Інформація призначена тільки для фахівців сфери охорони здоров'я, осіб,
які мають вищу або середню спеціальну медичну освіту.

Підтвердіть, що Ви є фахівцем у сфері охорони здоров'я.



СІМЕЙНІ ЛІКАРІ ТА ТЕРАПЕВТИ

НЕВРОЛОГИ, НЕЙРОХІРУРГИ, ЛІКАРІ ЗАГАЛЬНОЇ ПРАКТИКИ, СІМЕЙНІ ЛІКАРІ

КАРДІОЛОГИ, СІМЕЙНІ ЛІКАРІ, РЕВМАТОЛОГИ, НЕВРОЛОГИ, ЕНДОКРИНОЛОГИ

СТОМАТОЛОГИ

ІНФЕКЦІОНІСТИ, СІМЕЙНІ ЛІКАРІ, ПЕДІАТРИ, ГАСТРОЕНТЕРОЛОГИ, ГЕПАТОЛОГИ

ТРАВМАТОЛОГИ

ОНКОЛОГИ, (ОНКО-ГЕМАТОЛОГИ, ХІМІОТЕРАПЕВТИ, МАМОЛОГИ, ОНКО-ХІРУРГИ)

ЕНДОКРИНОЛОГИ, СІМЕЙНІ ЛІКАРІ, ПЕДІАТРИ, КАРДІОЛОГИ ТА ІНШІ СПЕЦІАЛІСТИ

ПЕДІАТРИ ТА СІМЕЙНІ ЛІКАРІ

АНЕСТЕЗІОЛОГИ, ХІРУРГИ

"Pain. Joints. Spine." 1 (21) 2016

Back to issue

Clinical efficacy of physiotherapy techniques in patients with primary gonarthrosis with the reduction of bone mineral density at sanatorium stage of rehabilitation

Authors: Bakalyuk T.G. - Ternopil State Medical University named after I.Ya. Gorbachevsky, Ternopil, Ukraine

Categories: Rheumatology, Traumatology and orthopedics

Sections: Medical forums

print version

The article was published on p. 65

 

Actuality. Drug therapy of primary gonarthrosis (PGA) is significantly limited by the frequency of side effects, so the use of physical factors for the low incidence of these adverse events have more opportunities, especially at the sanatorium stage of rehabilitation. Preformed physical factors affecting the deep structure in the joint were included in our rehabilitation program to ensure multifactor therapeutic effect on the pathological process in patients with PGA with low bone mineral density (BMD). It was considered literature data that alternating electric current of low frequency affects deep tissue and pulsed electric current is the best stimulus for bone receptors, therefore the stimulation of bone receptors in the affected bone and fibrous structures accompanied by marked neurotrophic effect.

Objective — investigate the efficacy of physical therapy influences in rehabilitation programs in patients with primary gonarthrosis with reduced BMD at the sanatorium stage of rehabilitation.
Materials and Methods. 34 patients age of 52–74 years (62,14 ± 0,88) with PGA and low BMD without comorbidities that could affect the metabolism of bone tissue included in the study using differentiated physical therapy methods. By the results of densitometric examination osteopenia revealed in 22 patients and osteoporosis — in 12. There were 6 (17,6 %) men and 28 (82,4 %) women. Duration of the disease is from 4 to 18 years on average (8,7 ± 0,7) years. The diagnosis of PGA was confirmed by X-ray, the investigation included patients with PGA stages II–III according to the classification Kellgren — Lawrence (27 persons — II stage, 7 people — III stage). All patients received basic medical complex, which included the use of sulfurated hydrogen baths with sulfide inhalation, applications of low-temperature pelotherapy on joints, massage, exercises. It was prescribed method of interference therapy (IFT) to patients of the 1st group (15 people) and for patients in group 2 (19 people) method osteoperiostal electrical stimulation (OPES) was prescribed.
Results. The application in the medical complex IFT and OPES reduce the degree of expression of clinical manifestations of pain syndrome, improve physical activity and physical working capacity in patients with PGA and low BMD. However, application of the OPES technique has more pronounced analgesic effect in patients with pain for VAS over 60 mm, contributing significantly (p < 0.05) reduction of (64,80 ± 1,39) to (36,40 ± 1,18) and significantly (p < 0.05) impact on quality of life by the index of the HAQ (16,0 ± 1,3) to (13,6 ± 0,2), while the application IFT method in patients with pain on VAS more than 60 mm analgesic effect was less expression: from (67,40 ± 0,24) to (45,20 ± 0,56), and quality of life by the HAQ index improved slightly: of (15,6 ± 0,5) to (14,8 ± 0,7). The application in the medical complex IFT has a pronounced analgesic effect in patients with pain by VAS at least 60 mm: before treatment (51,40 ± 1,52), after (36,20 ± 1,19). Changes HAQ index are also significant (p < 0.05): before (15,1 ± 0,4), after (13,1 ± 0,6).
Conclusions. Investigations have shown that exposure of pulse low-frequency and alternating current using methods IFT and OPES has analgesic effect, relieves spasms of periarticular structures and makes it possible to carry out rehabilitation more efficiently. But these methods should be applied differently, depending on the arthrological status of patients with PGA with decreased BMD.    

