Possibilities of using combined kinesiotherapy in patients with coxarthrosis

Abstract

Osteoarthritis is the most common disease of the musculoskeletal system. Coxarthrosis accounts for over 40% of all osteoarthritis. Physical exercises are an important component of the rehabilitation treatment of patients with coxarthrosis. The use of combined kinesiotherapy in the conservative treatment of coxarthrosis is pathogenetically justified because combined kinesiotherapy on an inclined plane contributes to the unloading of hip joints and the lumbar region of the spine, which has an impact on pathologically changed biomechanical relationships in the joint and prevents the development and progression of pathological changes on the part of the lumbar region of the spine, which are usually inherent in coxarthrosis and are biomechanically related to it. Patients and Methods: The study involved 68 patients with coxarthrosis who met the inclusion criteria from May 2018 to May 2020, followed by a 3-month follow-up. All patients were divided into two groups depending on the type of treatment and rehabilitation complex (TRC). 32 patients of the first group (control group) received TRK №1, which included complex treatment using standard physiotherapy exercises. The second group included 36 patients who received a complex of combined kinesitherapy (TRK №2). The study's results were analyzed by assessing the intensity of the pain syndrome and the quality of life according to the algofunctional Lequesne index, the WOMAC index, and the EuroQol-5D-3L questionnaire. The effectiveness of treatment was assessed after 1 and 3 months of using TRK. Data were collected and analyzed using common methods in MS Excel 2010 and Statistica software environments. Descriptive statistics were presented as frequencies and proportions (%) or mean ± standard deviation. The difference was considered significant if the achieved level of significance (p) was below 0.05. Results: Analysis of the results of the study showed significant advantages of using combined kinesitherapy in the complex treatment of patients with coxarthrosis in comparison to standard kinesiotherapy. Including combined kinesiotherapy in the complex rehabilitation treatment of patients with coxarthrosis significantly improved the quality of life according to the EuroQol-5D-3L scale and contributed to a decrease in the intensity of the pain syndrome (by 34.4% according to VAS, the Lequesne algofunctional index - by 2 times, the WOMAC index - by 36,4 %) (p˂0.05). Using combined kinesiotherapy helped to improve the functional activity of the joints and increase the adaptive capabilities of the body in the long-term follow-up period. Conclusions: The use of combined kinesiotherapy in the complex rehabilitation treatment of patients with coxarthrosis significantly increases the effectiveness of treatment.