IMPROVING THE METHODOLOGY OF PHYSICAL THERAPY IN ATHLETES WITH INJURIES OF THE KNEE JOINT CONNECTIVE APPARATUS

Abstract

Description and results of the action developed programs of kinesiotherapy with a combination of kinesiotape to restore impaired locomotor functions of the knee joint and the possibility of continuation playing sports after arthroscopic operations for damage to the ligamentous apparatus. Injuries of the musculoskeletal system (MS) are quite common, especially in athletes. According to statistics, up to 50-70% of all ORA injuries occur in the knee joint. Most often, this type of injury is received by athletes, representatives of complex coordination sports and martial arts. Among injuries to the knee joint, injuries to the ligaments, which later cause post-traumatic instability, take second place after damage to the menisci. 35 patients with injuries of the ligamentous apparatus of the CS (12 women and 23 men) who underwent arthroscopic surgery took part in our study. The patients were active athletes in various sports, in particular game sports. Patients were divided into two groups (the main group and the comparison group) depending on the kind of restorative treatment program. The main group included 23 people whose average age was (24.3±3.0) years. Patients of this group received a rehabilitation program in the conditions of an educational and scientific center Department of Physical Therapy, Occupational Therapy of PNU named after Vasyl Stefanyk. The comparison group (CP) consisted of 12 people, the average age of which was (23.8±3.1) years, who underwent rehabilitation in the polyclinic department of the 1st city polyclinic. The individual program of physical therapy for OG patients included kinesiotherapy and massage muscles of the lower limb, physiotherapeutic procedures and the use of kinesiotape. Kinesiotherapy included therapeutic gymnastics of independent classes, massage for the prevention of contracture of the CS and atrophy of the thigh muscles. Various types of massage were used - classic manual massage with passive movements in the joints, self-massage and hydro massage. Physiotherapy procedures were aimed at reducing swelling and pain, preventing the development of the inflammatory process. Patients were prescribed electrophoresis of painkillers, UV irradiation, and UHF or laser therapy, applications of ozokerite or paraffin. These procedures contribute to the stimulation of lymph and blood circulation, trophic processes in the joints, increasing the amplitude of movements and restoring the strength of the muscles of the limb. In order to objectify the results of the restorative treatment, the functional ability of the lower limb was assessed using the Lovett muscle test (six-point assessment of muscle strength), the amplitude of movements in the knee joint (goniometry) and the visual analog pain scale (VAS) on the 14th day, 1.5 months, 3 and 5 months after the operation. This part of the study showed the advantages of the developed rehabilitation program using elements of kinesiotaping, as only a few patients with functional disorders were found in OG while in the comparison group their number was up to 20%. Improvement of joint function and normalization of muscle strength and goniometry indicators occurred earlier in OG patients by 2 weeks, compared to patients who underwent restorative treatment according to the traditional method of the city polyclinic. A special place in the assessment of results is given to determining the quality of life using the SF-36 questionnaire. The dynamics of quality of life indicators showed a gradual and likely improvement of all components of quality of life at the entire stage of post-hospital rehabilitation. We proved that the proposed rehabilitation program is more effective compared to the traditional methods of restorative treatment of a medical institution and allows achieving better results in restoring the functions of the knee joint in the shortest possible time after the injury and can be recommended for wide use.