Sling therapy in the rehabilitation of children with knee injuries in the postoperative period: a randomized controlled study

INTRODUCTION. The high prevalence of knee joint injuries in children, often requiring surgical treatment and intensive rehabilitation, determines the relevance of searching for and developing new effective rehabilitation technologies that facilitate the full restoration of the function of the injured limb. АIM. Scientific substantiation of the use of kinesiotherapy with a suspension system in the medical rehabilitation of children with damage to the capsular-ligamentous apparatus of the knee joint. MATERIALS AND METHODS. The clinical study included 76 children aged 13 to 17 years with damage to the capsular-ligamentous apparatus of the knee joint after arthroscopic surgery (8 weeks after surgery). Of these, the main group consisted of 40 children who received kinesiotherapy with a suspension system, the comparison group — 36 children — without the use of kinesiotherapy. To assess the effectiveness of rehabilitation measures, an assessment of the orthopedic status, determination of the severity of pain syndrome according to visual analog scale data, muscle testing according to the motor deficit assessment scale, stabilometry, laser Doppler flowmetry were used. RESULTS AND DISCUSSION. The use of sling therapy contributes to a reliable increase in the muscle strength index of the injured limb by 1.5 times (from 3.1 [2.08; 4.07] to 4.5 [3.11; 5.13] points); improvement of stabilometry indices in the form of a decrease in the statokinesiogram area in the Romberg test with open and closed eyes, respectively, by 1.27 and 1.64 times and unidirectional changes in the deviation index of the general center of pressure. At the same time, all children under the influence of sling therapy showed a pronounced regression of edema in the area of injury, a reliable increase in the flexion angle in the joint from 100 [95; 110] to 120 [115; 130] degrees, which was accompanied by activation of microcirculation in the area of injury according to laser Doppler flowmetry in 66.6 % of children. A special neuromuscular training program improves the functional state of the lower limb. Restoration of postural balance in children with knee joint injury in the late post-immobilization period can be considered as one of the key tasks of the rehabilitation stage. CONCLUSION. The high efficiency of using kinesiotherapy on a suspension system in medical rehabilitation programs for children with damage to the capsular-ligamentous apparatus of the knee joint in the postoperative period has been established, which determines the feasibility of introducing the method into the practice of children’s medical and preventive medical organizations.