MODERN REHABILITATION METHODS FOR THORACIC BACK PAIN SYNDROME: A VERTEBRODYNAMIC PERSPECTIVE

The purpose of the study is to optimize rehabilitation measures for patients with degenerative-dystrophic pathology of the thoracic spine (DDPS) and thoracic back pain syndrome, based on vertebrodynamic indicators. Materials and methods. The patients’ ages ranged from 18 to 54 years, with 51 women (41.2%) and 73 men (58.8%). The duration of the disease varied from 2 to 23 years. A rehabilitation examination was conducted, assessing vertebrodynamic disorders using A. Stoddard's method. Functional block (FB) of the second degree was identified in the vertebral-motor segments (VMS) of the thoracic spine for all patients. The patients were divided into two groups, comparable in age and disease severity. The first group (n=56) received a standard rehabilitation program, including drug treatment (nonsteroidal anti-inflammatory drugs, muscle relaxants, analgesics), massage, personalized therapeutic exercise sets, and physical therapy methods (magnetotherapy, ultrasound therapy). The second group (n=68) received the basic treatment plus sessions of post-isometric and post-reciprocal muscle relaxation, mobilization techniques according to K. Lewit, R. Maigne, and V. Gubenko, as well as original kinesiotherapy methods developed based on vertebrodynamic indicators. The outpatient rehabilitation cycle lasted 14 days. Results. The subjective assessment of pain by all patients after the first one-time procedure decreased from 4.78±0.20 to 2.64±0.58 VAS points (p<0.05). Treatment of dysfunctions allowed the patients of the 2nd group to estimate pain sensations by 0.91±0.24 points (р<0.05). In patients of the 1st group, the subjective assessment of pain decreased significantly less (to 2.72±0.24 at p<0.05). After the rehabilitation cycle, in 78.6% of the patients of the 1st group, improvement of vertebrodynamic parameters was achieved, namely: restoration of the range of motion in the VMS at the chest level. In the 2nd group of patients, positive dynamics were observed in a larger proportion compared to the 1st group—94.1% of cases. Signs of functional block (FB) persisted in 12 (21.4%) of 56 patients in the 1st group and in 4 (5.9%) of 68 patients in the 2nd group. Thus, with the use of kinesiotherapy treatment techniques, the 2nd group achieved better rehabilitation outcomes. Conclusions. The implementation of our proposed optimized rehabilitation and treatment methods for thoracalgias caused by degenerative-dystrophic pathology of the thoracic spine (DDPS), incorporating original kinesiotherapy techniques, is recommended for clinical practice by physical and rehabilitation medicine specialists, neurologists, and other rehabilitation professionals.