EFFECTIVENESS OF PHYSICAL THERAPY, OCCUPATIONAL THERAPY IN THE PROCESS OF REHABILITATION OF MILITARY PERSONNEL WITH THE CONSEQUENCES OF A GUNSHOT POLYSTRUCTURAL FRACTURE OF THE BONES OF THE FOREARM ACCORDING TO INVOLVEMENT IN ACTIVITIES OF DAILY LIVING, I

Abstract

Purpose is to evaluate the effectiveness of the developed program of physical therapy, ergotherapy (hand therapy) on the parameters of involvement in activities of daily life, psycho-emotional status, quality of life in injured people with the consequences of a gunshot polystructural fracture of the bones of the forearm in the post-immobilization period. Material. In the process, 49 soldiers with the consequences of a gunshot polystructural fracture of the bones of the forearm were examined. The comparison group (23 people) underwent rehabilitation according to general polyclinic principles. The main group (26 people) consisted of patients undergoing rehabilitation using the tools and principles of hand therapy (therapeutic exercises and functional training for the wrist and fingers, forearm, shoulder, all joints of the upper limb, exercises on the “MAPS THERAPY” table; massage of the upper limb; kinesiological taping; position treatment with orthoses) lasting 2 months. The effectiveness of the hand therapy program was evaluated using the АBILIHAND, DASH, HADS, EQ‑5D‑5L indicators. The results. Soldiers with the consequences of a gunshot polystructural fracture of the bones of the forearm in the post-immobilization period were found to have impaired performance of activities of daily living according to АBILIHAND, DASH, psycho-emotional suppression (HADS), reduced quality of life (EQ‑5D‑5L), which are the consequences of impaired normal functioning of the upper limb. After the rehabilitation intervention, an improvement in the condition of all examined persons was found (facilitation of activities of daily life, reduction of anxiety and depression, improvement of quality of life): according to all studied indicators, patients of both groups showed a statistically significantly better result compared to the initial data (p < 0.05), however, individuals of the main group showed a better result than patients of the comparison group (p < 0.05). Conclusions. The program of hand therapy showed a statistically significantly better effect on all the studied indicators in comparison with the polyclinic rehabilitation program, which confirms the need for the use in patients with injuries of the upper limb of specialized directions of recovery that take into account the anatomical and physiological features of the upper limb and its role in carrying out activities of daily life.