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

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.