REHABILITATION DIAGNOSIS OF PATIENTS WITH GONARTHROSIS ON THE BASIS OF INTERNATIONAL CLASSIFICATION OF FUNCTIONING, LIMITATION OF LIFE ACTIVITY AND HEALTH

Abstract

Excessive training loads during sports cause chronic functional overload of the joints and their trauma, which reduces the quality of life of athletes, limits activity and participation, termination of sports careers, and in severe cases - disability. In sports practice, one of the most common sites of osteoarthritis is the knee joints (gonarthrosis). Gonarthrosis of the knee joint is a degenerative-dystrophic disease in which the destruction of hyaline cartilage, deformation of bone tissue and the qualitative composition of synovial fluid. A key link in the development of an individual program of rehabilitation intervention is the formulation of a rehabilitation diagnosis. The aim of the research: to determine the rehabilitation diagnosis of patients with gonarthrosis of the knee joints on the basis of the International Classification of Functioning, Restriction of Life and Health (ICF). Materials and methods: theoretical (analysis and generalization of scientific-methodical and clinical literature); clinical (analysis of medical records, communication, palpation, clinical and functional testing; physical examination); scale methods for assessing the condition of patients (Leken index, pain scale, depression scale (CES-D), assessment of quality of life according to the SF-36 questionnaire); instrumental (goniometry, manual-muscular testing). The research involved 7 veteran athletes aged 45 to 49 years with primary gonarthrosis stage II. Inclusion criteria: current athletes - men of different specializations; primary gonarthrosis of the second radiological stage according to Kellgren; duration of pain not less than 4 months; the level of pain when walking on the scale of YOUR 45 and more; age of patients older than 45 years; informational consent of patients to participate in the research. Inclusion criteria: secondary gonarthrosis of the knee joint; the presence of comorbidities; severe condition of the patient; knee surgery; planning of arthroplasty of the knee joint; intra-articular injections; lack of information consent. Rehabilitation diagnosis is the most complete reflection of the patient's current problems, which affect the level of his functioning, activity and participation, and are significant for him. It is established by all members of the multidisciplinary team, and is based on the results of comprehensive rehabilitation diagnostics. The main tool for establishing a rehabilitation diagnosis are the categories and domains of IFF. Rehabilitation diagnosis of patients with gonarthrosis: moderate structural changes in the knee joints (s750.2), episodic moderate pain (b28014.2), short-term morning stiffness (b7800.2), decreased mobility of the knee joint (b710.2), his stability (b7150.2) and support function, decrease in muscle tone (b7350.2) and strength of the quadriceps femoris (b7300.2), which limits domestic activity and prolongs it over time (d450.1); difficulties in changing body position (d410.2), moving up stairs and moving long distances (d460.3), which limits participation in active forms of recreation. Patients report poor mood, depression due to health and forced restriction of participation (b152. 1), and concerns about future careers. Conclusions. Rehabilitation care is provided to patients in several stages, one of which is the formulation of a rehabilitation diagnosis. Rehabilitation diagnosis was established, in which the current problems of patients at the level of structure and function, activity and participation, as well as contextual factors that contribute, limit or prevent the achievement of the desired level of functional independence, allow individualization of rehabilitation intervention to bring this level to the maximum possible.