The Effectiveness of Robotic Mechanotherapy in the Rehabilitation of Patients with Shoulder Joint Pathology: Randomized Clinical Trial

Abstract

INTRODUCTION. Prolonged inactivity associated with exacerbation of a chronic disease or immobilization of the upper limb after injuries and operations leads to the development of functional disorders in the shoulder joint and the development of secondary changes, such as muscle atrophy, contractures, osteoporosis. Therefore, the early application of functional methods of treatment is pathogenetically justified, among which mechanotherapy on robotic devices occupies an important place. AIM. To study the effectiveness of using the FLEX-F04 device in diseases and injuries of the shoulder joint. MATERIALS AND METHODS. According to the inclusion criteria, 60 patients were under our supervision. By random sampling, all patients were divided into two groups of 30 people each. All patients underwent a clinical examination, assessed algofunctional index on the VAS scale, the degree of dysfunction in the arm, shoulder and hand according to the DASH questionnaire, electrothermometry. RESULTS. As a result of treatment and rehabilitation measures, there was a significant increase in the angles of flexion, horizontal adduction, abduction, external and internal rotation in the shoulder joint, a decrease in pain syndrome and an increase in daily activity according to the DASH questionnaire in patients of both groups. In the main group, these indicators were significantly better than in the comparison group. The increase in thermal radiation as a result of the robotic mechanotherapy procedure averaged 0.6 0.1C. DISCUSSION. Robotic mechanotherapy allows movement in the shoulder joint in accordance with its biomechanics, reduces the load on the musculoskeletal system and thereby prevents the appearance or strengthening of the pain component during the procedure. This contributes to an active increase in the amplitude of movements and improvement of the functional capabilities of the shoulder joint, which has a positive effect on daily activity. An increase in thermal radiation in the shoulder joint area during the procedure can serve as an indirect sign of improved microcirculation and neuro-vascular regulation. CONCLUSION. The use of the FLEX-F04 robotic mechanotherapy device of the upper extremities according to the proposed method increases the volume of movements in the shoulder joint, reduces pain syndrome, increases blood circulation of the shoulder joint area and improves neuro-vascular regulation, increases daily household activity. Early inclusion of the device in the rehabilitation process makes it possible to shorten the duration of rehabilitation treatment and achieve a functional range of movements in the shoulder joint.