创伤后上肢关节挛缩整骨矫正与标准综合康复的比较分析

A. R. Zamanov, D. .. Miroshnichenko
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摘要

介绍。上肢在各种损伤后长期固定会导致持续性挛缩。上肢关节挛缩是一种严重的骨科病理,可导致长期工作能力下降和永久性残疾。在缺乏治疗的情况下,关节要素的持续变化可能会发展。上肢关节挛缩的患者长期在综合诊所和医院接受治疗,但治疗并不总能达到预期的效果。与此同时,在门诊医疗机构接受治疗的一个基本条件是患者能够进行日常自我护理和独立活动,以及每天到医疗机构就诊,但并非总是能够做到这一点。在这方面,有必要寻找具有相当效果,但需要较少次数的医疗程序的治疗方法,从而减少到专门机构就诊的次数。整骨矫正可能是这些方法之一。本研究的目的是比较创伤后上肢关节挛缩患者的骨科矫正和标准复杂康复的效果。材料和方法。这项研究涉及40名患有创伤后上肢挛缩的患者。采用简单随机化的方法分为两组:主组(20人接受整骨矫正- 3次,频率为7天1次)和对照组(20人接受标准复杂康复,包括物理治疗、物理治疗运动和机械治疗,每天10天)。在研究开始和结束时,对所有患者的骨科状态、上肢关节的活动范围和手部肌肉力量进行评估。研究结束时,两组患者的活动范围和手部肌肉力量均有统计学意义(p< 0.05)的增加。主组患者接受整骨矫正后,部分局部及局部躯体功能障碍检出率均有统计学意义(p< 0.05)的降低。所获得的结果表明,上肢关节创伤后挛缩的整骨矫正和标准的复杂康复的结果相当。由于创伤后挛缩的整骨矫正是每7-10天进行一次,所以对于由于各种原因长期不能定期到康复门诊就诊的患者,可以推荐使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative analysis of osteopathic correction and standard comprehensive rehabilitation of patients with posttraumatic contractures of the upper limb joints
Introduction. Prolonged immobilization of the upper limb after various injuries leads to persistent contracture. Contractures of the upper limb joints are a severe orthopedic pathology that leads to a long-term decrease in working capacity and permanent disability. In the absence of treatment, the persistent changes in the articular elements can develop. Patients with contractures of the upper limb joints get treatment for a long time in polyclinics and hospitals, but the treatment does not always lead to the desired results. At the same time, an essential condition for treatment in outpatient medical institutions is the possibility of daily self-care and independent movement of the patient, as well as daily visits to a medical institution, but it is not always possible. In this regard, the search for treatment methods with comparable effectiveness, but requiring a signifi cantly smaller number of medical procedures and, accordingly, visits to specialized institutions, is relevant. Osteopathic correction could potentially be among these methods.The aim of the study is to compare the effectiveness of osteopathic correction and standard complex rehabilitation of patients with post-traumatic contractures of the upper limb joints.Materials and methods. The study involved 40 patients suffering from post-traumatic contractures of the upper extremities. Two groups were formed by the method of simple randomization: the main group (20 people who received osteopathic correction — 3 sessions with a frequency of 1 time in 7 days), and the control group (20 people who received standard complex rehabilitation, which included physiotherapy, physiotherapy exercises and mechanotherapy, daily for 10 days). The osteopathic status, the motion range of the upper limbs joints, and the hand muscles strength were assessed in all patients at the beginning and at the end of the study.Results. A statistically signifi cant (p<0,05) increase in the motion range and the hand muscles strength was found in both groups at the end of the study. In patients of the main group, receiving osteopathic correction, a statistically signifi cant decrease (p<0,05) in the detection frequency of some regional and local somatic dysfunctions was observed.Conclusion. The obtained results indicate the comparable results of the osteopathic correction of the upper limb joints post-traumatic contractures, and of the standard complex rehabilitation. Since osteopathic correction of post-traumatic contractures is carried out once every 7–10 days, it can be recommended for patients who, for various reasons, cannot regularly visit outpatient rehabilitation departments for a long time.
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