Background. Clinically, functional instability (FI) of metacarpophalangeal joints (MCPJ) is not considered to represent a pathology. This excessive mobility can be detected by the application of external forces to a MCPJ at different angles. Our study aimed to measure the FI of 2nd to 5th MCPJ. Materials and methods. A group of 36 healthy right-handed individuals were enrolled. The value of FI was measured in millimeters and verified by a CT scan. Statistical calculations was made in Statistica v.10.0. Results. The largest values of the right and left-hand finger posterior displacement (FI) in the second to fifth MCPJ were obtained in the neutral position 0° (p<0.05). Measurements of volar displacement of the proximal phalanx second to fifth MCPJs in both hands revealed higher values at position 0° (p<0.05). Conclusions. 1. FI of the second to fifth MCPJs is determined by anatomical configuration and dynamic stabilizers. 2. Instability measurements show that posterior displacement of the proximal phalanges is greater by at least 1 mm in the 0° neutral position.
Regular revision of the management of osteoarthritis by world associations has been performing both to the epidemiologicalfeatures of the spread of the disease in 80% of the after-50-years-old population, and to the comorbidities. The groupof this age has the highest risk of susceptibility and severe course of COVID–19. Objective. To reveal the features of the step-bystep algorithm for the treatment of patients with osteoarthritis in the conditions of the COVID-19 pandemic. Methods. The study is based on the analysis of the published data on the peculiarities of non-pharmacological and pharmacological means according to the step-by-step algorithm for the treatment of patients with osteoarthritis. 227 published scientific sources, from which 54 editions with a reliable evidence base were selected. Results. The treatment of patients with osteoarthritis in the conditions of a pandemic requires correction, due to the use of drugs with certain pharmacokinetic and pharmacodynamic properties that can atypically or negatively affect the systems of the body. Each of the four steps of the treatment algorithms for patients with osteoarthritis was analyzed, taking into account the pathophysiological features of the course of chronic joint disease and acute viral damage to the respiratory system. It was noted that despite the high variability of treatment methods for patients with osteoarthritis, decisions regarding the therapeutic tactic should be made taking into consideration the individual characteristics of the body and comorbidities. It was emphasized that the final decision regarding the prescription of corticosteroids and non-steroidal anti-inflammatory drugs must be properly argumented. The correction of the treatment measures set at each step of the algorithm is proposed. It would prevent the aggravation of the chronic impression of the joints in the adverse situation of the COVID-19 pandemic. Conclusions. A profound search in the scientific published sources for evidence concerning the specifics of the effect of non-pharmacological and pharmacological means of treatment for patients with osteoarthritis will allow to use their effects effectively using step-by-step algorithm especially during the dangerous pandemic situation.
The paper is concerned with the current state of doctors’ training methodologies. Problems of teaching the discipline were identified: inability to memorize the amount of theoretical material, the ineffectiveness of methodological techniques for practical training, amount of new training centers. It has been proven that these faults are risky for mastering learning skills. The method of «see - repeat»preferred by coachers is not a panacea for the effective educational process during various medical interventions. Particular attention is paid to the psychological borders of young doctors in the recollection of new information that is needed to be improved. Objective. Build an innovative methodological strategy that requires a combination: high quality of theoretical medical knowledge and practical skills. Results. Among modern pedagogical techniques, the most profitable is the method of Peyton, which became the base of «Professor’s Sulyma training». Detailed instruction of the author's teaching strategy is suggested in the report. This way of education is based on neurobiological research and divided into 10 stages, which are theoretically and methodically described. The authors approbated training and paid attention to its effectiveness. Conclusions. «Professor’s Sulyma training» is a method that allows practicing any valuable skills in different medical areas
Aim: To develop a rehabilitation protocol for patients with the unstable ankle joint injuries by doing comparative analysis between HSEF functional results and the traditional method. Materials and Methods: The study was performed on 61 patients with the unstable ankle trans- or supra-syndesmotic fractures. Patients were divided into two equal groups where I = main and II = control due to the age, distribution and disorders. 10 patients from the group I were operated using HSEF, the other 51 were selected for the traditional osteosynthesis (plate and positioning screw). For the monitoring of osteosynthesis quality was used The Foot and Ankle Disability Index (FADI) scale. Nonparametric statistical analysis was completed using Statistica 13.0 computer software. Results: After application of HSEF method authors of this paper created original rehabilitation protocol. Limitations in the rehabilitation process (e.g., not weightbearing) on 42}3 day in the control group II caused a significant gap in the results of ankle joint functional recovery. On day56}3, the main group I overreached the control group II by 1.5 (p3<0.001). With each FU 1-3 of the main group I, the total sum of points according to FADI (subscale of sports activity) steadily increased by 5, and with FU 3 on the 56}3 day, reached 16 points. Positive quantitative dynamics in scores were the characteristic of patients from both groups (advantage of the group I was insignificant (by 2 points) (p4<0.001)), although none of them reached the normal (32 points) at the final term (FU 4). Conclusion:Provided results proved the effectiveness of the developed rehabilitation protocol. It enhanced patients recovery up to 1-2 weeks.
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