PHYSICAL THERAPY IS AN INTEGRAL PART OF THE SURGICAL TREATMENT OF VALGUS DEFORMITY OF THE FIRST TOE

Abstract

Objective. Determining the effectiveness of physical therapy in the surgical treatment of valgus deformity of the first toe. Methods. The clinical material of the conducted study includes 38 observations, 34 patients (38 operative interventions, 4 patients — on 2 feet. In the control group (CG) there were 16 patients (16 interventions), and in the main group (MG) — 18 patients (22 interventions). All patients who participated in the study had the same diagnosis — hallux valgus II–III degree. All patients received the same type of surgical intervention — a variant Z-shaped osteotomy of the first metatarsal bone according to the Scarf method or Chevron, which was supplemented with osteotomy of proximal phalanges of the I finger to Akin method. Patients were examined with the Visual-Analogue Scale (VAS), the Physiotherapy Clinical Outcome Variables (COVS) Motor Skills Testing Scale, and the American Orthopedic Foot and Ankle Society (AOFAS) Scale (module 2) for the Clinical Evaluation of Foot and Ankle Diseases of the American Foot and Ankle Association. Rehabilitation of MG patients consisted of developed physical therapy (PT) program, which included 4 periods. Rehabilitation included not only massage and exercises for the muscles of the front part of the foot, but also a complex of rehabilitation methods aimed to restore the function of the muscles of both lower limbs, hips and buttocks. PT program for KG consisted only of morning hygienic gymnastics, classical massage and therapeutic exercises to restore function of muscles of the foot and lower leg. Results. Assessment of the condition of patients after the end of PT on the COVS scale helped to conclude that the patients of MG have significantly better indicators of general physical activity than patients of CG. Analysis of the obtained results according to the (AOFAS) Scale confirmed that patients of MG after using developed PT program have statistically better results. Conclusions. The developed PT program significantly accelerate the clinical recovery of function not only the front part of the foot, but also general working capacity of patients.