Ефективність застосування засобів фізичної терапії для корекції обмеження життєдіяльності внаслідок поєднаного поперекового та тазового болю у жінок з дорсопатіями вагітності у післяпологовому періоді

Abstract

The purpose of the study was to evaluate the effectiveness of the developed program of physical therapy in terms of the dynamics of clinical indicators characterizing the limitation of life activity due to the syndrome of combined lower back pain and pelvic girdle pain in women with dorsopathy of pregnancy in the postpartum period. Materials and methods. 29 women in the postpartum period with combined pain syndrome in the lumbar region and pelvis were examined. They were divided into 2 groups. The control group consisted of 14 women who corrected pain with non-steroidal anti-inflammatory drugs orally and locally. The comparison group consisted of 15 women who underwent a developed program of physical therapy (therapeutic exercises, massage, proprioceptive neuromuscular facilitation, kinesio taping, patient education). The intensity of pain was determined on a visual analog scale at rest and on movements, the degree of disability was determined according to the Oswestry Disability Index, Pelvic Girdle Questionnaire, Pregnancy Mobility Index. Results and discussion. The study showed that in both study groups, after the correction at rest, women actually did not experience pain. However, movement loading revealed that the women in the control group had pain, albeit mild. At the same time, in the group of women who underwent active functional rehabilitation, pain during movements was not actually noted. Improvement in life activity, limited due to lower back pain, according to the Oswestry Disability Index in the control group was 17% compared with the initial result, in the comparison group – 60% (p<0.05). Under the influence of treatment and rehabilitation measures, a statistically significant decrease in the limitation of self-service caused by pelvic girdle pain, according to the Pelvic Girdle Questionnaire, was noted compared with the baseline: in women in the control group it was 31.5%, in the comparison group – 68%. The dynamics of the results of the Pregnancy Mobility Index showed a statistically significant improvement relative to the initial result in both groups of women on the subscales of daily mobility (in the control group – by 34.2%, in the comparison group – by 51.4%), household activity (respectively 21.2 % and 52.9%), mobility outdoors (respectively 20.6% and 58%). Conclusion. It is advisable to prescribe physical therapy means in the complex recovery of women with combined low back pain and pelvic girdle pain in the postpartum period to reduce the limitation of the degree of vital activity