INDICATORS OF THE FUNCTIONAL CAPACITY OF THE TISSUES OF THE MAXILLO-FACIAL REGION, THE PSYCHOEMOTIONAL STATE AND THE QUALITY OF LIFE OF PATIENTS WITH THE CONSEQUENCES OF THE MANDIBULAR FRACTURE UNDER THE INFLUENCE OF PHYSICAL THERAPY

Abstract

Purpose is to assess the effectiveness of the developed physical therapy program based on the dynamics of indicators of the functional capacity of maxillofacial tissue, psychoemotional state and quality of life of patients with the consequences of a mandibular fracture. Material. During the research 77 people were examined. The control group consisted of 32 people without consequences of injuries of the maxillofacial area and burdened dental status. Group 1 consisted of 24 people who underwent rehabilitation according to the general principles of rehabilitation of patients with a dental profile. Group 2 consisted of 21 people with the consequences of a mandibular fracture, who underwent rehabilitation with the use of therapeutic exercises; massage; thermal procedures; postisometric relaxation; kinesiological taping; patient education. Effectiveness was evaluated based on the results of surface electromyography, Hospital Anxiety and Depression Scale, SF-36 questionnaire. The results. In patients in the post-immobilization period after a mandibular fracture, signs of disturbances in the functional state of the neuromuscular apparatus were determined by changes in the amplitude of the bioelectric activity of the masticatory and temporal muscles at rest and when the jaws are maximally clenched in the position of habitual occlusion (according to surface electromyography data), psychoemotional suppression by type of anxiety and depression (according to the Hospital Anxiety and Depression Scale) and, as a result, deterioration of the physical and mental components of the quality of life (according to the SF-36). In patients who received an effect only on the peripheral component of the contracture of the temporomandibular joint (its mobility), a slight improvement in the indicators of bioelectric activity (temporal muscles when clenching the jaws) and certain components of the quality of life (on the scales of general health, vitality, role emotional, mental health) was determined (p<0.05 relative to baseline values), but a decrease in psycho-emotional stress according to the Hospital Anxiety and Depression Scale was not determined (p>0.05). All these diagnosed positive changes were less pronounced (p<0.05) compared to the group that was engaged in the complex physical therapy program. Conclusions. In the rehabilitation program of patients in the post-immobilization period after a fracture of the mandibular fracture, it is advisable to include measures taking into account and correcting not only dental changes, but also the consequences of damage to the tissues of the orofacial zone, neck, and which will improve not only the local condition of the tissues, but also their psycho-emotional status and quality of life.