ЛФК на нестабильной опоре и гидрокинезотерапия в реабилитации пациентов с болями в спине

Abstract

Purpose. A comparative analysis of the efficiency of different procedures of exercise therapy is carried out: hydrokinesitherapy and therapeutic gymnastics with the use of exercise on an unstable support (stabiloplatform) depending on the sex of patients. Materials and methods. Under our observation there were 72 patients undergoing rehabilitation on the basis of SBOH CC No. 201 DHM Zelenograd, an equal number of women and men and 36 people with back pain of vertebrogenic genesis. All patients repeatedly received standard medical therapy, physiotherapy (magnetotherapy, laser therapy) and a massage therapist. At the end of the physiotherapy treatment was assigned a set of physical therapy: group 1 included men and women, 36 — classes on stabiloplatform, a course of 10 treatments; Group 2 consisted of men and women, 36 — hydrokinesitherapy in the pool, a course of 10 treatments. The effectiveness of therapy was assessed: on a scale (VAS, mm), Schober’s test, test Tomiura test Ott summary index of health status (Oswestry questionnaire). Results. The intensity of the pain syndrome according to the VAS score in the compared groups before the rehabilitation did not differ (on average 5.8 in men and 6.15 in women), after the completion of the course of treatment it statistically significantly decreased in both groups. Significantly, the best indicators were determined in the group of men when practicing on the stable platform (1.4 vs. 3.8 in women), and in women with physical therapy in the pool (1.6 vs. 2.9 in men). Effectiveness of changes in the test values of the mobility assessment of different parts of the spine, depending on the method of rehabilitation performed: men were more efficiently restored on the stabiloblatform, women in the pool classes. The indicators of the Tomayer test (inclination forward) significantly changed in both groups: in men on the stabiloplatform from 28.3 ± 0.05 to 13.8 ± 0.1 (p <0.05); for those engaged in the basin from 28.5 ± 0.2 to 16.2 ± 0.5 (p < 0.05). Women in the stable platform — from 28.5 ± 0.05 to 16.2 ± 0.03 (p < 0.05); for those engaged in the basin from 28.5 ± 0.1 to 12.7 ± 0.2 (p < 0.05). Before treatment, the overall health index (according to the results of the Oswestry questionnaire) differed significantly in both groups. After the end of treatment, there was a significant decrease in the indices in all the patients examined. At the same time, in men, the indices were significantly better when exercising on the stabiloplatform (index decrease from 39 ± 0.2 to 12 ± 0.1, p < 0.01), and in women — in the second group with hydrokinetic therapy (index decrease from 36 ± 0.6 to 12 ± 0.2, p < 0.05). Conclusion. The results of the study of the psychoemotional state, the vertebroneurological status and the assessment of the pain of patients with dorsopathies suggest that men and women respond differently to rehabilitation methods, in particular: static and dynamic methods of exercise therapy, which, apparently, is related to gender differences and/or individual characteristics of the individual.