Results of osteopathic correction according to the stabilography data in patients with lower limb amputation at the transtibial level

Abstract

Introduction. In the comprehensive rehabilitation of patients with lower limbs amputations (LLA), there are currently used: physical therapy, mechanotherapy, physiotherapy. Despite the availability of rehabilitation methods, full correction of postural balance in patients with lower limbs amputations remains an urgent medical problem. Osteopathy has not been used in the rehabilitation of such patients until recently, despite the proven effect of normalizing muscle tone, neurohumoral system, as well as improvement of blood circulation and lymphatic outflow after osteopathic correction.Aims: To study the effect of osteopathic correction on postural balance in patients with lower limb amputations at the transtibial level.Materials and methods. 59 patients (37 men and 22 women, average age 57 years) with LLA at the transtibial level were examined using stabilography in outpatient on the basis of the Albrecht Federal Scientific Center for Rehabilitation of the Disabled. The patients were randomly divided into 2 groups: the main group (n=32) receiving osteopathic correction and the control group (n=27) receiving sham therapy. Both groups were divided into subgroups depending on the cause of amputation: traumatic and vascular. All patients underwent stabilography 4 times: before and after the first session of osteopathic correction or sham therapy, as well as before and after the second session. The stability of the position was assessed by the amplitude of the 1st maximum of the spectrum in the sagittal and frontal component, statokinesiogram area, work expended indicator, speed deviation of the center of pressure, standard deviation of the center of pressure in the sagittal and frontal planes.Results. The method of stabilography objectively confirmed the positive effect of osteopathic correction on postural balance in patients with traumatic and vascular genesis of amputation — in the form of stability increase after the 1st, before the 2nd and after the 2nd session of osteopathic correction compared to the data before osteopathic correction for all studied parameters (p<0,05). Patients from the control group of vascular genesis also had a statistically significant increase in stability after the 1st session and the 2nd sessions of sham therapy in terms of work expended, which returned to its original values before the second session, which indicates the short-term nature of the changes.Conclusion. The study showed an improvement in postural balance according to stabilography data in patients with lower limbs amputations of traumatic and vascular genesis who underwent osteopathic correction.