Features of the use of physical exercises at the long-term stage of rehabilitation after intra-articular fractures

Abstract

Background and Study Aim. The main demand after surgical treatment of the injury is to restore motor function and return to an active lifestyle. The inclusion of effective therapeutic exercises in the rehabilitation program will help to restore the physical activity of patients. The aim of the study is to develop and evaluate the effectiveness of a set of therapeutic exercises to restore the movements of the lower extremities of patients after surgery.
 Material and Methods. The program involved 14 patients who were randomized (n=6 - control group, CG; n=8 - main group, MG). All patients gave their informed consent to participate in the experiment and to the processing of their personal data. It was used the following scales: “6 minute walk test”, “Knee injury and Osteoarthritis Outcome Score” (KOOS). The International Classification of Functioning (ICF) categories were assessed and program objectives were set. Conducted individual classes according to the developed rehabilitation program in the MG and the generally accepted in the CG. After 2 months, the implementation of the goals set in the program was evaluated. Nonparametric statistics were used to determine differences between groups, Wilcoxon test for related sets, and Mann-Whitney criteria for independent sets. Values ​​of p <0.05 were considered significant.
 Results. The goal of "Restore lower limb function" and "Ability to drive a car" was fulfilled in the MG and CG. Significant differences in the dynamics of KOOS subscales “Pain”, “Symptoms and stiffness”, “Quality of life” confirm this (p <0.05). The goal "Ability to work in the backyard" was met only by MG patients. The distance traveled significantly improved in MG and CG (p <0.05), but there was a significant difference between the comparison groups on this indicator (p <0.05). The assessment of the scale of the KOOS “Sport” and “Active Recreation” subscales changed only for MG (p <0.05) and at the end of the program differed significantly from the CG (p <0.05). Category d850 “Paid work” significantly improved during the study period in MG (p <0.05), with a significant difference between these indicators with CG. 2 of 6 CG patients (33.3 ± 21.1%) and 6 of 8 patients with MG (75.0 ± 16.4%) returned to previous work at p <0.05.
 Conclusions. It is recommended to perform exercises with an emphasis on the posterior surface of the lower extremity. The author's program of physical rehabilitation is quite conditional. Depending on the situation and condition of patients, adjustments are made. But the general direction and nature of the impact must be maintained.