Robotic mechanotherapy in the prevention of contractures in patients after minimally invasive knee surgery

Abstract

The active introduction of minimally invasive operations into medical practice has caused the need to improve rehabilitation approaches. We observed patients aged 18–62 years in the early and late postoperative period after minimally invasive knee operations. In addition to traditional rehabilitation treatment, including therapeutic gymnastics, lower limb and lower back massage, and electrical stimulation of the quadriceps femoris, patients in the main group received robotic mechanotherapy. The eff ectiveness of treatment and rehabilitation measures was evaluated by clinical method, electrothermometry, using algofunctional indices (VAS) and the degree of disability (Leken scale). As a result of these measures, the increase in the bending angle in the main group averaged 38,7 ± 4,3° per course of treatment. The average number of robotic mechanotherapy procedures per treatment course was 7,9. In the comparison group, the increase in the bending angle was signifi cantly less (14,1 ± 0,5°) over 10 days of treatment and rehabilitation activities. Pain in the lower extremities at the end of the course of treatment signifi cantly decreased to 2,8 ± 0,09 in the comparison group and 1,8 ± 0,08 in the main group and was rated as mild pain. However, in the main group, its decline was signifi cantly lower. According to the Leken scale, as a result of 10-day course of treatment, patients in the comparison group maintained a moderate degree of disability (6,9 ± 1,7), and patients in the main group — light (4,5 ± 1,78). Analysis of electrothermometry results showed that robotic mechanical therapy procedures increase thermal radiation by an average of 0,6 ± 0,22 °C for 20 minutes of mechanical therapy on the fi rst day and by 1,1 ± 0,2 °C for 30 minutes on the last day. Thus, treatment and rehabilitation measures using robotic mechanotherapy have signifi cantly reduced the pain syndrome, reduced the degree of disability due to earlier normalization of the function of the operated joint, improved blood circulation and neuro-vascular regulation and, as a result, trophic and regenerative processes.