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Background. The postoperative period is often accompanied by pain and limited mobility in the ankle joint. There is a need to evaluate the effectiveness of additional rehabilitation methods in the late postoperative period. Aim. Evaluation of the effectiveness of complex (standard + osteopathic) treatment compared with standard restorative treatment in patients with distal tibia fractures in the late postoperative period. Material and methods. In the course of a randomized study, patients in the late postoperative period (68 weeks after surgery; n=40) were divided into two groups: the main group (n=20) received a standard rehabilitation treatment regimen and osteopathic treatment (correction of identified somatic dysfunctions); the comparison group (n=20) only the standard rehabilitation treatment regimen. The amplitude of motion of the affected ankle joint was assessed using a goniometer, the level of pain in the affected ankle joint was assessed using a visual analogue scale, and the level of quality of life was assessed using the SF-36 questionnaire. Data are presented as arithmetic mean and standard deviation M (SD). When analyzing intergroup differences, the nonparametric MannWhitney test (U-test) was used; when analyzing intragroup differences, the nonparametric Wilcoxon test (W-test) was used. The critical level of statistical significance was taken as 5% (p=0.05). Results. The addition of osteopathic treatment to the standard scheme led to a significant decrease in the level of pain (0.3 points in the main group, 1.5 points in the comparison group; p=0.0026), an increase in the amplitude of active movements in the ankle joint (64.7 in the main group, 51.8 in the comparison group; p=0.000217), improvement in the quality of life physical functioning (an increase in the indicator in the main group by 39 points, in the comparison group by 26 points), general health (an increase in the indicator in the main group by 47 points, in the comparison group by 28 points). Conclusion. Combined treatment (standard plus osteopathic) improves the results of restorative treatment compared with standard therapy alone in patients with fractures of the distal tibia in the late postoperative period.
Background. The postoperative period is often accompanied by pain and limited mobility in the ankle joint. There is a need to evaluate the effectiveness of additional rehabilitation methods in the late postoperative period. Aim. Evaluation of the effectiveness of complex (standard + osteopathic) treatment compared with standard restorative treatment in patients with distal tibia fractures in the late postoperative period. Material and methods. In the course of a randomized study, patients in the late postoperative period (68 weeks after surgery; n=40) were divided into two groups: the main group (n=20) received a standard rehabilitation treatment regimen and osteopathic treatment (correction of identified somatic dysfunctions); the comparison group (n=20) only the standard rehabilitation treatment regimen. The amplitude of motion of the affected ankle joint was assessed using a goniometer, the level of pain in the affected ankle joint was assessed using a visual analogue scale, and the level of quality of life was assessed using the SF-36 questionnaire. Data are presented as arithmetic mean and standard deviation M (SD). When analyzing intergroup differences, the nonparametric MannWhitney test (U-test) was used; when analyzing intragroup differences, the nonparametric Wilcoxon test (W-test) was used. The critical level of statistical significance was taken as 5% (p=0.05). Results. The addition of osteopathic treatment to the standard scheme led to a significant decrease in the level of pain (0.3 points in the main group, 1.5 points in the comparison group; p=0.0026), an increase in the amplitude of active movements in the ankle joint (64.7 in the main group, 51.8 in the comparison group; p=0.000217), improvement in the quality of life physical functioning (an increase in the indicator in the main group by 39 points, in the comparison group by 26 points), general health (an increase in the indicator in the main group by 47 points, in the comparison group by 28 points). Conclusion. Combined treatment (standard plus osteopathic) improves the results of restorative treatment compared with standard therapy alone in patients with fractures of the distal tibia in the late postoperative period.
Relevance. People involved in professional sports quite often encounter injuries. Thus, one of the main problems of modern traumatology and rehabilitation medicine is sports traumatism, which accounts for 2 to 7 % of all injuries.Objective: to analyze the available and modern methods of rehabilitation of athletes with fractures of the bones of the lower extremities.Materials and methods. In the course of the present study, we reviewed the literature data reflecting the current views on the problem of rehabilitation of athletes with fractures of lower limb bones.Results. Successful recovery of athletes and early return to the training process is largely determined by optimally selected rehabilitation measures. There is no unified algorithm in rehabilitation of athletes; the choice of tactics depends on a number of factors, such as localization and severity of the fracture, surgical and conservative treatment performed, individual characteristics of the athlete, and the desired result. The optimal algorithm is a combination of classical rehabilitation measures, which include therapeutic physical training, diet therapy, psychotherapy and physical therapy procedures such as massage, taping, low-frequency magnetic therapy, UHF in low-heat doses, electrophoresis of analgesics, calcium and phosphorus drugs and thermotherapy.Conclusion. All rehabilitation measures are aimed at gradual increase of physical load on the injured limb and strengthening the musculoskeletal system by improving tissue trophism, muscle tone, activation of metabolic processes as well as pain reduction and stimulation of regeneration of injured tissues. The adaptation basis of rehabilitation is the model of control of movements ("control-chaos continuum"), which provides the prevention of complications and re-injuries. Rational nutritional therapy contributes to increasing muscle mass and preventing the accumulation of fat mass. When choosing rehabilitation measures, the nature of the chosen treatment and objectives are taken into account, so that the choice of rehabilitation measures is made on an individual basis, in order to achieve the best possible results in a short period of time. Adequately chosen rehabilitation measures allow athletes to safely return to their original physical performance and reduce the risk of re-injury.
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