Bulletin of Rehabilitation Medicine

2078-19622713-2625

National Medical Research Center for Rehabilitation and Balneology

595724

10.38025/2078-1962-2023-22-2-16-24

Research Article

The Effectiveness of Robotic Mechanotherapy in the Rehabilitation of Patients with Shoulder Joint Pathology: Randomized Clinical Trial

Yashkov

Alexander V.

Dr. Sci. (Med.), Professor, Head of the Department of Medical Rehabilitation, Sports Medicine, Physiotherapy and Balneologya_yashkov@mail.ruhttps://orcid.org/0000-0003-1875-572XPolyakov

Viktor A.

Ph.D. (Med.), Associate Professor of the Department of Medical Rehabilitation, Sports Medicine, Physiotherapy and Balneologyviktorpolyakov47@gmail.comhttps://orcid.org/0000-0002-9161-6534Shelyhmanova

Marina V.

Ph.D. (Med.), Associate Professor of the Department of Medical Rehabilitation, Sports Medicine, Physiotherapy and Balneologyshelmv@mail.ruhttps://orcid.org/0000-0002-6383-6791Shelyhmanova

Anastasia A.

student of the Institute of Pediatricsshelykhmanova99@mail.ruhttps://orcid.org/0009-0005-2365-9224

Samara State Medical University

24092023

2221624

24092023

2023

INTRODUCTION. Prolonged inactivity associated with exacerbation of a chronic disease or immobilization of the upper limb after injuries and operations leads to the development of functional disorders in the shoulder joint and the development of secondary changes, such as muscle atrophy, contractures, osteoporosis. Therefore, the early application of functional methods of treatment is pathogenetically justified, among which mechanotherapy on robotic devices occupies an important place. AIM. To study the effectiveness of using the FLEX-F04 device in diseases and injuries of the shoulder joint. MATERIALS AND METHODS. According to the inclusion criteria, 60 patients were under our supervision. By random sampling, all patients were divided into two groups of 30 people each. All patients underwent a clinical examination, assessed algofunctional index on the VAS scale, the degree of dysfunction in the arm, shoulder and hand according to the DASH questionnaire, electrothermometry. RESULTS. As a result of treatment and rehabilitation measures, there was a significant increase in the angles of flexion, horizontal adduction, abduction, external and internal rotation in the shoulder joint, a decrease in pain syndrome and an increase in daily activity according to the DASH questionnaire in patients of both groups. In the main group, these indicators were significantly better than in the comparison group. The increase in thermal radiation as a result of the robotic mechanotherapy procedure averaged 0.6 0.1C. DISCUSSION. Robotic mechanotherapy allows movement in the shoulder joint in accordance with its biomechanics, reduces the load on the musculoskeletal system and thereby prevents the appearance or strengthening of the pain component during the procedure. This contributes to an active increase in the amplitude of movements and improvement of the functional capabilities of the shoulder joint, which has a positive effect on daily activity. An increase in thermal radiation in the shoulder joint area during the procedure can serve as an indirect sign of improved microcirculation and neuro-vascular regulation. CONCLUSION. The use of the FLEX-F04 robotic mechanotherapy device of the upper extremities according to the proposed method increases the volume of movements in the shoulder joint, reduces pain syndrome, increases blood circulation of the shoulder joint area and improves neuro-vascular regulation, increases daily household activity. Early inclusion of the device in the rehabilitation process makes it possible to shorten the duration of rehabilitation treatment and achieve a functional range of movements in the shoulder joint.

long-term passive mechanotherapyrobotic mechanotherapycontractureshoulder joint pathologyrehabilitationfunctional method

продолжительная пассивная механотерапияроботизированная механотерапияконтрактурапатология плечевого суставареабилитацияфункциональный метод

Шавловская О. А., Гордеева И. Е., Ансаров Х. Ш., Прокофьева Ю. С. Хронический болевой синдром при заболеваниях периартикулярных тканей. Журнал неврологии и психиатрии им. С. С. Корсакова. 2020; 120(3): 109–118. https://doi.org/10.17116/jnevro2020120031109 [Shavlovskaya O. A., Gordeeva I. E., Ansarov K. S.h, Prokofieva Yu. S. Chronic pain syndrome in diseases of periarticular tissues. Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova. 2020; 120(3): 109–118. https://doi.org/10.17116/jnevro2020120031109 (In Russ.).]

