Neuroprotective component of outpatient rehabilitation of patients with lumbosciatica and depression

The aim of the study was to investigate the effectiveness of including cytoflavin in complex outpatient rehabilitation therapy for patients suffering from lumboschialgia and depression . Material and methods . 86 patients (38 men and 48 women, average age — 53.2 ± 5.9 years) with lumboschialgia and depression were examined. All patients underwent dynamic somatic and neurological status examination (before and after therapy), laboratory and instrumental studies were performed. To assess the neurological profile, the following were used: digital rating scale (DRS) of pain, Oswestry questionnaire (version 2.1a), hospital anxiety and depression scale (HADS), CGI-S scale, DN4 and SF-36 questionnaires. All patients underwent dynamic diagnostics of spinal mobility using the following parameters: Thomayer test (spinal flexion, distance floor – fingers (FF)), distance fingers legs (FL), backward bend while standing and lying on the stomach. In addition to standard treatment, patients in the main group (n = 44) were prescribed cytoflavin: 2 tablets 2 times a day regardless of food intake, 30-day course. The subjects from the control group (n = 42) received only standard treatment. Results. Inclusion of cytoflavin in the regimens contributed to a more pronounced reduction in pain syndrome compared to the control group: by 5 times according to the Oswestry questionnaire (version 2.1a), by 1.7 times versus 1.3 times according to the DN4 questionnaire, respectively (p < 0.05). The disappearance or significant reduction of pain syndrome contributed to the expansion of motor activity due to the increase in mobility in the spine — a more pronounced positive dynamics in terms of extension: 34.2 % and 22.9% in the main group versus 15.9% and 17.7% in the control group (p < 0.05). The inclusion of the drug contributed to a more significant reduction in neurological symptomatology disorders than in patients in the control group: anxiety indicators (according to the HADS scale) in the control group decreased by 5.3 times, while in the control group they decreased only by 1.75 times (p < 0.05); signs of depression — by 2 and 1.5 times, respectively (p < 0.05). At the same time, the subjects to a greater extent noted a decrease in fatigue, an improvement in night sleep, an increase in activity and performance. The effectiveness of the presented outpatient rehabilitation scheme was confirmed by the positive dynamics of the patients’ quality of life indicators on all SF-36 scales: the most significant increase on the scales of “role functioning due to physical condition” and “pain intensity” — on average by 25.9 points in the control and 26.3 points in the main, respectively (p ≥ 0.05). Conclusion. The inclusion of cytoflavin in the complex treatment of patients with this pathology helps to reduce the intensity of pain, increase spinal mobility and eliminate the neuropathic component, which improves the quality of life of patients. The results obtained can serve as a basis for further research in this area.