PHYSICAL THERAPY OF PATIENTS WITH BRACHIAL NEURITIS BASED ON THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING

Abstract

The purpose of the work: to build a rehabilitation program for a patient with neuritis of the brachial plexus according to the International Classification of Functioning, Restriction of Life and Health (ICF).
Materials and methods. The object of study – patients with right neuritis of the humeral plexus. The study included 7 patients (5 men and 2 women) aged 23 to 38 years. The reason for the development of the disease was specific (professional) physical activity and hypothermia. The following methods were used in our study: theoretical (analysis and systematization of specialized scientific and methodological literature on the provision of rehabilitation care to patients with injuries and diseases of the peripheral nervous system); clinical (analysis of medical records, listening, examination), instrumental (dynamometry, manual muscle testing and scale methods for assessing the condition of patients on subjective indicators (visual analog pain scale (VAS), muscle spasticity study on the Ashworth scale, performance assessment on the DASH scale (The Disabilities of the Arm, Shoulder and Hand Score).
Results. Shoulder neuritis is a disease of the peripheral nervous system characterized by severe pain and the rapid development of paresis and atrophy of the shoulder girdle muscles. It was determined that idiopathic shoulder neuritis belongs to the category with the registered code G54.0 Brachial plexus disorders, which is accompanied by the following motor and nervous disorders: decreased muscle strength, changes in the dynamic function of the entire scapular-shoulder complex (loss of smoothness and accuracy of all movements shoulder joint), as well as dysfunction of the hands (grasping and holding objects, precise manipulation of the fingers), sharp pain with active movements of the limb. Most patients in this nosological group are people of working age, and without timely rehabilitation care in most cases they become disabled. That is why the problem of timely rehabilitation intervention requires considerable attention from health professionals, including specialists in physical and occupational therapy. Today, building a physical therapy program, formulating a global goal and setting long-term and short-term rehabilitation goals is based on the International Classification of Functioning, Disability and Health (ICF), which provides rehabilitation assistance in several stages: examination or assessment (assessment), planning or assignment, which involves the creation of a physical therapy program; (intervention) – implementation of a physical therapy program and control or monitoring (evaluation), aimed at assessing the results of rehabilitation interventions at different stages of its implementation. Taking into account the above recommendations, the organization and management of the process of physical therapy of patients with neuritis of the humeral plexus were carried out in stages with the following structure: the formation of individual rehabilitation diagnosis of the patient and his categorical profile; identification of global (complete restoration of the damaged shoulder-scapular complex), long-term (restoration of full range of motion in all joints of the upper limb and muscular strength of the shoulder joint, correction and consolidation of proper ergonomics, normalization of autonomic and trophic processes) and short-term goals of SMART physical therapy. A program of physical therapy has been developed, which includes key rehabilitation tools, each of which solves specific tasks: kinesitherapy, mechanotherapy, hydrokinesiotherapy, massage (classical and segmental-reflex) and postisometric relaxation.