ОЦІНКА ЕФЕКТИВНОСТІ ПРОГРАМИ ФІЗИЧНОЇ ТЕРАПІЇ ПРИ АНКІЛОЗУЮЧОМУ СПОНДИЛОАРТРИТІ

The aim of the study is to assess the impact of a physical therapy program on the functional indicators of a patient with ankylosing spondylitis. One patient (case study) participated in the physical therapy program – a 48-year-old male patient with a diagnosis of ankylosing spondylitis, established according to the classification criteria for ankylosing spondylitis of ASAS experts. The duration of the disease was 13.5 years. The patient was diagnosed with the disease at the age of 35, within the first year of the onset of initial symptoms. For a detailed assessment of the patient’s condition, a biopsychosocial model was developed based on the concept of the International Classification of Functioning, Health Limitations and Life Activities – which takes into account biological, psychological and social aspects of health. The main physical therapy interventions that were applied within the program, along with their volume and intensity, were determined by the patient’s identified impairment/limitation according to the International Classification of Functioning, Health Limitations and Life Activities. The patient participated in a rehabilitation program that was conducted over a period of six months. The program encompassed: stretching exercises to maintain spinal mobility, strength exercises to strengthen the muscular corset, breathing exercises to improve chest excursion, aerobic exercises (walking, swimming) to increase endurance. The stage of planning rehabilitation intervention, in addition to selecting rehabilitation interventions, involved drawing up short-term and long-term rehabilitation goals together with the patient with AS, which is a direct request from the patient and his motivation. The results were assessed using the BASDAI, BASFI, EQ-5D scales, as well as functional muscle testing. At the beginning of the course of physical therapy, the BASDAI index was 7.8 points, and after completing the program it was 3.6 points. The dynamics of the BASDAI index demonstrates the effectiveness of therapy aimed at reducing pain, stiffness and improving the patient's general condition. At the beginning of therapy, the BASFI index score was 7.4 points, and after 6 months – 2.8 points, which indicates a positive effect of physical therapy on the functional state and ability to perform daily activities. The health assessment according to the EQ-5D index at the stage of examination of a patient with ankylosing spondylitis was 12 points, at the end of the program implementation – 10 points, and the health assessment according to the EQ VAS was 40 points at the beginning and 75 points after the intervention. Such dynamics indicate a significant improvement in mobility, pain reduction and normalization of the psycho-emotional state of a patient with ankylosing spondylitis. The dynamics of functional muscle testing indices indicate the effectiveness of rehabilitation. Following the intervention, it was determined that the back, shoulder girdle and calf muscles attained a normal level of strength (5 points), while the abdominal and quadriceps muscles of the thigh achieved moderate strength (4 points). Consequently, the patient was able to perform the majority of his daily activities. Physical therapy is an effective method of rehabilitation of patients with ankylosing spondylitis, as it helps to reduce pain, improve mobility, maintain functional activity and improve quality of life. The results obtained emphasize the necessity for an individual approach to rehabilitation and further development of physical therapy standards for patients with ankylosing spondylitis.