Issue 24-5, 2025

Original article

https://doi.org/10.38025/2078-1962-2025-24-5-47-56

Sling Therapy in the Rehabilitation of Children with Knee Injuries in the Postoperative Period: a Randomized Controlled Study

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ORCID Irena V. Pogonchenkova1,2, ORCID Maya A. Khan1,3,4, ORCID Ekaterina L. Vakhova1,2,*, ORCID Dmitriy Yu. Vybornov3,5, ORCID Nikolay I. Tarasov3, ORCID Ivan N. Isaev3

1 National Medical Research Center for Rehabilitation and Balneology, Moscow, Russia
2 Ministry of Health of the Russian Federation, Moscow, Russia


ABSTRACT

INTRODUCTION.  Functional activity and independence of elderly people with type 2 diabetes mellitus (DM2) depend not only on the glycaemic control, but also on the severity of geriatric syndromes. This subanalysis was conducted to study the peculiarities of the effect of individual geriatric rehabilitation (GR) programs on functional status in patients with type 2 DM2 and frailty.

AIM.  Evaluation of the effect of geriatric rehabilitation on the level of functional activity in patients with DM2 and frailty.

MATERIALS AND METHODS.  A subanalysis of data from POSTSCRIPTUM, a multicentre, prospective study, was conducted to evaluate the effectiveness of 21-day geriatric rehabilitation programmes for patients aged 60 years and over with senile asthenia syndrome. The subanalysis included 475 patients, who were divided into two groups: 91 patients with type 2 diabetes mellitus (DM2+ group) and 384 patients without DM (DM2– group). On visit 1, a comprehensive geriatric assessment (CGA) was performed, and a personalized 21 day GR program was developed. Visit 2 took place after the completion of GR to evaluate the effectiveness of the course.

RESULTS AND DISCUSSION.  The frequency of diagnosing geriatric syndromes (GS) and the distribution of frailty severity were comparable in the DM2+ and DM2– groups. Frailty was found in 38 % in the DM2+ group and 34 % in the DM2– group. Median age in the DM2+ and DM2– groups was 76 [71; 81.5] vs 80 [73; 84] years, p = 0.001. After the 3-week GR program, the DM2+ group showed an improvement in a brief battery of physical functioning tests (p < 0.001), an increase in the mean MoCA (Montreal Cognitive Assessment) score of 2.06 ± 0.38 (p < 0.001), a decrease in pain intensity in self-assessments according to the visual analog scale in the last week (p < 0.001), decreased insomnia severity index p = 0.03), and improved MNA (Mini Nutritional Assessment) score (p = 0.006). The subgroup of patients with preasthenia gravis additionally demonstrated improvements in baseline activities of daily living, nutritional status, and a decrease in the insomnia severity index.

CONCLUSION.  The POSTSCRIPTUM study demonstrated the effectiveness of short-term individualized GR programs based on CGA results in patients with DM2 and frailty in improving physical and cognitive status; pain severity; while the subgroup of patients with preasthenia gravis showed improvement in baseline activities of daily living, nutritional status, and a decrease in the insomnia severity index.

REGISTRATION:   Clinicaltrials.gov identifier No. NCT05740436, registered 23.02.2023.


KEYWORDS: children, trauma, knee joint, arthroscopy, medical rehabilitation, sling therapy, kinesiotherapy, suspension system

FOR CITATION:

Рogonchenkova I.V., Khan M.A., Vakhova E.L., Vybornov D.Yu., Tarasov N.I., Isaev I.N. Sling Therapy in the Rehabilitation of Children with Knee Injuries in the Postoperative Period: a Randomized Controlled Study. Bulletin of Rehabilitation Medicine. 2025; 24(5):47–56. https://doi.org/10.38025/2078-1962-2025-24-5-47-56 (In Russ.). 

FOR CORRESPONDENCE:

Ekaterina L. Vakhova, E-mail: Е-mail: vakhovael@zdrav.mos.ru


References:

