ABSTRACT
THE RATIONALE: The differential approach taking into consideration the pathogenetic aspects of the pathological condition of interest with the identification of the principal cause of disorders in the musculo-skeletal system is a topical issue in the development of the measures for the rehabilitative treatment of the affected patients. Despite a great variety of methods and guidelines currently available for the conservative treatment of the musculoskeletal system diseases, further investigations and the development of the approaches and recommendations are needed for the correction and prevention of pathobiomechanical disorders and securing the optimal motor stereotype. AIM: The objective of the present study was to improve the existing methods for the correction of the lumbosacral orthosis in the patients presenting with patellofemoral pain syndrome with the use of physical exercise therapy for the improvement of their locomotor activity. MATERIAL AND METHODS: We have undertaken a randomized controlled clinical study involving 60 outpatients. They were divided into two groups designated as the main and control ones. The inclusion criteria were the age between 18 and 35 years, the feeling of discomfort or pain in the lumbosacral region, and the combined patellofemoral syndrome. All the patients underwent the comprehensive examination of the musculoskeletal system, and evaluation of pain intensity based on the relevant visual-analogue scales, stabilometry before and after the treatment of the patients comprising the main group with the use of the combined correction and of the control patients with the application of the conventional correction methods. RESULTS: The treatment with the use of the proposed original physical exercise therapy of the patients presenting with the pain syndrome in the lumbosacral region resulted in a reduction of its intensity by 27% on the average (p<0.05) and a significant 40% decrease in the frequency of dysfunction of the thoracoabdominal diaphragm. Simultaneously, the frequency of dysfunction of the muscles stabilizing the lumbosacral spine and the lower extremity on the side of the patellofemoral complex decreased by 53.4% and 17.8% on the average, respectively. Parameters of stabilometry evaluated from the results of the 'Mishen' (Target) test and the Romberg test with eyes closed improved by 1.9 times (p<0.05) and 2.5 times (p<0.05) on the average, respectively. CONCLUSION: The study has demonstrated that dysfunction of the sacral bone and muscles in the lumbosacral spine region responsible for the formation of the pain syndrome in the lower part of the back develops in 67% of the patients presenting with the patellofemoral pain syndrome. Physiotherapy including endurance-type exercises and activation of the muscles stabilizing the lumbosacral spine and lower extremities can improve results of rehabilitation.
