DOI: https://doi.org/10.22141/1608-1706.3.20.2019.172091

Biomechanical aspects of experimental study of functional treatment of C-shaped scoliosis

M.L. Golovaha, O.A. Tiazhelov, N.P. Letuchaya, I.A. Subbota, M.Yu. Karpinsky

Abstract


Background. Scoliotic disease is the object of nume-rous developments and studies of a wide variety of medical specialists. The multifaceted approach to one of the most difficult topics of orthopedics, vertebrology and pediatrics is absolutely justified. The data speak not only of an increase in the incidence of scoliosis as a whole, but also of an increase in the number of patients with severe deformities. Recently, in the treatment of this pathology, a surgical approach to correcting the deformation of the spine produces good results, while patient management actively includes in its program such a powerful factor as functional treatment of patients after surgery and patients who do not undergo surgical intervention. Many different methods of therapeutic gymnastics have been developed, but it is not always possible to evaluate all the proposed complexes subjectively. In our clinical practice, a set of physical exercises was developed, with topical features of the spinal deformity at its head. The purpose was to substantiate the effectiveness of physio-functional treatment of patients with C-shaped scoliotic disease based on mathematical modeling. Materials and methods. In the biomechanics laboratory of Sytenko Institute of Spine and Joint Pathology, mathematical models of the spine with C-shaped scoliotic deformations were developed, they were used to analyze the stress-strain state. We were interested in the distribution of internal stresses in the model, and not in the magnitude of the stresses produced by this force, so in all cases the load was assumed to be 10 N. In cases of additional compensating forces associated with maintaining the trunk in the initial position, for example, in a one-leg standing, additional load equal to 2 N was applied. As an experimental study, we used mathematical modeling, the basis of which was the mathematical model of the spine that made it possible to study the distribution of internal stresses in vertebral motor segments under different loading patterns. In this mathematical model, 15 exercises were tested. Conclusions. The study with the help of a mathematical model allowed studying the differentiated effect of kinesitherapy methods on spinal deformities, depending on its apex. This study allowed biomechanical substantiation of indications and contraindications for the use of various physical exercises in the treatment of scoliotic disease. The study made it possible to improve the methodological approach to the development of therapeutic gymnastics, taking into account the topical features of spine deformity.


Keywords


сколіоз; експериментальне моделювання; функціональне лікування

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