Application of infrared thermography in the study of the osteopathic correction results in patients with amputation defects of the lower extremities

N. Y. Kolyshnitsyn, D. Mokhov, L. M. Smirnova, E. Fogt, T. Ermolenko
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Abstract

Introduction. The main medical consequences of amputations are: phantom pain syndrome, degenerative changes in soft tissues, increased muscle tone of the stump, deterioration of microcirculation in the amputated limb. Methods of rehabilitation of such patients are physical therapy, physiotherapy, psychotherapy, mechanotherapy. The search for new methods of rehabilitation of patients with amputation of the lower limb is constantly underway due to the social significance of this disease. Osteopathic correction has proven effects of normalization of muscle tone, improvement of blood circulation, which can be assessed using infrared thermography.Aims: to evaluate the effect of osteopathic correction on blood circulation in the stump in patients with transtibial amputation.Materials and methods. The study includes 30 patients (21 men and 9 women) with transtibial amputation, undergoing diagnostic examination using infrared thermography on an outpatient basis in Albrecht Federal Scientific Centre of Rehabilitation of the Disabled. Patients were divided in two groups in random: main group (n=15), receiving osteopathic correction, and control group, receiving sham therapy. Both groups were divided in subgroups depending on amputation cause: cardiovascular diseases and trauma. Regardless the group infrared thermography was performed before and after first session of therapy or osteopathic correction and before and after second session. On thermograms, the temperature of the distal part of the stump was evaluated, the second limb — in the projection of the distal part of the stump.Results. The method of infrared thermography objectively confirmed the positive effect of osteopathic correction on blood flow in the lower leg stump: in patients with traumatic and vascular genesis of amputation — in the form of a decrease in the severity of distal hypothermia after the first, before the second and after the second session of osteopathic correction compared to the data before osteopathic correction. In the control group, there was also a statistically significant increase in the temperature of the distal part of the stump after the first session and the second sessions of sham therapy, which returned to its original values before the second session, which indicates the short-term nature of the changes.Conclusion. The study showed an improvement in blood circulation in the truncated limb, confirmed by an increase in the temperature of the stump in patients with transtibial amputation of traumatic and vascular genesis, which underwent osteopathic correction.
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应用红外热成像技术研究下肢截肢缺损患者的整骨矫正效果
介绍。截肢的主要医学后果是:幻肢痛综合征、软组织退行性改变、残肢肌肉张力增加、截肢肢体微循环恶化。这类患者的康复方法有物理疗法、物理疗法、心理疗法、机械疗法等。由于这种疾病的社会意义,寻找下肢截肢患者康复的新方法正在不断进行。骨科矫正已被证明有肌肉张力正常化、血液循环改善的效果,这可以用红外热成像来评估。目的:评价整骨矫正对经胫骨截肢患者残端血液循环的影响。材料和方法。该研究包括30名经胫骨截肢的患者(21名男性和9名女性),在阿尔布雷希特联邦残疾人康复科学中心门诊使用红外热像仪进行诊断检查。将患者随机分为两组:主组(n=15)接受整骨矫正,对照组(n=15)接受假治疗。两组根据截肢原因分为亚组:心血管疾病和创伤。无论如何,在第一次治疗或整骨矫正前后以及第二次治疗前后进行红外热成像。在热像图上,对残肢远端部分的温度进行了评估,第二肢-在残肢远端部分的投影。红外热成像方法客观地证实了骨科矫正对下肢残端血流的积极作用:在创伤性和血管源性截肢患者中,与骨科矫正前的数据相比,在第一次、第二次和第二次骨科矫正后,远端低温的严重程度有所降低。在对照组中,假药治疗第一阶段和第二阶段后,残肢远端温度也有统计学意义的升高,并恢复到第二阶段前的原始值,这表明这种变化是短期的。该研究表明,在创伤性和血管发生的经胫骨截肢患者中,经过整骨矫正的残肢的血液循环得到改善,这一点得到了残肢温度升高的证实。
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