Influence of kinesitherapy on the functional state of the open-moving apparatus in the persons with Scheuermann's disease

Abstract

The purpose of the work is the development of differentiated programs of kinesitherapy for patients with Schyermann-Mau's disease with different spine sagittal contours. Methodology of the research. Clinical X-ray examination of 44 patients with Schyermann-Mau's disease (all males) aged 16-26 years old (mean age 20.6 ± 0.3 years) was performed. All patients were divided into two groups: I (n = 22)and II (n = 22), depending on kinesitherapy complexes The studies were carried out twice –at the initial examination and after the sanatorium-resort treatment. During the examination of orthopedic status, the general mobility of the spine was measured using the Fingertip-t o-Floor (FTF) test, the mobility of the lumbar spine on the bending with Schober’s test, and the volume of mobility in hip joints. The intensity of vertebrogenic pain was recorded on the visual analogue scale (VAS); Oswestry Disability Index. Results of our work. Patients in both groups experienced sagittal spinal pelvic imbalance with uncompensated kyphotic deformity of the thoracic spine (in group I), as well as flattening of the sagittal contour of the spine by the “flatback deformity”type (in group II). It required various compensation devices in joints of the lower extremities and, accordingly, the postural activity of various muscle groups. In group І patients used our programs of kinesitherapy with differentiated therapeutic exercises developed for elimination of muscular imbalance with various sagittal contours of the spine. In group II the standard program of therapeutic gymnastics was used -exercises for kyphosis redistribution, as well as exercises for stretching the muscles ofthe back surface of the thigh and chest muscles. Conclusions. After the treatment in group I, there was a significant reduction in the pain intensity, disabilitation, anxiety and excitement, an increase in general mobility of the spine at bending forward with the Fingertip-t o-Floor test, a possible increase in the volume of mobility in the hip joints in the sagittal plane due to bending. In group II no significant changes in these parameters were detected. Thus, the optimal combination of different regimes(post isometric relaxation and isometric stabilization) in the exercises of kinesiotherapy program has been developed to reduce muscular imbalance and increase the mobility of the spine and hip joints in patients with Schyermann-Mau's disease with varioussagittal spine contours.