Корекція порушень рухової дієздатності засобами фізичної терапії у жінок, які перенесли кесарів розтин

Abstract

In modern obstetrics, the frequency of abdominal accouchement is constantly increasing. Therefore, the problem of restoring the state of health of women after surgical delivery requires the introduction of new medical knowledge and technologies into practical rehabilitation, in particular, methods of physical therapy. The purpose of the study was to determine the influence of the developed program of physical therapy on the dynamics of the parameters of the motor ability of women in the postpartum period after cesarean section. Materials and methods. 112 women were examined after childbirth. The comparison group consisted of 47 women who had a natural childbirth. The main group 1 consisted of 32 women who did not want to carry out the proposed program of physical therapy; they were provided with general recommendations for self-observation in the postpartum period after cesarean section. The main group 2 consisted of 33 women after cesarean section who underwent postpartum physical therapy for 12 months (kinesitherapy (therapeutic exercises, functional training to improve motor skills and abilities), abdominal wall bandage, kinesiotaping, abdominal and general massage, wellness nutrition, psychological relaxation, education of women). Determination of motor ability according to the Functional Movement Screen was performed in the late postpartum period (6-8 weeks), 6 and 12 months after childbirth. Results and discussion. In women in the late postpartum period, regardless of the type of delivery, signs of impaired motor ability are revealed, which was established by the results of the Functional Movement Screen test exercises. Within a year after childbirth, there is a gradual improvement in the motor ability of women, regardless of the type of delivery and their performance of active restorative interventions. The use of a physical therapy program starting from the early postpartum period in women after cesarean section revealed advantages regarding the state of their motor ability in relation to women who underwent natural delivery and those who recovered from cesarean section on their own, according to separate Functional Movement Screen tests already at the end of the late postpartum period. After 1 year after childbirth, women who underwent cesarean section and performed the developed physiotherapy intervention on all Functional Movement Screen tests demonstrated a statistically significantly better result compared to women who underwent natural delivery and those who recovered from cesarean section on their own. Women who underwent cesarean section, but recovered on their own with the help of general recommendations, according to the signs of impaired movement capacity 1 year after childbirth could not reach the levels of women who gave birth by vaginal delivery and women who underwent a physical therapy program. Conclusion. It is advisable to prescribe physical therapy means from the first day of postpartum rehabilitation in order to level the signs of impaired motor capacity for quick postpartum recovery of women and their return to full functioning