The effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports

Abstract

The purpose of the study: to study the effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports.Materials and methods: examined 48 male patients aged 25.9 ± 2.1 years with traumatic disease of the lumbar spinal cord. All examined were divided into 2 groups: patients of the main group (19 people) against the background of standard therapy received a course of active medical rehabilitation (AMR), including mechanotherapy and electrical stimulation with biofeedback under the control of electromyography (EMG) of the muscles of the lower extremities and back. Patients in the comparison group (29 people) received standard therapy. After the AMR course, a comprehensive examination was performed, including the data of the questionnaires: the ASIA classification (American Spinal Injury Association), the FIM (Functional Independence Measure) scale of functional independence, the modified functional assessment scale of activity and quality of life VFM (Valutazione Funzionale Mielolesi), State-Trait Anxiety Inventory, the Beck depression scale; electroneurophysiological studies on the Neurosoft Neuro-EMG-Micro device, heart rate variability (HRV) on the Neurosoft Poly-Spectrum computer electrocardiograph, indicators of free movement with concentric and eccentric muscle contractions on EN-TreeM.Results: polysympathetic reflex excitability (PRV) significantly decreased in patients of the main group. There was also an improvement in vegetative reactivity (coefficient 30/15 is 1.45; p <0.001) during the orthostatic test, indicating normalization of parasympathetic regulation and heart rate. The assessment on the ASIA scale revealed an improvement in sensory function by 13.4 % and motor function by 17.4 %. On the VFM scale, an increase in indicators was observed by 14.7 % and on the FIM scale by 11.5 %. When assessing the psycho-emotional sphere on the Spielberger-Khanin scale, a significant decrease in the level of reactive anxiety was noted by 10.9 %, and the level of depression by 30.5 %. A significant increase in muscle strength by 18.1 % (p < 0.001) was also observed during concentric contractions, the average power increased by 83.1 % (p < 0.001), the average amplitude increased by 68.7 % (p < 0.001), the average speed by 27.2 % (p=0.002). When analyzing the indicators after the treatment, significant differences were obtained between the main and the comparison group (p < 0.001).Conclusion: the use of biofeedback technologies under the control of electromyography leads to an increase in the effectiveness of medical rehabilitation and improves the quality of life in Paralympians with traumatic spinal cord disease.

Keywords

• paralympians
• active medical rehabilitation
• biofeedback
• electromyostimulation
• mechanotherapy