UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine
ISSN 2079-0325(p)
DOI 10.36927/2079-0325

Effi ciency of complex treatment of the patients with vertebral thoracalgia using the manual therapies

Type of Article

In the Section

Index UDK:

Abstract

Objective: to increase the eff ectiveness of complex treatment of patients with vertebral thoracalgia (VT) through the diff erential use of manual therapy and kinesiotherapy, depending on the character of neurological signs.

We observed 507 patients with VT. Among them, 368 patients (72.6 %) were included in the main group, where complex treatment was carried out using manual therapy (MT) and kinesiotherapy. There were 128 men (34.8 %), 240 women (65.2 %). The comparison group consisted of 139 patients (27.4 %) who received similar treatment, but without MT and kinesiotherapy. There were 51 men (36.7 %), women — 88 (63.3 %). Groups of patients with VT were comparable in terms of the duration of the disease, the timing of exacerbation, the severity of pain and the limitation of vertebrodynamics.

At the diagnostic phase, all patients were given a detailed vertebral neurological examination according to a specially developed protocol and computed tomography of the spine. Statistical analysis was performed using descriptive statistics methods.

As a result of treatment the patients in the main group, where MT was used in complex treatment, 261 patients (70.9 %) were discharged, 75 patients (20.4 %) — with improvement, 29 (7.9 %) — with slight improvement, and only 3 patients (0.8 %) with thoracalgia with autonomicvisceral singns were discharged without improvement. The average bed-day was 13.8 ± 1.9. In the comparison group, the results of treatment were worse: for example, 56 patients (40.3 %) were discharged with a signifi cant improvement, 29 people (20.9 %) — with improvement, with a slight improvement 18 (12.9 %) and 36 patients without improvement (25.9 %). The average duration of inhospital stay was 19.9 ± 1.9.

The use of MT in the complex treatment of patients with VT contributed to increased effi ciency, better recovery of patients and reduced length of stay in the department. The results of complex treatment with the using of MT and kinesiotherapy were better in patients who had VT with muscular-tonic signs.

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References

  1. Pain syndromes in neurological practice / edited by Prof. V.L. Golubev. 3 ed. Moscow: MEDpress-Inform, 2010. 336 с.
  2. Veselovsky V. P., Mikhailov M. N., Samitov M. Sh. Diagnostics of spinal osteochondrosis syndromes. Kazan : Kazan University Press, 1990. 290 с.
  3. Epifanov V. A., Epifanov A. V. Rehabilitation in neurology. М. GEOTAR-Media, 2014. 416 с.
  4. Kozelkin A. A., Medvedkova S. A., Lisova O. A. Diagnosis and treatment of vertebrogenic pain syndromes. A. Diagnostics and treatment of vertebrogenic pain syndromes. Zaporozhye, 2008. 123 с.
  5. Oros MM, Grabar VV Pain in the heart area: a neurologist's view // Internat. neurol. journal 2017. № 7. С. 77-81.
  6. Popelyansky Ya. Y. Orthopedic neurology (Vertebro-neurology) : manual for doctors. 5 ed., supplement. and revision. М. MEDpress-Inform, 2011. 672 с.
  7. Evaluation of noncardiogenic chest pain / [V. I. Dorofeev, D. N. Monashenko, D. A. Svirido, A. A. Saveliev] // Bulletin of the North-West State Medical University named after I. I. Mechnikov. 2017. № 3. С. 12-23.
  8. Treatment of vertebral pain syndrome in osteochondrosis of the cervical-thoracic spine in women with menopausal disorders / [V. V. Povoroznyuk, T. V. Orlik, O. T. Dudko, N. V. Grigorieva] // Problems of Osteology. 2003. Т. 6, № 4. С. 4-10.
  9. Tyushina M. V., Malakhovsky V. V. V. Treatment of cardialgia caused by psychovegetative and somatic disorders by reflexotherapy methods // Bulletin of New Medical Technologies. 2016. № 2. С. 104-113.
  10. The effectiveness of noninvasive interventions for musculoskeletal thoracic spine and chest wall pain: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration / D. Southerst, A. A. Marchand, Р. Côté [et al.] // J Manipulative Physiol Ther. 2015. 38 (7). Р. 521—31. DOI: https://doi.org/10.1016/j.jmpt.2015.06.001.
  11. Roldan C. J., Huh B. K. Iliocostalis Thoracis-Lumborum Myofascial Pain: Reviewing a Subgroup of a Prospective, Randomized, Blinded Trial. A Challenging Diagnosis with Clinical Implications // Pain Physician. 2016. 19 (6). Р. 363—72. PMID: 27454266:
  12. LFK on unstable support and hydrokinesotherapy in the rehabilitation of patients with back pain / E. V. Filatova, O. A. Bulakh, E. V. Polkovnikova [et al.] // Research'n Practical Medicine Journal. 2017. № 4. С. 58-66.
  13. Yaroshevsky AA, Morozova O. G. G. Skeletal-muscular pain in the chest area // Semeyniy doktor. 2015. № 2. С. 28-36.
  14. Treatment efficacy for non-cardiovascular chest pain: a systematic review and meta-analysis / Burgstaller J. M., Jenni B. F., Steurer J. [et al.] // PLoS One. 2014 Aug 11; 9 (8): e104722. DOI: https://doi.org/10.1371/journal.pone.0104722.
  15. The effect of sitting posture on the loads at cervicothoracic and lumbosacral joints / Kwon Y., Kim J. W.2, Heo J. H. [et al.] // Technol Health Care. 2018. 26 (S1). Р. 409—418. DOI: https://doi.org/10.3233/THC-174717.
  16. Antonov I. P. Classification and formulation of the diagnosis of diseases of the peripheral nervous system // Journal of Neuropathology and Psychiatry. С. С. Korsakov. 1985. Т. 85, № 4. С. 481-487.