Clinical effectiveness of complex differentiated rehabilitation of patients with vertebral thoracic pain due to degenerative-dystrophic pathology of the thoracic spine

The aim of the study. To determine the effectiveness of complex differentiated rehabilitation in patients with degenerative-dystrophic pathology of the thoracic spine (DDPS) and thoracic back pain syndrome depending on the indicators of vertebrodynamics. Materials and methods. Rehabilitation measures were carried out in 124 patients with DDPS complicated by thoracalgia syndrome at the post-acute stage of rehabilitation. The age of the patients was from 18 to 54 years. There were 51 (41.2 %) women, 73 (58.8 %) men. The duration of the disease was from 2 to 23 years. A rehabilitation examination was carried out with an assessment of vertebrodynamic disorders indicators according to the A. Stoddard method. All patients had functional block of the 2nd degree in the vertebral-motor segments of the thoracic spine. Patients were divided into 2 groups, comparable in age and disease severity. The first group (n = 56) received a basic complex of rehabilitation: massage, personalized sets of therapeutic exercises, physical methods of treatment (magnetotherapy, ultrasound therapy) against the background of drug treatment (nonsteroidal anti-inflammatory drugs, muscle relaxants, analgesics). Patients of the second group (n = 68) were prescribed, in addition, sessions of post-isometric and post-reciprocal muscle relaxation, mobilization techniques according to K. Lewit, R. Maigne, V. Gubenko, as well as the original methods of kinesiotherapy developed by us depending on the indicators of vertebrodynamics. The outpatient rehabilitation cycle lasted 14 days. Results. The developed comprehensive scheme of of patients examination based on neurological, manual, instrumental studies, assessment of pain syndrome, insomnia and affective disorders allows early diagnosis of the disease, as well as dynamic monitoring during treatment. The developed and tested complex kinesiotherapeutic treatment method with the use of manual therapy leads to a faster regression of neurological symptoms, restoration of the lost range of motion in the thoracic spine, reduction of pain and the risk of DDPS exacerbation, shortening the time of treatment and rehabilitation of patients, and improving their quality of life. Conclusions. The comprehensive differentiated rehabilitation with the use of manual therapy developed and researched in the work has confirmed its effectiveness, which allows recommending its use in clinical and rehabilitation practice, and provides significant economic effect in the treatment of this contingent of patients.