Кутя С. А., Ткач А.В. Функциональная анатомия плечевого сустава в норме и при повреждении вращательной манжеты. Крымский журнал экспериментальной и клинической медицины. 2019; 9(3): 61–67. [Kutia S. A., Tkach A. V. Functional anatomy of the shoulder joint in normal and damaged rotator cuff. Krymskij Zhurnal Eksperimental’noj i Klinicheskoj Mediciny. 2019; 9(3): 61–67 (In Russ.).]

Гаврилюк С. А. Повышение эффективности восстановительного лечения пациентов с воспалительно-дегенеративными заболеваниями ротаторной манжеты плеча. Известия Российской военно-медицинской академии. 2019; 38 (1–1): 90–92. [Gavrilyuk SA. Improving the effectiveness of restorative treatment of patients with inflammatory and degenerative diseases of the rotator cuff of the shoulder. Izvestia of the Russian Military Medical Academy. 2019; 38 (1–1): 90–92 (In Russ.).]

Калинский Е. Б., Слиняков Л. Ю., Черняев А. В., Гончарук Ю. Р., Лычагин А. В. Полиморфизм проявлений шейно-плечевого синдрома у пациентов с последствиями травм плечевого сустава и надплечья. Клинико-статистическое обоснование. Медицинский вестник Северного Кавказа. 2019; 14 (4): 590–595. https://doi.org/10.14300/mnnc.2019.14147 [Kalinsky E. B., Slinyakov L.Yu., Chernyaev A. V., Goncharuk Yu.R., Lychagin A. V. Polymorphism of manifestations of the cervical-shoulder syndrome in patients with results of injuries of the shoulder joint and shoulder girdle. Clinical and statistical substantiation. Medical News of the North Caucasus. 2019; 14(4): 590–595. https://doi.org/10.14300/mnnc.2019.14147 (In Russ.)].

Иванов В. А., Харченко В. В., Лашин В. Э. Плече-лопаточный периартрит. Интегративные тенденции в медицине и образовании. 2021; (1): 41–48. [Ivanov V. A., Kharchenko V. V., Lashin V. E. Shoulder-scapular periarthritis. Integrativnye Tendencii v Medicine i Obrazovanii. 2021; (1): 41–48 (In Russ.).]

Майко О. Ю., Тукенова Г. Б. Оценка качества жизни при остеоартрите плечевого сустава в условиях поликлиники. Международный журнал прикладных и фундаментальных исследований. 2022; (11): 30–35. [Maiko O.Yu., Tukenova G. B. Assessment of the quality of life in osteoarthritis of the shoulder joint in a polyclinic. International Journal of Applied and Fundamental Research. 2022; (11): 30–35 (In Russ.).]

Бобунов Д. Н., Михайлов В. Д., Овсянников М. С., Баядян Л. О., Танрвердиев Д. К., Черемисина Т. Е., Кузнецова Е. Д., Гаджиев И. Г., Сироткина А. С. Лечебная физкультура при повреждении ротаторной манжеты плеча. Уральский медицинский журнал. 2019; 14(182): 92–99. [Bobunov D. N., Mikhailov V. D., Ovsyannikov M. S., Bayadyan L. O., Tanrverdiev D. K., Cheremisina T. E., Kuznetsova E. D., Gadzhiev I. G., Sirotkina A. S. Therapeutic physical education in case of damage to the rotator cuff of the shoulder. Ural Medical Journal. 2019; 14(182): 92–99 (In Russ.).]

Тутуров А. О., Кузьмин П. Д., Пиманчев О. В. Хирургическая стабилизация плечевого сустава. Результаты пятилетнего опыта. Вестник национального медико-хирургического центра им. Н. И. Пирогова. 2021; 16(1): 39–45. https://doi.org/10.25881/BPNMSC.2021.48.23.007 [Tuturov A. O., Kuzmin P. D., Pimanchev O. V. Surgical stabilization of the shoulder joint. The results of five years of experience. Bulletin of Pirogov National Medical & Surgical Center. 2021; 16(1): 39–45. https://doi.org/10.25881/BPNMSC.2021.48.23.007 (In Russ.).]

