EFFECTIVENESS OF THE APPLICATION OF REHABILITATION MEASURES TO RESTORE JOINT FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

The article substantiates the fact that the active functioning of the upper and lower limbs largely depends on the movement amplitude in the joints. It has been found that patients with rheumatoid arthritis endure a limitation of active and passive movements in the affected joints due to the pain syndrome and the development of muscle contractures. It has been established that the progressive inflammatory process in the joints leads to a significant limitation of their mobility, the development of joint deformations, ankyloses and impaired functions. The purpose of the paper is to evaluate the effectiveness of the rehabilitation measures to restore joint function in patients with rheumatoid arthritis. Material and methods: we conducted an analysis of disease histories, medical records, surveys, anamnesis collection, objective examination of patients with rheumatoid arthritis (n=188). We evaluated motor activity indicators of small joints of hands and feet in all patients with rheumatoid arthritis using goniometry at the beginning of the study, after three months and after six months of an ongoing process of physical therapy. Research results. A technology of rehabilitation measures has been developed, taking into account the personalized approach, functional insufficiency of the joints, which includes therapeutic exercises, therapeutic massage, self-massage, orthotics, physiotherapeutic procedures, hydrotherapy, kinesiotaping, mechanotherapy and psychological support for patients with rheumatoid arthritis. The presented results of the goniometric indicators of the affected joints in rheumatoid arthritis in the dynamics and after six months of rehabilitation measures indicate a significant improvement in the function of the radiocarpal joint, joints of fingers and toes in the examined patients of the experimental group. The active flexion of the hand joints increased significantly in the radiocarpal, metacarpal phalangeal, and proximal interphalangeal joints of the experimental group of patients with joint functional impairment (JFI) of degree 1 and 2, which exceeded the same indicators of the control group. Similarly, at the end of the study, positive dynamics of active movements in the joints of feet and toes were observed in patients of both groups. Accordingly, there was an improvement in ankle flexion indicators in the experimental group with JFI degree 1 and 2: active dorsiflexion and plantar flexion, but these indicators were worse in patients of the control group. At the end of the study, significantly higher indicators of motor function were observed in the metatarsal phalangeal joints of patients in the experimental group than those in the control group. Conclusion. The positive impact of the developed technology of rehabilitation measures has been statistically proven, which is confirmed by a reliable improvement in the motor and functional capacity of the small joints of hands and feet in patients with rheumatoid arthritis of the experimental group.