Algorithm for the use of physical therapy in patients with compression-ischemic neuropathies of the upper limb

Abstract

Оlena Bismak Purpose: to develop an algorithm of rehabilitation measures in people with compression-ischemic neuropathies of the upper limb. Material & Methods: the study involved 67 patients with compression-ischemic neuropathy of the upper limb, among whom were 43 (64.2%) men and 24 (35.8%) women. The duration of the disease ranged from 3 to 18 months. The age of the examined varied from 18 to 67 years, on average 42,3±9,4 years. The study was conducted on the basis of the neurological department and the physiotherapy department of the Kiev city clinical hospital No. 4 of Kyiv in the period from 2017 to 2019. We used the following research methods: analysis and synthesis of literature data, content analysis of medical records, rehabilitation examination. Results: an important condition for the treatment of tunnel neuropathies is an integrated approach, which should have the following components: a comprehensive rehabilitation examination to determine the main rehabilitation problems; statement of tasks with prediction of the final result; selection of appropriate individual and optimal physical therapy means for each patient. An algorithm of physiotherapeutic intervention has been developed, including the use of the following measures: kinesitherapy with neurodynamic mobilization, taping, stimulating massage, instrumental physiotherapy, mechanotherapy and hydrotherapy. The proposed algorithm of physical therapy measures differed from standard programs in that it allowed to formulate the goals of the rehabilitation process taking into account a differentiated approach to solving the problem of rehabilitation of patients with compression-ischemic neuropathies of the upper limb with varying severity of motor function disorders; had a comprehensive, multidisciplinary approach to solving the problems of patients with this pathology. Conclusions: the development of an algorithm of physiotherapeutic intervention for people with compression-ischemic neuropathies of the upper limb is an urgent problem due to the fact that compression-ischemic neuropathies of the upper limb often lead to a decrease in the patient's quality of life and long-term disability. When developing an algorithm of rehabilitation measures, it is necessary to take into account: individual features of the functional state of patients with this pathology, the presence and severity of motor and sensory disturbances, which depend on which particular nerve of the arm is affected (median, ulnar or radiation), the nature of the lesion, age, professional activity and patient needs.