STUDY OF THE EFFECTIVENESS OF PHYSICAL THERAPY INTERVENTIONS ON THE INDICATORS OF ASTHENO- VEGETATIVE SYNDROME AND QUALITY OF LIFE IN OLDER INTERNALLY DISPLACED PERSONS WITH PARKINSON’S DISEASE

Abstract

Physical therapy of internally displaced persons with Parkinson's disease – one of the most common neurodegenerative brain pathologies in older people – is a multifaceted problem that includes medical, social, psychological and organizational components, which makes its solution urgent.Aim: to determine the effectiveness of the impact of the developed physical therapy program on the dynamics of astheno- vegetative syndrome and quality of life of internally displaced elderly people with Parkinson’s disease.Methodology. The control group consisted of 18 elderly people who were not diagnosed with Parkinson’s disease. The main group consisted of 16 internally displaced elderly people with diagnosed Parkinson’s disease, who underwent rehabilitation according to the developed program (therapeutic exercises, functional training, therapeutic education). The program was evaluated by a test with isometric loading, the Kerdo index, analysis of the spectrogram of 24-hour heart rate variability monitoring, Fatigue Assessment Scale, Fatigue Severity Scale, Parkinson’s Disease Quality of Life Questionnaire-39.Novelty. The results of the recalculation of the Kerdo index showed positive dynamics in people with Parkinson’s disease towards the balance of the autonomic nervous system (sympathetic and parasympathetic): by 29.3% (p<0.05). Positive changes were determined in the results of the isometric load test: the dynamics of the diastolic blood pressure indicator at the third minute of the study was 19.1% (p<0.05). According to the data of the re-registration of heart rate variability, a decrease in the power value in the LF frequency range was noted (by 16.1%, p<0.05). Positive dynamics of the frequency reflection of the activity of the parasympathetic department – HF waves, the value of which in the main group improved by 11.9% (p<0.05). Accordingly, the LF/ HF ratio improved in the main group by 25.1% (p<0.05). Identical trends were identified for the dynamics of the Baevsky index – by 36.7%. The result of the program was a decrease in the feeling of fatigue of the studied contingent of people to a moderate level according to the parameters of the Fatigue Assessment Scale – by 25.5% (p<0.05). Compared with the initial examination, the importance of fatigue according to the Fatigue Severity Scale significantly decreased (by 18.2%, p<0.05); although the parameters of the control group were not achieved (p>0.05). In patients of the main group, a statistically significant (p<0.05) improvement in the PDQ-39 scales “Mobility”, “Daily Activity”, “Emotional Well-Being”, “Physical Discomfort” was found compared to the initial one. Conclusions. Internally displaced elderly people with Parkinson’s disease require the development of physical therapy programs that take into account and correct astheno-vegetative manifestations and impaired quality of life.