Особливості обстеження хворих з болем у колінному суглобі

Abstract

The purpose of the study was to determine and substantiate the feasibility of examination methods in patients with рain in the knee joint at the arthralgia stage for further development of the pathogenetically sound physical therapy program. Materials and methods. The study involved persons who had complaints of pain in the knee with a preliminary diagnosis: knee functional arthralgia of the joint (n = 32, 65.6% – women; age (M±SE) – 55.1±2.7 years; frequency of lesion of the right knee joint was 57.1%, the average term of the functional breakdown of the knee joint is 2-2.5 months). The paper uses the tools that provided for the collection of anamnesis (questioning, definition of body mass index), the evaluation of the function and the level of activity of the knee joint (Lovett test, Lysholm scale) and various human quality parameters (WOMAC's questionnaire and EuroQol-5D questionnaire). Results and discussion. The article analyzed the data of modern research methods in patients with functional pain in the knee joint. To establish a connection between the pain in the knee and functional arthralgia, a questionnaire was carried out and anamnesis of patients was analyzed. This allowed to identify the following: the vast majority of persons (65.6%) was represented by women who had complaints of pain in the knee joint; 93.75% still experienced pain in the knee, and 62.5% of patients felt stiffness in the knee joint. In 45% of people pain influenced their daily life, and 36% limited their physical activity. It should also be noted that the frequency of lesions of the right knee joint was 57.1%. When carrying out manual muscle testing, Lovett and Lysholm scales were used, which made it possible to determine the level of functional activity of the knee joint at the arthralgia stage: manual muscle testing flexors was 3.01±0.02 points, and manual muscle testing extensors corresponded to 2.65±0.015 points. Measurement of the circle of the knee joints showed that the right will be somewhat wider than the left with the indicators of 38.2±1.5 cm and 37.8±0.7 cm respectively. This confirmed a decrease in muscle strength, especially the muscles of the knee. In 76% of the examined women, the state of the knee joint function was on the verge of "satisfactory" and "unsatisfactory". This can be explained by the fact that the prevalence of arthralgia seems to increase in women with a menopausal transition and is considered a result of a decrease in estrogen, an increase in body mass index, etc. Conclusion. WOMAC and EuroQol-5D tests made it possible to estimate the dynamics of the development of pain and the level of discomfort of patients with pain in the knee joint. It has been found that the steadiest is pain in women (61±5.1 points), and functional failure in men (49±3.6 points). Thus, the pain in the knee in functional arthralgia adversely affects both the main spheres of human life, and reduces the quality of life in general. The results of functional performance tests indicate a violation of the balance and the ability to walk, which is due to the detection of different lengths of the muscles, the weakness of the thigh muscles and the disposition of the extraction. The methods of research proposed by the authors allow to comprehensively assess the functional state of the patient at the arthralgia stage in the knee area, which is a predictor to the next stage of the study, namely planning an integrated individual rehabilitation program. The use of a comprehensive approach in the examination of patients can give a physical therapist a more substantiated approach to the introduction of treatment products, which will more effectively affect the elimination of the primary cause of the formation of pain syndrome and prevent the further development of pathological processes in the structures constituting the knee joint