Application of computer stabilometric technologies with biofeedback in patients with lumbosacral pain

Abstract

Introduction. Low back pain is one of the most common sufferings of modern humans. In developed countries, such manifestations are a serious medical and economic problem. Lumbosacral pain in many cases is caused by the occurrence of somatic dysfunction of the bones of the pelvis and sacrum. The main methods of treatment are prescribing drug therapy and non-drug treatment. Today, osteopathic techniques are highly effective for the diagnosis and correction of somatic dysfunctions of the pelvic region. Such treatment in patients with pain in the lower back helps to reduce pain and restore the functional state of patients. Equally important are computer technologies with biofeedback (BFB) with the possibility of effective correction of proprioceptive innervation and muscle-tonic syndromes. The stabilometric platform allows you to register the parameters of the static-dynamic function of support and balance maintenance. The resulting changes in the position of the sacrum and pelvic bones create a distortion of proprioceptive somatosensory afferentation, postural tonic reflexes of the axial skeleton and limbs are blocked, the sequence of activation of the motor units of the locomotor apparatus is disrupted, the mechanisms for maintaining support and walking change. The aim — to study the effectiveness of using a stabiloplatform with biofeedback in the diagnostic mode of coordinating and static-dynamic disorders in patients with somatic dysfunctions of the pelvic and sacral bones in a training mode in combination with osteopathic correction for pain in the lumbosacral region. Materials and methods. In a prospective controlled study in patients with lumbosacral pain with somatic dysfunctions of the pelvic bones, the results of treatment were analyzed in 66 patients aged 23–56 years. Diagnosis of dysfunctions of the iliac bones was carried out according to the generally accepted rules of osteopathic examination — osteopathic examination and determination of the position of bone landmarks. The observed patients were divided into groups and subgroups depending on the type of dysfunction. The main group consisted of patients with clinical and osteopathic signs of somatic dysfunctions of the pubic bone and ilium. The patients were followed up for 14 days. The observation and treatment program included: osteopathic correction of diagnosed somatic dysfunction and stabilometric examination (3 control points) with a training regimen (3 sessions). Stabilometric testing was carried out at the stage of diagnosis and selection of patients for inclusion in the study. Re-examination was carried out 14 days after the moment of treatment. The clinical effect was compared with the results of stabilometric tests. In addition, the intensity of the pain syndrome and the severity of muscle-tonic reactions were analyzed. According to the results of the test regime, the stability in the «eyes open» and «eyes closed» modes was assessed. Results. A decrease in the intensity of pain is achieved, normalization of the balance in axial parameters with an improvement in the function of coordination of movements is noted. The Romberg coefficient decreases most significantly in somatic dysfunctions of the iliac bones in the position of anterior rotation without a significant difference in lateralization: on the right, a decrease from 570 ± 12% to 295 ± 23% and on the left from 550 ± 22 to 260 ± 25% (p <0.05). Conclusion. In the event of somatic dysfunctions of the pelvic bones with lumbosacralgia, the combined use of osteopathic correction and physiotherapy exercises on a stabiloplatform in a training mode with biofeedback has a significant effect. The training regimen promotes pain regression in acute and chronic pain. The best results have been achieved in patients with dysfunction in the anterior rotation of the ilium. Stabilometric testing in the diagnostic mode allows you to obtain objective data on the nature of imbalance and imbalance. The training regime ensures the achievement of a therapeutic result in 3 sessions and can be used in inpatient and outpatient conditions of medical institutions.