Complex rehabilitation of children and adolescents with dysfunction of the sacroiliac joints

Abstract

BACKGROUND: Back pain (BP) is encountered by physicians in many specialties. Sacroiliac joint (SIJ) dysfunction is one of the most common causes of non-specific BP (NBP). Many approaches have been accepted for the treatment of this pathology, including drug correction, physiotherapy, therapeutic blockade, and manual therapy (MT). In most cases, these methods help reduce the severity of the pain syndrome and restore the physiological mobility of the SIJ. Despite ongoing therapy, BP persists in some cases. The most likely reason for the ineffectiveness of MT is impaired muscle balance. The correction of this impairment is carried out with the help of other rehabilitation techniques. AIM: To develop a comprehensive program for the rehabilitation of patients with NBP associated with SIJ dysfunction. MATERIALS AND METHODS: A prospective study included 54 patients aged 718 years who complained of pain in the lumbosacral spine. The patients were divided into two groups: the first group underwent manual correction of dysfunction, followed by mechanotherapy on block simulators, and the second group underwent correction of articular dysfunction using specially selected movements performed asymmetrically depending on the identified disorders, and the therapeutic gymnastics program included mechanotherapy and postural workout. At all stages of rehabilitation treatment according to the progression system, training for muscle control was carried out. According to indications, all children underwent mild MT. RESULTS: A dynamic step-by-step system for assessing the biomechanics of movements and tonicphasic balance has been developed. A technique for the rehabilitation treatment of NBP with concomitant SIJ dysfunction has been developed, which was selected individually depending on the identified disorders and features of motor activity. CONCLUSION: The proposed rehabilitation system simplifies and systematizes work in patients who complained of BP associated with osteoarticular dysfunction. The effectiveness of rehabilitation increased due to the precisely selected methods, depending on the root cause of NBP associated with acute or recurrent SIJ dysfunction. A rehabilitation technique aimed at preventing recurrent SIJ dysfunctions helps prevent relapses of BP and minimize the risk of developing articular pathology of the lower extremities.