OPPORTUNITIES OF CONSERVATIVE ORTHOPEDIC CORRECTION OF POSTINSULT UPPER EXTREMITY SPASTICITY

Aim. To study the peculiarities of formation of orthopedic pathology of the upper extremity in invalids after stroke and to offer new methods of rehabilitation treatment. Materials and methods. The examination of 88 patients after stroke with motor abnormalities, formed in the arm against the background of spastic hemiparesis, was carried out. Results. Central and peripheral pain syndromes in the shoulder joint on the side of paresis, muscular spasticity and arm joint contractures were diagnosed. Pain syndrome was corrected, vascular drugs, massage, curative gymnastics, physiotherapeutic procedures and prosthetic-orthopedic devices were administered. A unified orthesis, produced from sheet thermoplastic material using the method of vacuum molding in the form of cartridge, covering the hand and a part of the forearm was developed. Orthesis permitted to fulfill a staged, controlled orthopedic correction of the elevated muscular tonus of the hand, thus changing its position at three stages of rehabilitation. The hand was gradually taken from the pathological position. Efficiency of this correction was estimated by muscular strength, tonus, dynamics of pain syndrome and articular movements. Conclusions. Timely diagnosis of the postinsult orthopedic pathology of the upper extremity, early terms of starting treatment, complex approach, adequacy of prosthetic-orthopedic goods contribute to efficiency of rehabilitation measures.

Postinsult hand spasticity, orthesis, controlled orthopedic correction