Search

The aim of the study. To determine the effectiveness of complex differentiated rehabilitation in patients with degenerative-dystrophic pathology of the thoracic spine (DDPS) and thoracic back pain syndrome depending on the indicators of vertebrodynamics. Materials and methods. Rehabilitation measures were carried out in 124 patients with DDPS complicated by thoracalgia syndrome at the post-acute stage of rehabilitation. The age of the patients was from 18 to 54 years. There were 51 (41.2 %) women, 73 (58.8 %) men. The duration of the disease was from 2 to 23 years. A rehabilitation examination was carried out with an assessment of vertebrodynamic disorders indicators according to the A. Stoddard method. All patients had functional block of the 2nd degree in the vertebral-motor segments of the thoracic spine. Patients were divided into 2 groups, comparable in age and disease severity. The first group (n = 56) received a basic complex of rehabilitation: massage, personalized sets of therapeutic exercises, physical methods of treatment (magnetotherapy, ultrasound therapy) against the background of drug treatment (nonsteroidal anti-inflammatory drugs, muscle relaxants, analgesics). Patients of the second group (n = 68) were prescribed, in addition, sessions of post-isometric and post-reciprocal muscle relaxation, mobilization techniques according to K. Lewit, R. Maigne, V. Gubenko, as well as the original methods of kinesiotherapy developed by us depending on the indicators of vertebrodynamics. The outpatient rehabilitation cycle lasted 14 days. Results. The developed comprehensive scheme of of patients examination based on neurological, manual, instrumental studies, assessment of pain syndrome, insomnia and affective disorders allows early diagnosis of the disease, as well as dynamic monitoring during treatment. The developed and tested complex kinesiotherapeutic treatment method with the use of manual therapy leads to a faster regression of neurological symptoms, restoration of the lost range of motion in the thoracic spine, reduction of pain and the risk of DDPS exacerbation, shortening the time of treatment and rehabilitation of patients, and improving their quality of life. Conclusions. The comprehensive differentiated rehabilitation with the use of manual therapy developed and researched in the work has confirmed its effectiveness, which allows recommending its use in clinical and rehabilitation practice, and provides significant economic effect in the treatment of this contingent of patients.

Purpose The purpose of this study was to evaluate the reaction of the cardiovascular system of men with vertebral thoracalgia to manual therapy procedures on the chest during the course of sanatorium-resort treatment of spinal osteochondrosis. Material and methods Under supervision were 26 men aged 32.3 (27.9; 42.9) years who underwent a course of sanatorium-resort treatment for vertebral thoracalgia in the clinical sanatorium named after V.P. Chkalov (Odesa, Ukraine) in 2010-2011. The treatment complex included of 4 thoracic spine manual therapy (TSMT) procedures, which were performed every 5-7 days of sanatorium-resort treatment. The indicators of the cardiovascular system were recorded using the Omron M1 Classic device (Japan) in a supine position before and after every procedure TSMT. Results The results obtained in this study indicated sufficiently characteristic significant changes in heart rate (min-1), which mainly decreases, DBP (mm Hg), which mainly increases, PBP (mm Hg), which mainly decreases in each of the procedures TSMT in men with vertebral thoracalgia. Separately, according to the data of the rank evaluation of changes in indicators, the types of response of the contractile function of the heart (Δ Double product) and autonomic support of hemodynamics (Δ Index Kerdo) in men were characterized. They showed that there are individual differences in response to the TSMT procedure in the course of sanatorium-resort treatment. Conclusion. Determining the changes in Δ Double product and Δ Index Kerdo for the procedure of manual therapy of the thoracic spine made it possible to develop criteria for evaluating the types of response of the contractile function of the heart and autonomic support of hemodynamics. Their analysis in the course of sanatorium treatment of patients with thoracalgia showed that there are individual characteristics of reactions that should be taken into account in order to prevent the occurrence of negative effects of the TSMT procedure.

Abstract. Background. Approximately 1% of all reasons for visits to primary care physicians are chest pain, and in 2–4% of these patients pain is the cause of potentially life-threatening cardiovascular disease. For a correct and quick diagnosis, it is extremely important that the clinician and the patient speak “one language”: the described complaints should be interpreted quickly and correctly, and the doctor’s questions should be clear to the patient. It is very important to get information from the patient about any accompanying symptoms and a detailed description of chest discomfort. History taking and physical examination should take the minimum amount of time required. That is why it is necessary to understand how and why conditions develop, the manifestation of which is pain in the chest. To highlight the significant variability of clinical manifestations of thoracalgia, mechanisms of development and features of clinical and laboratory-instrumental diagnosis of the causes of chest pain is a main aim of the review. Materials and methods. Modern foreign guidelines for the management of patients with chest pain, written in English, were used. Conclusions. After injuries, chest pain is the main reason of patients visits to the admission department for urgency care. Longstanding classification of the chest pain causes divides it into cardiac and non-cardiac, and cardialgia, in turn, can be subdivided to pain, caused by ischemic changes in the myocardium, and the one with a non-ischemic origin. Patients often do not use the term “pain” to describe their symptoms, but often use other terms such as discomfort, compression, or may associate discomfort with indigestion. When chest pain is caused by ischemia or insufficient coronary blood flow, it is called ischemic thoracalgia. Detection of angina pectoris is one of the main problems in the examination of patients with chest pain, and thoracalgia, which clinically and instrumentally correlates with acute angina pectoris, requires urgent diagnosis and treatment, as it may be a sign of acute coronary syndrome (ACS). Thoracic pain can not only affect the heart muscle, but also radiate from other anatomical areas or be felt secondarily, if it develops in an adjacent anatomical area (eg, thoracic spine, epigastric pain, etc.). Both acute and chronic chest pain should be carefully evaluated by a clinician, and further examination may be performed based on his findings. Appropriate and necessary laboratory and instrumental examination of patients, taking into account all possible risks, not only allows to quickly establish an accurate diagnosis, but also leads to more effective treatment.