In the general structure of joint diseases in terms of incidence, coxarthrosis ranks second after gonarthrosis and first in terms of the degree of disability. The development of this disease is accompanied by a persistent, severe pain syndrome, as well as functional disorders such as lameness, limited mobility, and then premature disability of patients. The main factors for the occurrence of coxarthrosis are congenital, but there are also internal factors that lead to a decrease in the resistance of the cartilage itself when performing standard loads (walking). To prevent exacerbations during the period of remission of coxarthrosis, physiotherapy exercises are prescribed to prevent exacerbations. The authors developed an optimal exercise therapy scheme for patients with coxarthrosis and compared the effectiveness of the therapy in patients treated with traditional physical therapy and an original set of physical exercises. This comparison showed that the values obtained when testing on a visual analogue scale (assessment of pain intensity) in all two analyzed samples correspond to the presence of severe pain in patients. As a result of the treatment, the indicator significantly (p<0.05) decreased by 58.6% in the experimental group and by 16.9% in the control group. The values of pain assessment according to the Lequesne index, noted by patients, also decreased in all two groups ‒ by 11.9% in the control group (p<0.05), by 46.3% in the experimental group (р<0.05). At the same time, according to the Harris test, the assessment of pain intensity in patients after treatment decreased approximately the same as in the control group (by 60.9%, p<0.05). The results of the study showed the best results in reducing pain, eliminating stiffness of movements and increasing the functionality of the musculoskeletal system. Keywords: coxarthrosis, physical therapy, joints, physiotherapy.
The purpose of this study is to investigate the changes in blood leptin level of patients with arterial hypertension, who has or has no concomitant abdominal obesity. The study included 87 patients (45 men and 42 women), aged from 32 to 71 years; among them 47 patients had abdominal obesity, and 40 patients had normal body weight. Arterial hypertension stage 2 was diagnosed in 46 (53%) people, stage 3 – in 41 (47%) people, abdominal obesity class 1 was found in 56 (64%) people, class 2 – in 31 (36%) people. Among the patients included in the study, burden of hereditary risk factors was found in 67 patients (77%). The control group included 25 healthy individuals who had normal body weight (body mass index <25 kg/m²), waist circumference <88 cm (in women) and <102 (in men), normal levels of glucose, triglycerides and fasting high-density lipoprotein cholesterol. The study has found out the patients with arterial hypertension and concomitant obesity have significantly higher levels of systolic and diastolic blood pressure, heart rate, significant disorders of lipid, purine, and carbohydrate metabolism, disorders of leptin synthesis; leptin resistance, insulin resistance occurred in significantly higher number of cases than compared with the group of patients with arterial hypertension and normal body weight. The studied groups of patients differed in terms of carbohydrate metabolism: the average fasting blood glucose level was significantly higher in people with arterial hypertension with obesity than in patients with hypertension without obesity. A statistically significant difference remained when comparing with the control group, where the average blood glucose was by 0.9 mmol/l (16.1%) lower than in hypertensive patients with abdominal obesity. A statistically significant increase in the level of blood leptin was found in the group of women suffering from arterial hypertension with abdominal obesity, in comparison with women suffering from arterial hypertension without obesity and the control group of individuals. There has been revealed a reliable positive correlation between the level of blood leptin and the level of blood uric acid.
The purpose of the study was to develop a comprehensive program of physical rehabilitation to improve the course of shoulder-scapular periarthritis in patients with the help of therapeutic massage with elements of manual therapy. Materials and methods. The paper presents the results of studying the effect of physical therapy in shoulder-scapular periarthritis. The main group included 37 patients aged 50–75 years with shoulder-scapular periarthritis who underwent a complex rehabilitation program proposed by us, including massage. The control group consisted of 33 patients in the same age category who were prescribed a standard rehabilitation program by a physical therapy doctor. Results and discussion. The term humeroscapular periarthritis was first proposed in 1872. This is how the syndrome was characterized, including stiffness and the presence of chronic pain in the area of the shoulder joint that occurs after an injury. The prevalence of humeroscapular periarthritis among the adult population is 4–7%, with age it increases (from 3–4% at the age of 40–44 years to 15–20% at the age of 60–70 years). An important condition for a faster and more effective treatment of humeroscapular periarthritis is massage. Its main task is to prevent the development of limited mobility of the joints and coarse scar tissue, prevent muscle atrophy and restore the functional affiliation of the upper limbs. As a result of the treatment, significant improvement was noted in 26 patients, improvement – in 9 patients, insignificant effect was noted in 2 patients. So, before the operation, pain syndrome according to visual analogue scale was on average 6.4 ± 0.39, in the early postoperative period – 5.1 ± 0.19, in the late recovery period – 1.7 ± 0.14. The effectiveness of complex treatment when affecting the affected limb was 3.4 points in dynamics before and after the massage course. Thus, the comparative characteristics of the two examined groups of patients according to functional results, even according to an incomplete list of clinical and biomechanical indicators of statics and dynamics, showed the effectiveness of conducting a comprehensive program of rehabilitation measures. Taking into account the high prevalence of diseases of the musculoskeletal system, we consider it advisable to use manual therapy methods more widely in patients with shoulder-scapular periarthritis. Conclusion. After a course of massage with elements of manual therapy, the majority of patients noted positive dynamics, elimination of pain syndrome, restoration of the function of the affected limb
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