STUDY OF THE EFFECTIVENESS OF PHYSICAL THERAPY IN WOMEN WITH KNEE REPLACEMENT AS A CONSEQUENCE OF RHEUMATOID ARTHRITIS IN THE POSTPARTUM PERIOD AFTER VAGINAL DELIVERY

Abstract

Despite the growing interest in the topic of postpartum rehabilitation, studies related to the restoration of the functional state of women with joint endoprosthesis, in particular due to rheumatoid arthritis, during this period of time remain isolated, which necessitates the need for further scientific exploration in this direction.Purpose of the work: to determine the parameters of the physical condition of women with endoprosthetic knee joint due to rheumatoid arthritis in the postpartum period as a criterion for the effectiveness of the physical therapy program.Methodology. The comparison group consisted of 25 women without endoprosthetics of the lower limb joints. The main group consisted of 12 women with endoprosthetic knee joint due to rheumatoid arthritis 4 weeks after vaginal delivery. The developed physical therapy program lasted 4 weeks. Therapeutic exercises, functional training, postisometric relaxation were used; massage of the lower extremities, back. Movement restrictions associated with the presence of the endoprosthesis were taken into account; accordingly, safe movement strategies related to caring for the child were created. The indicators of physical status (hand and deadlift dynamometry, PWC170) were determined, the condition of the endoprosthetic knee joint (according to Forgotten Joint Score-12), complex changes in vital activity (according to Pregnancy Mobility Index).Scientific novelty. The improvement in the result of deadlift dynamometry and the deadlift strength index in the comparison group was 15.2% and 9.8%, respectively, in the main group – 25.9% and 20.0% (p<0.05 relative to the initial result). The strength of the hand did not change in both groups of women compared to the initial examination. Physical performance according to the results of PWC170 in women in the comparison group improved by 15.3%, in the main group – by 26.1% (p<0.05). During the repeated examination, according to the Forgotten Joint Score-12, an improvement in the condition of the main group was determined by 59.6% (p<0.05). The dynamics of the Pregnancy Mobility Index results showed a statistically significant improvement in the condition of the examined women compared to the initial result on the subscales of daily mobility at home (in the comparison group – by 59%, in the main group – by 70.5%), household activity (in the comparison group – by 68.2%, in the main group – by 67.6%), outdoor mobility (in the comparison group – by 64.5%, in the main group – by 66.1%). According to the Pregnancy Mobility Index indicators, women in the main group reached the level of the comparison group (p>0.05).Conclusion. Physical therapy is advisable to prescribe in the comprehensive rehabilitation of women with knee joint replacement due to rheumatoid arthritis, to reduce muscle weakness, increase work capacity, improve the functioning of the endoprosthesis, and facilitate the performance of various activities.