Similar articles

Using of physical restoration treatment methods in patients with primary gonarthrosis with low bone mineral density at sanatorium stage of rehabilitation
Authors: Bakalyuk T.G., Mysula I.R., Kvasnitska O.S., Vahnovska E.E. - Ternopil State Medical University named after I.Ya. Gorbachevsky, Ternopil, Ukraine
"Pain. Joints. Spine." 1 (21) 2016
Categories: Rheumatology, Traumatology and orthopedics
Sections: Medical forums
Evaluating spine micro-architectural texture (via TBS) discriminates major osteoporotic fractures from controls both as well as and independent of site matched BMD: the Eastern European TBS study
Authors: Vasic J. - Department of Physical Medicine and Rehabilitation, Railway Healthcare Center, Belgrade, Serbia; Petranova T. - Clinic of Rheumatology, Medical University, Sofia, Bulgaria; Povoroznyuk V. - Department of Clinical Physiology and Pathology of Locomotor Apparatus, D.F. Chebotarev; Institute of Gerontology NAMS Ukraine and Ukrainian Scientific-Medical Center for the Problems of Osteoporosis, Kiev, Ukraine; Barbu C.G. - Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Karadzic M. - Institute for Treatment and Rehabilitation «Niska Banja», Nis, Serbia; Gojkovic F. - Department of Physical Medicine and Rehabilitation, Railway Healthcare Center, Belgrade, Serbia; Elez J. - Department of Internal Medicine, Railway Healthcare Center, Belgrade, Serbia; Winzenrieth R. - R&D Department, Med-Imaps, PTIB, Hopital Xavier Arnozan, Pessac, France; Hans D. - Bone Diseases Center, DAL, Lausanne University Hospital, Lausanne, Switzerland; CulaficVojinovic V. - Department of Internal Medicine, Railway Healthcare Center, Belgrade, Serbia; Poiana C. - Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Dzerovych N. - Department of Clinical Physiology and Pathology of Locomotor Apparatus, D.F. Chebotarev;Institute of Gerontology NAMS Ukraine and Ukrainian Scientific-Medical Center for the Problems of Osteoporosis, Kiev, Ukraine; Rashkov R. - Clinic of Rheumatology, Medical University, Sofia, Bulgaria; Dimic A. - Institute for Treatment and Rehabilitation «Niska Banja», Nis, Serbia
"Pain. Joints. Spine." 3 (15) 2014
Categories: Rheumatology, Traumatology and orthopedics
Sections: News
The changes of bone metabolism in gonarthrosis
Authors: Syniachenko O., Iermolaeva M., Taktashov G., Geiko I., Potapov Yu., Keting E. - Donetsk National Medical University named after M. Gorky, Liman, Ukraine
"Pain. Joints. Spine." 1 (21) 2016
Categories: Rheumatology, Traumatology and orthopedics
Sections: Medical forums

Back to issue