THE INFLUENCE OF THE PHYSICAL THERAPY PROGRAM ON THE FUNCTIONAL STATUS OF PATIENTS WITH INTERCORTAL NEUROPATHY OF COMPRESSION GENESIS

Abstract

The purpose of the study was to assess the impact of the physical therapy program on the functional state of patients with intercostal neuropathy of compression genesis. Intercostal neuropathy (neuropathy of the intercostal nerves) is a neurological pathology that occurs as a result of damage or compression of the intercostal nerves, which manifests itself as pain in the course of the intercostal spaces, which can significantly impair the quality of life of patients (G58.0 Intercostal neuropathy according to ICD-11). Rehabilitation care is organized according to the patient’s disease profile in accordance with the patient’s individual rehabilitation program. 20 patients aged from 35 to 55 years old participated in the study, the average age of the patients was 42.3 years, which were divided into two main study groups (SG n=10) and a comparison group (CG n=10). The following research methods were used in the work: analysis, systematization and generalization of information from scientific literature; collection of information for the ICF; objective research methods from the standpoint of ICF: at the level of structure/function (manual muscle testing (MMT), visual analogue pain scale (VASH) (Visual analogue scale), symptom severity scale (Symptom Severity Scale, SSS), scale of functional disorders (Function Status Scale, FSS), diagnostic questionnaire for the definition of neuropathic pain Douleur Neuropathique en 4 Questions (DN4), Leeds assessment of neuropathic symptoms and signs (LANSS); on the level of activity, participation and influence of environmental factors (SF-36 (The Medical Outcomes Study 36-item Short-Form Health Survey), Timed Up and Go test/TUG, mathematical statistics methods. The algorithm for the implementation of the physical therapy program for patients with intercostal mononeuropathy of compression genesis included the following components: objective examination of patients, determination of the rehabilitation period, assessment of the levels of rehabilitation potential and rehabilitation forecasting in the SMART format, rehabilitation intervention and assessment of rehabilitation intervention. Rehabilitation intervention included positioning, kinesiotherapy, therapeutic massage, postisometric relaxation, which consistently addressed the main goals of physical therapy. Forms and methods of solving the goals of physical therapy are an individual approach to each patient, an individual form of conducting classes, visibility, accessibility, and the patient’s conscious attitude to classes. Directed use of special therapeutic exercises, post-isometric relaxation and massage procedures with the aim of restoring motor and sensory disorders caused by intercostal neuropathy of compression genesis, are manifested by a pattern of gradual clinical improvements that form stable functional recovery. Evaluating the effectiveness of the developed program of physical therapy for patients with intercostal neuropathy of compression genesis in the post-acute rehabilitation period, aimed at reducing pain, restoring functioning and quality of life, we can conclude that it has a positive effect on the results of the examination of patients with SG, which is confirmed by the achievement of the planned long-term and short-term goals of rehabilitation and a positive the dynamics of indicators in accordance with the selected clinical and instrumental methods of examination from the positions of the ICF, namely: improvement of muscle strength according to MMT in SG patients occurred by 2.2±0.2 points (p<0.05), in CG patients – by 0, 6±0.2 points (p<0.05); decrease in indicators of coordination of movements and balance during walking according to the TUG test in SG patients occurred by 13±0.2 seconds (p<0.05), in CG patients – by 6±0.4 seconds (p<0.05); a decrease in the assessment of pain perception according to the VAS of pain in SG patients occurred by 3.5±0.3 points (p<0.05), in CG patients – by 2.8±0.3 points (p<0.05); reduction of symptoms of intercostal neuropathy according to the SSS symptom severity scale in SG patients occurred by 2.1±0.1 points (p<0.05), in CG patients – by 0.6±0.1 points (p<0.05); improvement of functional disorders in intercostal neuropathy according to the FSS scale in SG patients occurred by 1.9±0.2 points (p<0.05), in CG patients – by 0.5±0.3 points; a decrease in the level of the neuropathic pain component according to the DN4 questionnaire in SG patients occurred by 3.4±0.1 points (p<0.05), in CG patients – by 3.1±0.2 points (p<0.05); reduction in severity of neuropathic symptoms of intercostal neuropathy according to the LANSS neuropathic symptom assessment scale in SG patients by 3.9±0.3 points (p<0.05), in CG patients – by 2.7±0.1 points (p<0 .05); improvement of patients’ quality of life according to the SF-36 scale in SG by 36.8±0.1 (p<0.05) points, in CG – by 10.7±0.2 points (p<0.05).