The use of osteopathic correction in the complex rehabilitation of patients with acute cerebrovascular accident

Abstract

Introduction. Acute disorders of cerebral circulation - strokes - are the most important medical and social problem, due to their high proportion in the structure of morbidity and mortality of the population, signifi cant indicators of temporary labor losses and primary disability. In this regard, one of the main tasks of Russian healthcare is to slow down the increase in the disability of the population, which is carried out through the active development of the rehabilitation system in our country, including neurorehabilitation. Osteopathic correction can become one of the new areas of rehabilitation for this group of patients. There have already been made previous attempts to study the osteopathic status in patients with acute cerebrovascular accident and to assess the possible contribution of somatic dysfunctions to the pathogenesis of this disease. At the same time, there are no publications in the available scientifi c literature about the possibility of osteopathic correction using in the rehabilitation of patients with acute cerebrovascular accident in the early recovery period. All of the above predetermined the purpose of the study.The aim of the study is to substantiate the possibility of osteopathic correction methods using in the complex rehabilitation of patients with acute cerebrovascular accident in the early recovery period.Materials and methods. A prospective randomized controlled study was conducted from February 2019 to March 2020 on the basis of the neurorehabilitation department of the State Clinical Hospital № 11 (Omsk). 40 patients with a diagnosis of acute cerebrovascular accident, early recovery period were under observation. The sample was entire. Patients, depending on the method of used treatment, were divided with using the method of simple randomization into two comparable groups of 20 people: main and control. All patients received complex rehabilitation treatment, which included drug therapy, physiotherapy, kinesiotherapy, massage, and acupuncture. Additionally, patients of the main group received osteopathic correction (3 sessions). All patients, regardless of the group, before the start, as well as after the completion of the rehabilitation course, were assessed for osteopathic status, the level of self-care, daily activity and mobility of patients was determined using functional scales, and muscle strength of the hands was studied using dynamometry.Results. Patients with ischemic stroke in the early recovery period are characterized by the presence of somatic dysfunctions, mainly at the global and regional levels. 100 % of the examined participants had a global rhythmogenic cranial disorder. The most characteristic regional somatic dysfunctions were of the neck region, the structural component (29 %), and of the dura mater region (24 %). After completion of rehabilitation, global rhythmogenic cranial somatic dysfunction remained in all patients (100 %), however, in the group that received osteopathic correction, its severity was statistically signifi cantly reduced (p<0,05). Also, in the main group, the average number of regional somatic dysfunctions and their severity changed statistically more signifi cantly (p<0,05). At the background of complex rehabilitation treatment, all patients had an increase in the level of self-care, daily and physical activity according to neurorehabilitation scales, and also increased arm muscle strength according to dynamometry. However, in the group receiving additional osteopathic correction, these indicators were statistically signifi cantly higher (p<0,05).Conclusion. Rehabilitation of patients with vascular pathology, including those with ischemic stroke, is one of the most important directions in the development of the modern healthcare system. This dictates the need to search and study new methods and means of rehabilitation, one of which could be osteopathy. This study showed that the inclusion of osteopathic correction in the program of complex rehabilitation of patients with ischemic stroke in the early recovery period will achieve better results in terms of restoring lost functions and improving self-care skills. In order to introduce the new method more widely, it is advisable to continue the study on an even larger sample.