Rehabilitation of children with Lyme arthritis

Abstract

Background. Lyme disease is a common tick-borne infection. Untimely diagnosis and treatment lead to the chronicity of the process with the development of late lesions of various systems and organs and possible disability. The purpose of the study was to develop a program of rehabilitation measures for children with Lyme disease. Material and methods. The research was conducted on the basis of the Ternopil Regional Children’s Hospital. Twenty children, residents of the Ternopil region, who applied to the Ternopil Regio­nal Children’s Hospital for tick bites and, as a result, diagnosed Lyme arthritis, took part in the study. To assess the severity of pain, we used scales and questionnaires for the diagnosis of DN4 neuropathic pain. Laboratory and instrumental studies were performed such as evaluation of the level of malondialdehyde, diene conjugates, superoxide dismutase. Results. Clinical examination of tick-affected children with Lyme disease showed that the most common primary clinical manifestation is a typical skin lesion — erythema migrans. In case of arthritis, all children notice inflammatory changes and pain in the joints. As a result of the conducted studies, the activation of peroxidation in children with Lyme disease was detected (an increase in the level of malondialdehyde and a decrease in superoxide dismutase, diene conjugates). It was shown that combined therapy with the use of magnetic laser therapy leads to the normalization of lipid peroxidation. Conclusions. All children with Lyme arthritis have a pain syndrome of varying severity. In patients with Lyme disease, there is an increase in the activity of lipid peroxidation and a decrease in the functional capacity of the antioxidant defense system. Children who underwent traditional treatment for Lyme arthritis reported a partial normalization of lipid peroxidation as evidenced by a significantly decreased level of diene conjugates compared to controls. In the group of patients who underwent combined treatment for Lyme arthritis (antibacterial therapy + magnetic laser therapy), the activity of antioxidant defense was normalized. Combination of magnetic laser therapy with antibacterial therapy demonstrates an improvement of pain status and faster rehabilitation of children.