FEATURES OF MEDICAL REHABILITATION OF PATIENTS WITH PELVIC FRACTURES
DOI:
https://doi.org/10.15674/0030-59872026296-103Keywords:
Unstable pelvic ring injury, external osteosynthesis with multidirectional threaded rods, physical rehabilitation, kinesiotherapyAbstract
The goal is to develop and test a program for early active rehabilitation of patients after osteosynthesis of unstable fractures using external fixation devices (EFD) with rods with multidirectional threads. Methods. The clinical and radiological examination protocols of 42 patients were studied, who were randomized into two groups: main A (n = 25) and control B (n = 17). In g roup A, rods with a multidirectional thread were used in the EFD and the active early rehabilitation program developed by us was applied. In group B, rods in the EFD had a unidirectional thread; a standard rehabilitation program was prescribed. The control examination was carried out 3 months after surgery. Results. The developed plan of active early postoperative rehabilitation differed from the standard one in the presence of a training program that corrected the level of kinesiophobia and anxiety associated with the expectation of pain; in kinesiotherapy, the following additional methods were used: in the 1st period — extended mobilization of the trunk muscles, ideomotor exercises, dosed load in a vertical position with the use of additional support; in the 2nd — soft manual therapy techniques; in the 3rd - isometric exercises for the muscles of the lumbopelvic zone and the muscles of the pelvic floor. The average period of bed rest was (8.2 ± 3.7) days for group A and (16.9 ± 10.2) days for group B; p < 0.05. Conclusions. The developed technique had the following effectiveness: during the control examination after 3 months. All indicators (pain intensity according to VAS ((3.6 ± 1.8) cm in group A and (4.8 ± 1.8) cm in B), level of kinesiophobia according to Tampa TSK scale ((31.7 ± 9.8) points and 40.6 ± 11.4 respectively), level of anxiety according to PASS-20 questionnaire (21.6 ± 9.4 and (36.2 ± 8.9) points respectively), integral quantitative indicator of the degree of patient participation (full — in 24 and 12 % respectively; moderately limited — 40 and 24 %; significantly limited — 28 and 46 % respectively; nominal — 8 and 18 %), endurance of flexor muscles (112.1 ± 34.8 and (101.9 ± 35.4) s) and extensors of the pelvis and hips (96.4 ± 36.2 and (90.5 ± 36.2) s), the functional assessment of the consequences of pelvic fractures according to the Majeed scale (78.6 ± 4.4 and (76.2 ± 4.81) points) in the main group A was higher than the results of group B.
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