根据稳定学数据对经胫段下肢截肢患者进行整骨矫正的结果

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

介绍。在下肢截肢(LLA)患者的综合康复中,目前常用的有:物理疗法、机械疗法、物理疗法。尽管康复方法的可用性,下肢截肢患者的姿势平衡的完全纠正仍然是一个紧迫的医疗问题。直到最近,整骨疗法才被用于此类患者的康复,尽管证实了整骨疗法矫正后肌肉张力、神经体液系统正常化以及血液循环和淋巴流出改善的效果。目的:探讨整骨矫正对下肢经胫段截肢患者体位平衡的影响。材料和方法。59例(37男22女,平均年龄57岁)胫骨水平LLA患者在Albrecht联邦残疾人康复科学中心门诊使用稳定术进行检查。将患者随机分为两组:主组(n=32)接受整骨矫正,对照组(n=27)接受假治疗。两组根据截肢原因分为亚组:外伤性和血管性。所有患者均接受了4次稳定术:在第一次整骨矫正或假治疗前后,以及在第二次整骨矫正前后。通过矢状面和额状面光谱第一大幅值、静动图面积、功耗指标、压力中心速度偏差、矢状面和额状面压力中心标准差来评价体位的稳定性。稳定性法客观地证实了骨科矫正对创伤性和血管源性截肢患者的姿势平衡的积极作用——与骨科矫正前的所有研究参数相比,在第一次、第二次和第二次骨科矫正后的稳定性增加(p< 0.05)。血管生成对照组的患者在假治疗第一阶段和第二阶段后的稳定性也有统计学意义的增加,在工作消耗方面恢复到第二阶段之前的原始值,这表明这种变化的短期性质。该研究显示,根据稳定性数据,创伤性和血管性下肢截肢患者接受骨科矫正后,姿势平衡得到改善。
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Results of osteopathic correction according to the stabilography data in patients with lower limb amputation at the transtibial level
Introduction. In the comprehensive rehabilitation of patients with lower limbs amputations (LLA), there are currently used: physical therapy, mechanotherapy, physiotherapy. Despite the availability of rehabilitation methods, full correction of postural balance in patients with lower limbs amputations remains an urgent medical problem. Osteopathy has not been used in the rehabilitation of such patients until recently, despite the proven effect of normalizing muscle tone, neurohumoral system, as well as improvement of blood circulation and lymphatic outflow after osteopathic correction.Aims: To study the effect of osteopathic correction on postural balance in patients with lower limb amputations at the transtibial level.Materials and methods. 59 patients (37 men and 22 women, average age 57 years) with LLA at the transtibial level were examined using stabilography in outpatient on the basis of the Albrecht Federal Scientific Center for Rehabilitation of the Disabled. The patients were randomly divided into 2 groups: the main group (n=32) receiving osteopathic correction and the control group (n=27) receiving sham therapy. Both groups were divided into subgroups depending on the cause of amputation: traumatic and vascular. All patients underwent stabilography 4 times: before and after the first session of osteopathic correction or sham therapy, as well as before and after the second session. The stability of the position was assessed by the amplitude of the 1st maximum of the spectrum in the sagittal and frontal component, statokinesiogram area, work expended indicator, speed deviation of the center of pressure, standard deviation of the center of pressure in the sagittal and frontal planes.Results. The method of stabilography objectively confirmed the positive effect of osteopathic correction on postural balance in patients with traumatic and vascular genesis of amputation — in the form of stability increase after the 1st, before the 2nd and after the 2nd session of osteopathic correction compared to the data before osteopathic correction for all studied parameters (p<0,05). Patients from the control group of vascular genesis also had a statistically significant increase in stability after the 1st session and the 2nd sessions of sham therapy in terms of work expended, 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 postural balance according to stabilography data in patients with lower limbs amputations of traumatic and vascular genesis who underwent osteopathic correction.
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