  1. Зябкин И.В., Панкратов И.В., Петров М.А. и др. Перспективы диагностики и лечения минимальных травм и повреждений крупных суставов у несовершеннолетних спортсменов: современные представления. Медицина экстремальных ситуаций. 2024; 26(4): 104–113. https://doi.org/10.47183/mes.2024-26-4-104-113 [Zyabkin I.V., Pankratov I.V., Petrov M.A., et al. Prospects for diagnosis and treatment of minimal trauma and injury of large joints in underage athletes: a review Extreme medicine. 2024; 26(4): 104–113. https://doi.org/10.47183/mes.2024-26-4-104-113 (In Russ.).]
  2. Исаев И.Н., Коротеев В.В., Тарасов Н.И. и др. Реконструкция мягкотканных стабилизаторов коленного сустава у детей. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2021; 11(3S): 58. https://doi.org/10.17816/psaic1102 [Isaev I.N., Koroteev V.V., Tarasov N.I., et al. Reconstruction of soft tissue stabilizers of the knee joint in children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021; 11(3S): 58. https://doi.org/10.17816/psaic1102 (In Russ.).]
  3. Соловьева К.С., Залетина А.В. Травматизм детского населения Санкт-Петербурга. Ортопедия, травматология и восстановительная хирургия детского возраста. 2017; 5(3): 43–48. https://doi.org/10.17816/PTORS5343-49 [Solovyova K.S., Zaletina A.V. Injury rate in the pediatric population of Saint Petersburg. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2017; 5(3): 43–48. https://doi.org/10.17816/PTORS5343-49 (In Russ.).]
  4. Хан М.А., Вахова Е.Л., Кульчицкая Д.Б. и др. Физические факторы при травматической артропатии у детей. Вестник восстановительной медицины 2019: 4: 8–12 [Khan M.A., Vakhova E.L., Kulchitskaya D.B., et al. Physical Factors in Traumatic Arthropathy in Children. Journal of Restorative Medicine and Rehabilitation. 2019: 4: 8–12 (In Russ.).]
  5. Ardern C.L., Ekås G., Grindem H., et al. International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Кnee surgery, sports traumatology, arthroscopy. 2018: 26(4): 989–1010. https://doi.org/10.1007/s00167-018-4865-y
  6. Ekås G.R., Moksnes H., Grindem H., et al. Coping with Anterior Cruciate Ligament Injury from Childhood to Maturation: A Prospective Case Series of 44 Patients with Mean 8 Years’ Follow-up. American Journal of Sports Medicine. 2019: 47(1): 22–30. https://doi.org/10.1177/0363546518810750
  7. Wellsandt E., Khandha A., Capin J., et al. Operative and nonoperative management of anterior cruciate ligament injury: Differences in gait biomechanics at 5 years. Journal of Orthopaedic Surgery. 2020: 38(12): 2675–2684. https://doi.org/10.1002/jor.24652
  8. Вахова Е.Л., Хан М.А., Крестьяшин И.В. Современные технологии физиотерапии при травмах коленного сустава у детей. Физиотерапевт. 2018: 6: 52–58. [Vakhova E.L., Khan M.A., Krestyashin I.V. The use of physical factors in knee injuries in сhildren. Physiotherapist. 2018: 6: 52–58 (In Russ.).]
  9. Khan M.A., Krestyashin V.M., Krestyashin I.V., Zimina O.Y. The use of physical therapy for knee injuries in children Аrchiv EuroMedica. 2019; 1: 116.
  10. Хан М.А., Разумов А.Н., Корчажкина Н.Б., Погонченкова И.В. Физическая и реабилитационная медицина в педиатрии. Москва: ГЭОТАР-Медиа, 2018. 408 с. [Khan M.A., Razumov A.N., Korchazhkina N.B., Pogonchenkova I.V. Physical and rehabilitation medicine in pediatrics. Moscow: GEOTAR-Media. 2018; 408 р. (In Russ.).]
  11. Вахова Е.Л., Выборнов Д.Ю., Турова Е.А. и др. Применение импульсного низкочастотного электростатического поля при повреждениях капсульно-связочного аппарата коленного сустава у детей: проспективное открытое рандомизированное сравнительное исследование. Вестник восстановительной медицины. 2022; 21(4): 71–78. https://doi.org/10.38025/2078-1962-2022-21-4-71-78 [Vakhova E.L., Vybornov D.Y., Turova E.A., et al. Low-Frequency Electrostatic Field Application for Injuries of Knee Joint Capsular Ligament Apparatus in Children: a Prospective Randomized Comparative Study. Bulletin of Rehabilitation Medicine. 2022; 21(4): 71–78. https://doi.org/10.38025/2078-1962-2022-21-4-71-78 (In Russ.).]
  12. Хан М.А., Разумов А.Н., Погонченкова И.В., Лян Н.А., Вахова Е.Л. Методы электролечения в педиатрии. Учебное пособие. Москва, 2021. 80 с. [Khan M.A., Razumov A.N., Pogonchenkova I.V., Lyan N.A., Vahova E.L. Electrotherapy methods in pediatrics. Tutorial. Moscow. 2021; 80 р. (In Russ.).]
