EFFECTIVENESS OF CORRECTION OF UPPER EXTREMITY FUNCTION IN ELDERLY WOMEN WITH A FRACTURE OF THE DISTAL METAEPIPHYSIS OF THE RADIUS AND DEMENTIA BY PHYSICAL THERAPY AND OCCUPATIONAL THERAPY

Abstract

Purpose is to evaluate the effectiveness of the developed rehabilitation program using physical therapy and occupational therapy on the parameters of the structural and functional characteristics of the distal parts of the upper limb in elderly women with the consequences of an osteoporotic of the distal metaepiphysis radius fracture of the in the post-immobilization period. Material. 63 elderly women were examined. The control group consisted of 23 women who did not receive treatment for the fracture. The comparison group consisted of 22 women with an osteoporotic fracture, but without signs of dementia, who received rehabilitation according to the appropriate medical care protocol. The main group consisted of 18 women after osteoporotic fracture, with signs of dementia according to the MMSE, who received rehabilitation taking into account the features of the clinical course of dementia and geriatric status (therapeutic exercises and functional training for hands and the whole body, exercises on the MAPS THERAPY table; simulator of simulator “Blasepod”, upper limb massage; kinesiological taping; cognitive rehabilitation, correction of the risk of repeated falls) lasting 2 months. The effectiveness of the program was evaluated by the results of goniometry, dynamometry, and the Patient-Rated Wrist Evaluation questionnaire The results. In women with an osteoporotic fracture of the distal metaepiphysis of the radial bone in the post-immobilization period, limitation of the amplitude of movements in the carpal joint, a decrease in the strength of the upper limb, and a deterioration of its functional abilities were determined (Patient-Rated Wrist Evaluation). According to all studied indicators, the women of both groups showed a statistically significantly better result compared to the initial data (p<0.05), however, the women of the main group during the implementation of the program needed a special approach (facilitation) to performing tasks taking into account dementia. Conclusions. The program of physical therapy for elderly women with dementia and the consequences of a low-energy fracture of the radius bone, created taking into account the presence of a cognitive defect in women with dementia, demonstrated its effectiveness according to a statistically significant improvement relative to the initial result of the parameters of the functioning of the upper limb – amplitude of movements, hand strength, forearm functioning.