CORRECTION OF FUNCTIONAL INDICATORS OF THE LOWER LIMBS AND GAIT PARAMETERS IN ELDERLY PATIENTS WITH BILATERAL HIP ARTHROPLASTY USING PHYSICAL THERAPY

Abstract

Purpose: to assess the effectiveness of the developed physical therapy program for elderly people with bilateral hip replacements according to the parameters of the functional state of the lower extremities and gait in the long-term rehabilitation period. Material. 112 elderly people (69.6±1.2 years) were examined. The control group consisted of 42 people who had no history of lower limb joint replacement. The comparison group consisted of 37 people with unilateral total hip replacement. The experimental group consisted of 33 people with two hip replacements, the effectiveness of which is presented in our study. A three-month physical therapy program was developed and implemented for them using therapeutic exercises (using weights, Thera-Band, MFT Challenge Disc Digital); gait training (self-control, practicing gait phases, overcoming an obstacle course), functional training of symmetry of lower limb movements (PROCEDOS PLATFORM 9 platform), Nordic walking; educational component – learning to control one’s condition, movement limitations, reducing the risk of falling, awareness of the need for regular rehabilitation interventions; reshaped physical factors – electromyostimulation of the quadriceps femoris muscle, gluteal muscles, and calf muscles. The effectiveness was assessed by the results of goniometry, anthropometry, Modified Harris Hip Score, Functional Gait Assessment, and the 6-minute walk test. Results. Elderly patients with bilateral hip replacements were found to have asymmetry of the circumference of the lower extremities, limitation of the amplitude of extension, adduction and abduction in the hip joint, difficulties in performing activities of daily living (according to the Modified Harris Hip Score), decreased distance and impairment during various types of gait (according to the results of the 6-minute walk test, Functional Gait Assessment). The functional capabilities of the patients studied were worse (p<0.05) compared to the contingent of patients with one hip replacement and the control group of individuals. The approved physical therapy program revealed an improvement in the patients' condition due to the impact on the components of hip joint dysfunction by increasing the amplitude of movements, reducing the structural and functional symmetry of the lower extremities, and expanding the motor functional capabilities when performing various activities compared to the baseline indicators for all studied parameters (p<0.05). Conclusions. Physical therapy is advisable to prescribe for the comprehensive correction of structural and functional dysfunctions of the operated limbs and to improve gait in elderly patients with bilateral hip arthroplasty.