Бобунов Д. Н., Михайлов В. Д., Татарин Н. Т., Бровина Н. В., Думбадзе Р. Д., Борисова Н. Е., Лапаева О. Е., Щербатых Н. А., Синякова Я. Г. Лечебная физкультура при травматических повреждениях плечевой кости (1-й этап восстановительного лечения). Уральский медицинский журнал. 2020; 3(186): 133–140. https://doi.org/10.25694/URMJ.2020.03.27 [Bobunov D. N., Mikhailov V. D., Tatarin N. T., Brovina N. V., Dumbadze R. D., Borisova N. E., Lapaeva O. E., Shcherbatykh N. A., Sinyakova Ya. G. Physical therapy for traumatic injuries of the humerus (1st stage of rehabilitation treatment). Ural Medical Journal. 2020; 3(186): 133–140. https://doi.org/10.25694/URMJ.2020.03.27 (In Russ.).]

10.

Кабаев Е. М., Симонов К. В., Хамад Ю. А. Совершенствование методов анализа биомеханики плечевого сустава в послеоперационной реабилитации. Медицина и высокие технологии. 2020; (1): 27–34. [Kabaev E. M., Simonov K. V., Hamad Yu. A. Improvement of methods of analysis of biomechanics of the shoulder joint in postoperative rehabilitation. Journal Medicine and High Technology. 2020; (1): 27–34. (In Russ.).]

11.

Никитин М. В., Кончугова Т. В., Павловский С. А. Инновационные технологии в санаторно-курортном лечении пациентов с плечелопаточным болевым синдромом. Вестник восстановительной медицины. 2020; 2(96): 90–93. https://doi.org/10.38025/2078-1962-2020-96-2-90-93 [Nikitin M. V., Konchugova T. V., Pavlovsky S. A. Innovative technologies in the sanatorium treatment of patients with shoulder pain syndrome. Bulletin of Rehabilitation Medicine. 2020; 2(96): 90–93. https://doi.org/10.38025/2078-1962-2020-96-2-90-93 (In Russ.).]

12.

Буйлова Т. В., Балчугов В. А., Северова Е. А. Плечелопаточный болевой синдром у пациентов, занимающихся физической культурой и спортом: современные аспекты реабилитации. Вестник восстановительной медицины. 2020; 2(96): 24–43. https://doi.org/10.38025/2078-1962-2020-96-2-24-28 [Buylova T. V., Balchugov V. A., Severova E. A. Shoulder pain syndrome in patients engaged in physical culture and sports: modern aspects of rehabilitation. Bulletin of Rehabilitation Medicine. 2020; 2(96): 24–43. https://doi.org/10.38025/2078-1962-2020-96-2-24-28 (In Russ.).]

13.

Старосельский Я. Л., Мельничук Н. В., Мельничук В. И. Методика механотерапии в коррекции повреждения капсульно-связочного аппарата плечевого сустава у ватерполистов. Физическая культура студентов. 2020; 69(2): 43–46. [Staroselsky Ya.L., Melnichuk N. V., Melnichuk V. I. The method of mechanotherapy in the correction of damage to the capsule-ligamentous apparatus of the shoulder joint in water polo players. Physical culture of students. 2020; 69(2): 43–46 (In Russ.).]

14.

Голованова М. В., Потехина Ю. П., Плохов Р. А. Руководство пользователя инфракрасного термометра СЕМ®Thermodiagnostics. Н. Новгород: «Бегемот». 2008: 32 с. [Golovanova M. V., Potekhina Yu.P., Plokhov R. A. User manual of the infrared thermometer SEM ® Thermodiagnostics. Nizhny Novgorod. Behemoth. 2008: 32 p. (In Russ.).]

15.

Калинский Е. Б., Черняев А. В., Слиняков Л. Ю., Богатов В. Б., Гончарук Ю. Р., Чеканов А. С., Колышенков В. А., Еремушкин М. А. Оценка биомеханических нарушений плечевого сустава у пациентов с шейно-плечевым синдромом после травм надплечья. Российский журнал биомеханики. 2020; 24(2): 196–202. [Kalinskiy E. B., Chernyaev A. V., Slinyakov L.Yu., Bogatov V. B., Goncharuk Yu.R., Chekanov A. S., Kolyshenkov V. A., Eremushkin M. A. Assessment of biomechanical disorders of the shoulder joint in patients with cervical-shoulder syndrome after injuries of the upper arm. Russian Journal of Biomechanics. 2020; 24(2): 196–202 (In Russ.).]