Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России, Москва, Россия
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Москва, Россия
Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России, Москва, Россия
Московский государственный медико-стоматологический университет им. А.И. Евдокимова Минздрава России, Москва, Россия
INTRODUCTION. Rehabilitation of children with knee joint injuries is very relevant due to a high prevalence of such a localization of injuries leading to loss of limb function and often requiring surgical treatment and intensive rehabilitation. AIM. To establish scientifically the isolated use of low-frequency pulsed electrostatic field and in combination with robotic mechanotherapy in treatment of the knee joint capsular ligamentous apparatus injuries in children. MATERIAL AND METHODS. 60 children aged 13 to 18 years with damage to the capsular ligamentous apparatus of the knee joint were included in the clinical study. The study group was represented by 30 children receiving a combined effect of the low-frequency pulsed electrostatic field and robotic mechanotherapy. A comparison group of 30 children was exposed to the low-frequency pulsed electrostatic field. Medical rehabilitation was prescribed in the early post-immobilization period after arthroscopic operations. To determine the effectiveness of medical rehabilitation techniques, we used orthopedic status assessment, a subjacent determinationof the severity of pain syndrome according to the VAS, clinical assessment of motor deficit, laser Doppler flowmetry, ultrasound examination of knee joints, infrared thermography, and psychological testing using the Spielberg-Hanin scale. RESULTS AND DISCUSSION. A prospective open randomized comparative study revealed a more pronounced regression of pain syndrome, earlier restoration of the motions in the injured joint, and relief of posttraumatic synovitis signs when using two physical factors in children with damage to the capsule-ligament apparatus of the knee joint in combination. The clinical and functional results obtained are of great importance in injuries of the knee joint with the risk of contracture formation in the postoperative period. CONCLUSION. High therapeutic efficacy, good tolerability of procedures, and the absence of adverse reactions substantiate expediency of the low frequency pulsed electrostatic field introduction in combination with robotic mechanotherapy for injuries of the capsular ligamentous apparatus of the knee joint in children into the practice of children’s medical and preventive medical organizations.
children, trauma, knee joint, medical rehabilitation, low-frequency pulsed electrostatic field, robotic mechanotherapy
1. Solov'eva K.S., Zaletina A.V. Travmatizm detskogo naseleniya Sankt-Peterburga. Ortopediya, travmatologiya i vosstanovitel'naya hirurgiya detskogo vozrasta. 2017; 5(3): 43-49. https://doi.org/10.17816/PTORS5343-49
2. Han M.A., Vahova E.L., Kul'chickaya D.B., Krest'yashin I.V., Pochkin E.O., Rumyanceva M.V. Fizicheskie faktory pri travmaticheskoy artropatii u detey. Vestnik vosstanovitel'noy mediciny. 2019; 4(92): 8-11.
3. Ardern C.L., Ekås G., Grindem H., Moksnes H., Anderson A., Chotel F., Cohen M., Forssblad M., Ganley T.J., Feller J.A., Karlsson J., Kocher M.S., LaPrade R.F., McNamee M., Mandelbaum B., Micheli L., Mohtadi N., Reider B., Roe J., Seil R., Siebold R., Silvers-Granelli H.J., Soligard T., Witvrouw E., Engebretsen L. International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Knee Surgery, Sports Traumatology, Arthroscopy. 2018; 26(4): 989-1010. https://doi.org/10.1007/s00167-018-4865-y
4. Wellsandt E., Khandha A., Capin J., Buchanan T.S., Snyder-Mackler L. Operative and nonoperative management of anterior cruciate ligament injury: Differences in gait biomechanics at 5 years. Journal of Orthopaedic Research. 2020; 38(12): 2675-2684. https://doi.org/10.1002/jor.24652
5. Han M.A., Vahova E.L., Krest'yashin I.V. Sovremennye tehnologii fizioterapii pri travmah kolennogo sustava u detey. Fizioterapevt. 2018; (6): 52-58.
6. Vutescu E.S., Orman S., Garcia-Lopez E., Lau J., Gage A., Cruz A.I. Jr. Psychological and Social Components of Recovery Following Anterior Cruciate Ligament Reconstruction in Young Athletes: A Narrative Review. International Journal of Environmental Research and Public Health. 2021; 18(17): 9267 p. https://doi.org/10.3390/ijerph18179267
7. Ekås G.R., Moksnes H., Grindem H., Risberg M.A., Engebretsen L. Coping with Anterior Cruciate Ligament Injury arom 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
8. Ponomarenko G.N. Fizicheskaya i reabilitacionnaya medicina. Nacional'noe rukovodstvo. Moskva. GEOTAR-Mediayu 2017: 512 s.
9. Khan M.A., Krestyashin V.M., Krestyashin I.V., Zimina O.Y. The use of physical therapy for knee injuries in children. Archiv-EuroMedica. 2019; (1): 116 p.
10. Razumov A.N., Pogonchenkova I.V., Han M.A., Lyan N.A., Vahova E.L., Mikitchenko N.A. Primenenie impul'snogo nizkochastotnogo elektrostaticheskogo polya v pediatrii. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul'tury. 2019; 96(1): 55-62. https://doi.org/10.17116/kurort20199601155
11. Han M.A., Razumov A.N., Pogonchenkova I.V., Lyan N.A., Vahova E.L. Metody elektrolecheniya v pediatrii. Uchebnoe posobie. Moskva. 2021: 80 s.
12. Kulikov A.G., Yarustovskaya O.V., Kuzovleva E.V., Zayceva T.N., Kul'chickaya D.B., Konchugova T.V. Primenenie nizkochastotnogo elektrostati- cheskogo polya v klinicheskoy praktike. Uchebnoe posobie. Moskva. 2015: 126 s.
13. Shimarova O.V., Achkasov E.E., Timashkova G.V. Effektivnost' i celesoobraznost' razlichnyh podhodov k reabilitacii posle endo- protezirovaniya kolennogo sustava. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul'tury. 2019; 96(3):64-69. https://doi.org/10.17116/kurort20199603164
14. Epifanov V.A., Glazkova I.I., Epifanov A.V. Osnovy reabilitacii. Moskva. GEOTAR-Media. 2020: 640 s.
