexes differed in methods of using volumetric pneumopressing.
Results and Discussion. Reliable (p <0.05) reduction of pain syndrome both in the joint and in the lumbar spine, improvement of functional activity, tone of muscles and physical capacity when using the proposed rehabilitation complex with correction of pathobiomechanical disorders was established.
Conclusions. On the basis of the obtained results, a differentiated approach is proposed for the appointment of rehabilitation measures in patients with primary gonarthrosis depending on pathobiomechanical disorders. With the help of the combined method of using volumetric pneumopressing locally on the knee joints and on the back muscles are eliminated changes in the muscular system of the knee joints and the spine.
References
Vasilyeva, L.F. (2003). Klinika i vizualnaya diagnostika ukorochennykh myshts [Clinic and visual diagnosis of shortened muscles]. Moscow: Meditsina [in Russian].
Zaytsev, A.A., Miryutova, N.F., Mikhaylova, E.V., & Popova, A.V. (2011). Kompleksnaya fizioterapiya bolnykh dorsopatiyami s soputstvuyushchim osteoartrozom [Comprehensive physiotherapy in patients with dorsopathies with concomitant osteoarthrosis]. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kultury – Questions of Balneology, Physiotherapy and Medical Physical Culture, 2, 21-24 [in Russian].
Eremeyev, A.M., Trofimova, A.A., Shaykhutdinov, I.I., Zagidullin M.V., & Valeev, Y.A. (2011). Osobennosti funktsionirovaniya myshts nizhnikh konechnostey i ikh spinalnykh tsentrov pri gonartrozakh [Features of the functioning of the muscles of the lower extremities and their spinal centers in gonarthrosis]. Prakticheskaya meditsyna – Practical Medicine, 7 (55), 64-68 [in Russian].
Kovalenko, V.N., & Bortkevich O.P. (2010). Osteoartroz: prakticheskoye rukovodstvo [Osteoarthritis: a practical guide]. Kiev: Morion [in Russian].
Koroleva, S.V., & Lvov, S.E. (2007). Rol miofastsialnogo sindroma v destabilizatsii kolennogo sustava pri osteoartroze [The role of myofascial syndrome in the destabilization of the knee with osteoarthritis]. Sovremennyye problemy nauki i obrazovaniya – Modern Problems of Science and Education, 2, 50-54 [in Russian].
Shostak, N.A., Pravdiuk, N.H., & Klymenko, A.A. (2011). Klinicheskiye varianty osteoartroza – podkhody k terapii [Clinical variants of osteoarthritis – approaches to therapy]. Russkiy meditsynskiy zhurnal – Russian Medical Journal, 19 (2), 93-97 [in Russian].
Bennell, K.L., Hunt, M.A., Wrigley, T.V., Lim, B.W., & Hinman, R.S. (2008) Role of muscle in the genesis and management of knee osteoarthritis. Rheum. Dis. Clin. North Am., 34 (3), 731-754.
Gallagher, R.M. (2005). Chronic pain: sources of late life pain and risk factor for disability. Geriatrics, 55, 40-47.
Hinman, R.S., Hunt, M.A., & Creaby, M.W. (2010). Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res. (Hoboken), 62 (8), 1190-1193.
Elboim-Gabyzon, М., Rozen, N., Laufer Y. (2013). Quadriceps femoris muscle fatigue in patients with knee osteoarthritis. Clin. Interv. Aging, 8, 1071-1077.
National Clinical Guideline Centre. (2014). Osteoarthritis. Care and management in adults. London: National Institute for Health and Care Excellence.
Oiestad, B.E., Juhl, C.B., Eitzen, I., & Thorlund, J.B. (2014). Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthritis Cartilage, 1, 1305-1308.
Roos, E.M., Herzog, W., Block, J.A., & Bennell, K.L. (2011). Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis. Nat. Rev. Rheumatol., 7 (1), 57-63.
Sofat, N., Ejindu, V., & Kiely, H. (2011). What makes osteoarthritis painful? The evidence for local and central pain processing. Rheumatology (Oxford), 50, 2157-2165.
Stemberger, R., & Kerschan-Schindl, K. (2013). Osteoarthritis: physical medicine and rehabilitation-nonpharmacological management. Wien Med. Wochenschr., 163(9-10), 228-235.
