Dynamics of disability in patients with spinal muscular atrophy after medical rehabilitation

Abstract

Introduction. Rehabilitation of patients with spinal muscular atrophy (SMA) requires proper routing and stratification of the applied physical methods of treatment and dynamic assessment of the results obtained. To evaluate the obtained results, it is promising to use the basic set of categories of the International Classification of Functioning, Disability and Health (ICF) that allows assessing the dynamics of clinical and functional status of the patient during rehabilitation, which is a relevant topic of scientific research. Aim: to evaluate the dynamics of disability in SMA patients under the influence of comprehensive medical rehabilitation. Materials and methods: the study included 42 patients with types II and III SMA, who received medical rehabilitation courses for 12 months. Clinical and instrumental methods of examination, specialized questionnaires and scales (HFMSE, CHOP INTEND, KUSS, MRCS, etc.), and a primary set of basic ICF categories for orthopedic SMA patients were used. Results and discussion: a primary set of basic ICF categories was formed based on the analysis of leading syndromes. Disorders in functions, activity and participation of SMA patients were revealed in the process of rehabilitation. Significant correlations between the categories of patients’ function, activity and social participation were determined. Rehabilitation techniques significantly reduced the degree of disability in the categories of walking, movement in different places, joint mobility function and muscle strength. The severity of function impairments was reduced by one or two MCF categories in 27% of patients with type II SMA and in 53% of patients with type III SMA. Summary: rehabilitation technologies significantly improved post-rehabilitation dynamics of muscle strength function and joint mobility. The high efficiency of complex rehabilitation in SMA patients is associated with a decrease in the degree of patients’ disability. The primary set of basic ICF categories can be used as an objective method of assessment of disability in the process of complex rehabilitation in SMA patients.