Відновлення функційних можливостей пацієнтів з синдромом хребцевої артерії засобами фізичної реабілітації

Abstract

Проведено обстеження методом доплерографії судин голови та шиї стан кровообігу 57 хворих с синдромом хребцевої артерії. За методами лікування було сформовано дві групи: в першій групі (30 осіб) застосовувались засоби фізичної реабілітації та медикаментозна терапія, в другій (27 осіб) проводилась медикаментозна терапія. Використання програми комплексного застосування засобів фізичної реабілітації, що патогенетично впливає на міофасциальні структури та суглоби хребта, забезпечило регулюючий вплив на кровообіг вертебробазилярного басейну та стан моторних функцій; Проведено обследование методом допплерографии сосудов головы и шеи, состояние кровообращения 57 больных с синдромом позвоночной артерии. В соответствии с методами лечения были сформированы две группы, в первой из которых (30 человек) проводилось комплексное использование средств физической реабилитации и медикаментозной терапии, а во второй, состоявшей из 27 человек, применялась медикаментозная терапия. Применение комплексной программы физической реабилитации, патогенетически направленной на миофасциальные структуры и суставы позвоночника, обеспечило регулирующее влияние на кровообращение в вертобробазилярном бассейне и на моторные функции в сравнении с применением медикаментозной терапии; Syndrome of vertebral artery – clinically and socially meaningful problem in medicine From different data, frequency of disgemia in a cervical and cranial vessels from 25 to 30% all disorders of cerebral circulation, including to 70% cases of origin of transitors ischemic attacks. One of modern approaches in treatment of miodistonic and compression syndromes of backbone there is the use of facilities of physical rehabilitation. The purpose. Influence of treatment gymnastic and manual therapy on basis of structure impairment of motors and cerebral hemodynamic disorders a regulation functional condition patients verterbrae artery sindrom was investigated. Object and methods. A research aim was a study of dynamics of the state of circulation of blood in a cervical and cranial vessels under act of complex methodology of physical rehabilitation. We inspected 57 patients 42-50 age (28 men of и 29 women), with a diagnosis there is a syndrome of vertebral artery. The reflex syndromes of vegetative prevailed in the structure of neurological displays, oculomotor violations, coordinating and motion violations. At the manual testing miofascial appeared triggers points of muscles. In neurological status muscularly-tonic violations registered mostly. In accordance to the methods of treatment two groups were formed, the complex use of facilities of physical rehabilitation and medicamental therapy was conducted in first from that (30 patients), and medicamental treatment was conducted in the second (27 patients). Application of the complex program of the physical rehabilitation sent to the miofascial structures and joints of backbone provided regulative influence on circulation of blood in a cervical and cranial vessels and on motor functions by comparison to application of medicamental therapy. The program of physical rehabilitation was consist with the successive use of facilities of physical rehabilitation. The massage of muscles of back and neck department of backbone is conducted for the sake of reduction of myotonic syndrome (МТS) and removal of dystonic syndrome (DS). For more effective weakening of deep muscles of backbone use methodology of postisometrical relaxation. After the achievement of weakening of muscles relaxation passive motions for the joints of all departments of backbone and joints of pelvis with the manual correction of the functional blocking. At first conduct the manual correction of joints of pelvis, farther spinale joints of lumbar department, thoracal and, in the end, neck department. Proceeding in correct correlation of vertebrae of neck department gave an opportunity to improve circulation of blood for to the vertebral arteries. After a manual therapy correction a neck department is fixed on 1-1,5 hours. Procedures are conducted three times for a week, all 10 procedures are appointed. Research results. In all inspected there was the educed asymmetry in speed and volume of blood stream on vertebrals, cerebellars and carotis arteries: of considerable degree (to 50%). The results achieved testly that the use of an individual physical culture in combination with medical therapy favours the development of compensatory mechanisms. Regress of asymmetry of blood stream after realization of course therapy was marked in 72% patients of the first group and 65% – the second group. Efficiency of treatment was traced for 71% first groups patients with vessels spasm in vertebral at basilar arteries. Less efficiency in the removal of vessels spasmatic reactions at the second group (medicine treatment) – 57%. Conclusions 1. Presence of neurodynamic plasticity of structures, allows to use the program of complex application of facilities of physical rehabilitation for children, that due to aethiopathogenetic influence on myofascial structures and joints of backbone provided regulative influence on cerebral circulation of blood and state of agile functions. 2. Taking into account all foregoing it is expedient to recommend application of the complex program of treatment in obedience to the state of haemodynamic violations and motive disorders.