In patients with peripheral vertigo, central vertigo and unsteadiness, vestibular-spinal reflex was disturbed at different levels of vestibular analyzer.
Хроническая неспецифическая боль в нижней части спины (ХНБС) представляет серьезную медицинскую и социальную проблему, являясь одной из основных причин инвалидизации и значительного снижения качества жизни людей в современной популяции. Разработка эффективных методов лечения ХНБС требует совместных усилий представителей разных медицинских специальностей: терапевтов, ревматологов, неврологов, нейрохирургов и реабилитологов. Одной из частых причин развития ХНБС следует считать остеоартрит фасеточных и крестцово-подвздошных суставов. Авторы рассматривают вопросы патогенеза и клинических проявлений, проблемы диагностики, а также различные подходы к лечению данной патологии. На основании собственного опыта и анализа данных литературы определены ряд положений, которые в дальнейшем могут использоваться для формирования рекомендаций по лечению и реабилитации больных с ХНБС. Ключевые слова: хроническая неспецифическая боль в спине; остеоартрит; фасеточные суставы; крестцовоподвздошные суставы; нестероидные противовоспалительные препараты; глюкокортикоиды; гиалуроновая кислота; радиочастотная денервация.
Introduction. Nowadays an acute cerebrovascular accident and its consequences have become an important public health issue. One of the most common and severe complications of the stroke is periarthropathy of the shoulder joint, known as «frozen shoulder». According to different sources of information, the frequency of occurrence of this pathology ranges from 40 to 80 %. By now, no single concept of treatment of post-stroke periarthropathy of the shoulder joint has been developed.Goal of research — to study the effectiveness and safety of osteopathic correction in complex therapy of pain syndrome in post-stroke periarthropathy.Materials and methods. Patients undergoing treatment in the hospitals were randomly divided into 3 groups. In the fi rst group, the osteopathic treatment was performed in addition to the basic treatment. А periarticular blockade was additionally used in the second group. In the third group, traditional basic treatment was performed. The severity of the pain syndrome was assessed with the help of the visual analogue scale (VAS). The ability of movement in the shoulder joint and daily activity was controlled by a simple shoulder test (SST). The complex state of the shoulder joint was assessed according to the Swanson scale, which included both the patient′s subjective assessment and the medical examination data.Results. The data obtained in the course of the study indicated that the additional use of medical diagnostic blockades provided a signifi cantly more important reduction in the intensity of pain syndrome, in comparison with the control group. This is of particular importance for patients with severe pain syndrome. At the same time, in the fi rst group, additional osteopathic treatment contributed to a more rapid and pronounced restoration of the functions of the affected limb with less regression of the pain syndrome.Conclusion. Thus, the additional use of therapeutic blockade and osteopathic techniques should be differentiated and determined by the clinical performance of post-stroke periarthropathy of the shoulder joint.
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