  13. Солодянкин Е.Е., Бурмистров А.Л., Бондарева Е.А., Мозоль В.В. Нейромышечная активация с применением подвесных систем в реабилитации пациентов. Международные обзоры: клиническая практика и здоровье. 2014; 11: 54–59. [Solodyankin E.E., Burmistrov A.L., Bondarevа E.A., Mozol V.V. Neuromuscular activation using suspension systems in the rehabilitation of patients. International Reviews: Clinical Practice and Health. 2014, 11: 54–59 (In Russ.).]
  14. Федулова Д.В. Бердюгин К.А. Физическая реабилитация спортсменов после травмы передней крестообразной связки и мениска коленного сустава с применением баланс-тренинга. Под редакцией Н.М. Белокрылова. Екатеринбург. 2022; 124 с. [Fedulova D.V., Berdyugin K.A. Physical rehabilitation of athletes after injury to the anterior cruciate ligament and meniscus of the knee joint using balance training. Edited by N.M. Belokrylov. Ekaterinburg. 2022; 124 p. (In Russ.).]
  15. Papalia R., Franceschi F., Tecame A., et al.. Anterior cruciate ligament reconstruction and return to sport activity: postural control as the key to success. International Orthopaedics. 2015; 39(3): 527–534. https://doi.org/10.1007/s00264-014-2513-9
  16. Коновалова Н.Г., Филатов Е.В., Ляховецкая В.В., Фроленко Ю.С. Опыт применения кинезиотерапевтической установки «Экзарта» в реабилитации пациентов с патологией спинного мозга на шейном уровне. Физиотерапия, бальнеология и реабилитация. 2017; 16(2): 102–108. http://dx.doi.org/10.18821/1681-3456-2017-16-2-102-106 [Konovalova N.G., Filatov E.V., Lyakhovetskaya V.V., Frolenko Yu.S. Тhe experience with the application of the «Ekzarta» (REDCORD) kinesiotherapeutic equipment for the rehabilitation of the patients with spinal cord pathology at the cervical level. Russian journal of physiotherapy, balneology and rehabilitation. 2017; 16(2): 102–108. http://dx.doi.org/10.18821/1681-3456-2017-16-2-102-106 (In Russ.).]
  17. Huang D.D., Chen L.H., Yu Z., et al. Effect of suspension training on neuromuscular function, postural control, and knee kinematics in anterior cruciate ligament reconstruction patients. World J Clin Cases. 2021; 9(10): 2247–2258. https://doi.org/10.12998/wjcc.v9.i10.2247
  18. Eun-Ju Song, Eun-Jung Lee, Hae-Yeon Kwon. The effects of sling exercise program on balance and body activities in children with spastic cerebral palsy. Journal of Exercise Rehabilitation 2021; 17(6): 410–417. https://doi.org/10.12965/jer.2142608.304
  19. Выборнов Д.Ю., Прохорова Е.С., Подгорная О.В., Орусоол В.К. Оценка эффективности гальваногрязелечения у детей с хроническими посттравматическими синовитами коленных суставов после артроскопии. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2012; 89(5): 44–48. [Vybornov D.Yu., Prokhorova E.S., Podgornaia O.V., Orusool V.K. The estimation of the efficacy of galvanic peloid therapy for the treatment of the children with chronic post-traumatic knee-joint synovitis following arthroscopy. Problems of Balneology, Physiotherapy and Exercise Therapy. 2012; 89(5): 44–48. (In Russ.).]
  20. Королева С.В., Кирпичев И.В., Михайлов Д.В. Оценка ходьбы при травме передней крестообразной связки коленного сустава с использованием технологии инерциальных сенсоров. Современные проблемы науки и образования. 2023 (3): 61–66. https://doi.org/10.17513/spno.32600 [Koroleva S.V., Kirpichev I.V., Mikhaylov D.V. Assessment of walk in injury of the anterior cruciate ligament of the knee joint using the technology of inertial sensors. Modern problems of science and education. 2023 (3): 61–66. https://doi.org/10.17513/spno.32600 (In Russ.).]
  21. Батуева А.Э. Саногенетические аспекты использования подвесной системы «Экзарта» в восстановлении пациентов с заболеваниями позвоночника и крупных суставов. Физиотерапия, бальнеология и реабилитация. 2013; 3: 42. [Batuyeva A.E. Sanogenetic aspects of using the Exarta suspension system in recovery of patients with diseases of the spine and large joints. Russian journal of physiotherapy, balneology and rehabilitation. 2013; 3: 42 (In Russ.).]



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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.