The purpose of the study was to determine and substantiate the feasibility of examination methods in patients with рain in the knee joint at the arthralgia stage for further development of the pathogenetically sound physical therapy program. Materials and methods. The study involved persons who had complaints of pain in the knee with a preliminary diagnosis: knee functional arthralgia of the joint (n = 32, 65.6% – women; age (M±SE) – 55.1±2.7 years; frequency of lesion of the right knee joint was 57.1%, the average term of the functional breakdown of the knee joint is 2-2.5 months). The paper uses the tools that provided for the collection of anamnesis (questioning, definition of body mass index), the evaluation of the function and the level of activity of the knee joint (Lovett test, Lysholm scale) and various human quality parameters (WOMAC's questionnaire and EuroQol-5D questionnaire). Results and discussion. The article analyzed the data of modern research methods in patients with functional pain in the knee joint. To establish a connection between the pain in the knee and functional arthralgia, a questionnaire was carried out and anamnesis of patients was analyzed. This allowed to identify the following: the vast majority of persons (65.6%) was represented by women who had complaints of pain in the knee joint; 93.75% still experienced pain in the knee, and 62.5% of patients felt stiffness in the knee joint. In 45% of people pain influenced their daily life, and 36% limited their physical activity. It should also be noted that the frequency of lesions of the right knee joint was 57.1%. When carrying out manual muscle testing, Lovett and Lysholm scales were used, which made it possible to determine the level of functional activity of the knee joint at the arthralgia stage: manual muscle testing flexors was 3.01±0.02 points, and manual muscle testing extensors corresponded to 2.65±0.015 points. Measurement of the circle of the knee joints showed that the right will be somewhat wider than the left with the indicators of 38.2±1.5 cm and 37.8±0.7 cm respectively. This confirmed a decrease in muscle strength, especially the muscles of the knee. In 76% of the examined women, the state of the knee joint function was on the verge of "satisfactory" and "unsatisfactory". This can be explained by the fact that the prevalence of arthralgia seems to increase in women with a menopausal transition and is considered a result of a decrease in estrogen, an increase in body mass index, etc. Conclusion. WOMAC and EuroQol-5D tests made it possible to estimate the dynamics of the development of pain and the level of discomfort of patients with pain in the knee joint. It has been found that the steadiest is pain in women (61±5.1 points), and functional failure in men (49±3.6 points). Thus, the pain in the knee in functional arthralgia adversely affects both the main spheres of human life, and reduces the quality of life in general. The results of functional performance tests indicate a violation of the balance and the ability to walk, which is due to the detection of different lengths of the muscles, the weakness of the thigh muscles and the disposition of the extraction. The methods of research proposed by the authors allow to comprehensively assess the functional state of the patient at the arthralgia stage in the knee area, which is a predictor to the next stage of the study, namely planning an integrated individual rehabilitation program. The use of a comprehensive approach in the examination of patients can give a physical therapist a more substantiated approach to the introduction of treatment products, which will more effectively affect the elimination of the primary cause of the formation of pain syndrome and prevent the further development of pathological processes in the structures constituting the knee joint
The purpose of the study was to search for and analyze data from modern sources of information on the features of the occurrence and manifestations of pain in the knee joint and approaches to treatment. Materials and methods. The paper presents an analysis and generalization of modern scientific and methodological literature of domestic and foreign authors according to the Internet and Google Scholar service on the peculiarities of arthralgia of the knee joint and concomitant manifestations of this disorder (back pain, posture, etc.). Results and discussion. The article analyzed modern views on the occurrence and development of the process of pain syndrome in the knee joint. Sources on request in the Google Scholar service were analyzed, where the overwhelming majority of publications are described by pain slander and approaches to its treatment after the occurrence of anatomical changes in the structures of bone and soft-wound structures or after surgical interventions. Thus, the prevailing approach is the purpose of non-steroidal anti-inflammatory drugs in combination with chondroprotectors. According to the authors of the article, this approach to the treatment of pain in the area of the knee joint does not take into account one of the main components of the occurrence of arthralgia – muscle imbalance, both at the local level of the lower extremities and muscular-fascial chains. According to the theory of muscular chains, the dislocation of bones forming the knee joint leads to uneven loading of the femoral and tibial bones to the metaphizar deposits, which leads to a circulatory disorder and further leads to degenerative-dystrophic diseases. Understanding this component of pathogenesis can give a specialist in physical therapy and ergotherapy a more informed approach to the development of balanced treatment tactics aimed at eliminating the primary causes of pain syndrome. Conclusion. Pain in the knee joint can be caused not only by degenerative-dystrophic changes in the bones, but also can be associated with muscle imbalance of the posterior surface line. The development of a rehabilitation program for knee pain should include not only the use of local remedies, but also take into account the impact on the relevant reflex areas in the spine. Emerging degenerative-dystrophic processes in the bones that are part of the structure of the knee joint can be caused by their dislocation due to muscle imbalance. Uncontrolled and unauthorized use of analgesics by patients with knee pain can smooth the clinical picture and reduce the effectiveness of rehabilitation measures
Introduction Fractures of the humeral condyle make up 0.5-5.0 % of all fractures and about 30.0 % of adult elbow fractures. Complications develop in 18.0-85.0 % of cases and 29.9 % of the injured have signs of disability, giving these fractures a reputation of injuries with a poor prognosis for functional recovery. Objective To improve the treatment results of the injured with humeral condyle fractures by developing differential treatment tactics taking into account the biomechanical characteristics of the injured anatomical structures. Material and methods The authors analyzed the results of conservative and surgical treatment of 194 patients with fractures of the humeral condyle. The average age of the patients was 50.2 years (range from 19 to 89 years); there were 75 (38.7 %) males and 119 (61.3 %) females. Based on the method of treatment, the patients were divided into 2 groups, each group included a control subgroup and the results of treatment were analyzed. The main subgroup of the clinical group 1 (surgical treatment) consisted of 99 patients with an average age of 49.1 years (range from 19 to 85 years). There were 49 (49.5 %) men and 50 (50.5 %) women. The control subgroup of the clinical group 1 (surgical treatment) consisted of 41 patients with an average age of 51.4 years (from 21 to 89 years). There were 17 (41.5 %) men and 24 (58.5 %) women. The main subgroup of the clinical group 2 (conservative treatment) consisted of 29 patients with an average age of 51.2 years (from 21 to 88 years). There were 5 (17.2 %) men and 24 (82.8 %) women. The control subgroup of the clinical group 2 (conservative treatment) consisted of 25 patients with an average age of 52.9 years (from 21 to 87 years). There were 4 (16.0 %) men and 21 (84.5 %) women. The fractures were rated according to the AO classification: type 13A – 15 (7.7 %) individuals, type 13B - 40 (20.7 %) subjects and type 13C – 139 (71.6 %) patients. Results The mean duration of follow-up was 39.0 ± 1.0 months (7 to 48 months from injury). The mean range of motion in the elbow joint was 110.5 ± 1.2º (50º to 140º), the mean score on the Mayo clinic scale was 81.7 ± 0.9 (45 to 100), and on the Score Scale was 62.7 ± 0.7 (38 to 76). Excellent functional results were obtained in 95 (49.0 %) patients (p < 0.001), good – in 41 (21.2 %) (p < 0.001), fair – in 28 (14.4 %) (p < 0.001) and poor – in 30 (15.5 %) patients (p < 0.001). Conclusion Differentiated treatment tactics in humeral condyle fractures permitted to obtain positive results in 92.2 % (p < 0.001) of the patients in comparison with 89.4 % (p < 0.001) of the control group and to decrease the number of complications by 20.2 % (p < 0.001).
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