Оцінка ефективності та доцільності застосування засобів фізичної терапії у хворих із діабетичною периферійною полінейропатією

Abstract

The use of modern pharmacological agents in the treatment of complications of diabetes mellitus does not solve all problems of this severe and diverse pathology, so the search for using of methods of physical therapy and rehabilitation for patients with diabetic peripheral polyneuropathy remains relevant. In addition, an effective combination of medications and physical therapy can accelerate the achievement of diabetes compensation, prevent or cause regression of neurovascular complications. The purpose of the work was to evaluate the efficacy of physical therapy application for patients with diabetic peripheral polyneuropathy in outpatient treatment. Material and methods. We examined 30 patients aged 55-70 years with diabetes mellitus of the 2nd type, complicated by diabetic peripheral polyneuropathy. The patients were divided into two groups depending on the conducting of the proposed physical therapy. A course of physical therapy lasted 3 months and consisted of 36 sessions and relaxation exercises with dosed walking. Dynamic assessment of the severity of manifestations diabetic peripheral polyneuropathy was performed using visual analogue scale and the Questionnaire DN4 (Bouhassira D. et al., 2005). Moderate and severe diabetic peripheral polyneuropathy with the existing pain syndrome, sensory and motor disorders were diagnosed. Results and discussion. The results of the course of physical therapy demonstrated substantial (up to 40%) decrease of severity of diabetic peripheral polyneuropathy symptoms only in patients of the main group. The average subjective pain assessment after a course of physical therapy by the visual analogue scale in patients from the main group was 3.2±1.3 cm, with a variation from 2 to 5 cm. Reduction of pain syndrome as a result of course of physical therapy can be considered objective and significant, because the values of visual analogue scale were different from the previous ones in average of 15.3±1.3 mm. According to the DN4 questionnaire, after the course of physical therapy patients from the main group demonstrated the average values 5.1±0.7 points, with the differences of the score from 4 to 6, which confirmed the presence of a positive influence on the neurovascular complications of diabetes mellitus in patients with diabetic peripheral polyneuropathy. Conclusion. Therefore, an additional prescription of complex physical therapy by its effectiveness demonstrates significant benefits in reducing of the clinical manifestations and progression of diabetic peripheral polyneuropathy in patients with diabetes 2-type in comparison with medical therapy along. The conducted study allowed us to prove the efficiency and to propose the inclusion of complex physical therapy treatment programs for patients with diabetic peripheral polyneuropathy during outpatient treatment