The importance of muscular disbalance in physical therapy of the patients presenting with pneumonia

Abstract

Thematic justification. Pneumonia holds a leading position among the pathological conditions responsible for temporary disability. The objective of the present study was to develop a rationale for the system of therapeutic physical exercises designed to treat the patients presenting with pneumonia taking into consideration the myofascial disorders and to elucidate its advantages, if any, over the conventional approaches. A total of 134 patients the patients presenting were examined and treated after they were randomly divided into two groups. The study group was comprised of 73 patients at the mean age of 48.0 ± 4.0 years while the control group consisted of 61 patients (mean age 48.0 ± 4.0 years). The standard clinical and laboratory examination and the chest X-ray study of all the patients were supplemented by the evaluation of the external respiration function and the assessment of the state of myofascial structure with the use of the methods for testing the muscular function. The complete resolution of pneumonia documented by X-ray investigations in the patients of the study group was achieved 20.6% more frequently than in controls (p < 0.05). Chest excursion in the study and control groups increased by 36.63% (p < 0.01) and 7.46% (p < 0.05) respectively. The number of the patients with the unaltered vital lung capacity (VLC) (up to more than 90% of the normal value) increased in the study group by 35.6% (p < 0.01). Simultaneously, the number of the patients with moderate and severe disorders decreased in the study group by 21.9% (p < 0.01) and 12.3% (p < 0.05) respectively. The results of the testing of the muscular function suggest that it was most frequently altered in the erector muscle of the spine, gluteus maximus and gluteus medius muscles, musculus quadriceps femoris, iliopsoas muscle, rectus abdominis muscle and oblique abdominal muscle, deep cervical flexor muscles, pectoralis major and pectoralis minor muscles on the side of the affected lung. After the treatment, these changes in the patients of the study group were observed significantly less frequently than in those of the control one. The patients with pneumonia developed the signs of muscular disbalance as a result of pathological myofascial disorders in the muscles of the neck, thoracic cage, abdominal wall, paravertebral region, thigh, and the ilio-lumbar region. The program for the combined treatment of the patients presenting with pneumonia based at a hospital facility including the newly proposed method of physical rehabilitation promoted the accelerated resolution of the inflammatory process as is apparent from the results of the X-ray examination. The respiratory exercises prescribed with due regard for the localization of the inflammatory process and specific changes of spirographic measurements together with microcorrection procedures exerted a more pronounced positive influence on the external respiration function and the state of the locomotor system in the patients of the study group in comparison with the control subjects prescribed a complex of conventional therapeutic physical exercises.