Abstract

BackgroundDifferent types of physical exercises relieve pain, improve functional status and quality of life in patients with osteoarthritis (ОА) in addition to drug treatment [1–4].ObjectivesTo evaluate the efficiency of robotic mechanotherapy (continuous passive motion) in the complex rehabilitation of patients with OA.Methods58 patients with ОА of the knee, hip, wrist and hand joints (76% females, age of 49 to 65 years, disease duration of 3 to 11 years) were included in the study and randomized into 2 groups. 28 study group patients underwent robotic passive mechanotherapy (continuous passive motion) for the knee and hip joints using «ARTROMOT K1» machine (Ormed gmbh, Germany), for the wrist and hand joints using «Kinetec Maestra hand and wrist CPM» machine (Kinetec, UK) (10 sessions for 20–25 min) in addition to the standard rehabilitation program (2 weeks). 30 control group patients received only the standard rehabilitation program, which included 10 group sessions of physical exercises for the joints for 45 min under the supervision of a trainer, 10 procedures of electrostatic massage for muscles and periarticular tissues, 10 sessions of occupational therapy for 45 min (joint protection strategies, use of assistive devices and adaptive equipment). All patients received NSAIDs and SYSADOA at standard dosages. Intra-articular corticosteroids were not used. Tender joint count, joint pain on 100-mm VAS, Lequesne and WOMAC indexes, the amplitude of flexion in the knee joint measured by goniometer, the march test (passage time of 20 meters per sec), hand grip strength measured by a dynamometer were evaluated at baseline and at 2 weeks.ResultsAfter 2 weeks in the study group pain on VAS decreased by 40,9% (p<0,05), tender joint count – by 38,7% (p<0,05), Lequesne index – by 1,53 times (р<0,01), WOMAC – by 1,21 times (р<0,01). In the study group the amplitude of flexion in the knee joint increased by 34,2% (p<0,05), the march test decreased by 3,5±1,2 sec (28,8%) (p<0.05), the grip strength of the more affected hand enhanced by 22,3% (p<0,05), of the less affected hand – by 18,5% (р<0,05). In the study group there were statistically significant differences from the control group in all parameters (р<0,05), excluding the grip strength of the less affected hand (р>0,05).Conclusion2-week complex rehabilitation program, including robotic mechanotherapy (continuous passive motion), relieves pain, improves functional ability, motor activity (march test, range of motion in the knee joint, hand grip strength) in patients with OA.

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