THE EFFECTIVENESS OF CORRECTION OF HAND MOTILITY BY MEANS OF PHYSICAL THERAPY, OCCUPATION THERAPY (HAND THERAPY) IN THE REHABILITATION PROCESS OF MILITARY SERVANTS WITH THE CONSEQUENCES OF GUNSHOT POLYSTRUCTURAL FOREARM BONE FRACTURES

Abstract

Aim: to evaluate the effectiveness of the developed program of hand therapy on the parameters of upper limb motility in wounded military servants with the consequences of a gunshot polystructural forearm bones fracture in the post-immobilization period
 Materials and methods. 49 military servants with the consequences of a gunshot polystructural forearm bone fractures were examined. The control group (23 persons) underwent rehabilitation according to general polyclinic principles. The main group (26 persons) underwent rehabilitation using tools and principles of hand therapy (therapeutic exercises and functional training for the wrist and fingers, forearm, shoulder, all joints of the upper limb, exercises on the mechanotherapeutic table MAPS THERAPY; Proprioceptive Neuromuscular Facilitation, massage of the upper limbs; kinesiological taping; orthotics) lasting 1 month. The effectiveness of the program was evaluated by the functioning of the upper limb when performing the Action Research Arm Test and dexterity by the Nine-hole peg test.
 Results. In the injured persons with the consequences of a gunshot polystructural fracture of the bones of the forearm in the post-immobilization period, deterioration of the motility of the upper limb according to the Action Research Arm Test and dexterity according to the Nine-hole peg test, which are factors of disruption of the normal functioning of the upper limb, were determined. After the rehabilitation intervention, all examined persons showed an improvement in motility according to the Action Research Arm Test in the control group by 14.7%, in the main group by 35.4%, according to the Nine-hole peg test - by 61.8% and 22.3%, respectively. According to all studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p<0.05), however, the subjects of the main group showed a better result than the patients of the control group (p<0.05).
 Conclusions. The hand therapy program demonstrated a statistically significantly better effect (p<0.05) on all studied indicators of upper limb motility compared to the polyclinic rehabilitation program, which confirms the need for the use of specialized rehabilitation directions in patients with upper limb injuries that take into account the anatomical and physiological features of the hand and its role in activities of daily living.