The effectiveness of drug puncture in patients with dorsalgia

Authors:

Nedopekina Oksana Anatolyevna — neurologist, scientific consultant of the Research Department of Physiotherapy, Medical Climatology and Resort Factors, the Academic Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov, 10/3 Mukhina Street, 298603 Yalta, Republic of Crimea, Russian Federation, e-mail: nevrolog.zdorovie@yandex.ru; https://orcid.org/0000-0003-4589-0900.

Annotation:

Introduction. Current clinical guidelines, standards and methodological guidelines provide information on the use of physical therapeutic factors (PTF) in patients with dorsalgia (DA), but this information is not sufficiently specific. Also, modern physical therapy is underrepresented, which includes drug puncture (DP). The literature also does not provide data on the effectiveness of DP according to the criteria of the International Classification of Functioning, Disability and Health (ICF).

Aim. Rationale for the inclusion of DP in the physiotherapeutic rehabilitation treatment of patients with dorsalgia.

Materials and methods. A randomized clinical trial conducted in a group of 103 patients with DA (M54.5 — Dorsalgia, polysegmental dorsopathy, with predominant damage to the lumbosacral spine), male and female, with an average age of 53.1±1.2 years, who underwent outpatient rehabilitation treatment at the “Health” medical center (Yalta).
The complex of examinations before and at the end of treatment included: magnetic resonance imaging; anthropometry; clinical neurological examination; functional and psychophysiological research. The treatment effectiveness assessed by the doctor according to the ICF criteria and by the patient himself using a visual analogue scale, as a percentage of the patient’s desired treatment effect.
The complex of treatment was consisted of drug and non-drug therapy, incl. shock wave therapy, carboxytherapy and high-intensity laser therapy. In the main group of 70 patients, additional exposure to DP performed. The average number of DP procedures received by patients was 8.500±0.313. The control group of 33 patients not exposed to DP.

Results. In the main group, using DP, there was a more pronounced positive dynamics in the functional state of patients, assessed by the dynamics of the values of 6 ICF domains: b4200 “Increased blood pressure”, b7301 “Power of muscles of one limb”, b755 “Involuntary movement reaction functions”, d4158 “Maintaining body position, other specified”, d4500 “Walking short distances” and d598 “Self-care, other specified”.

Discussion. A comparison of the correlation coefficients of the entire DP course and the second half of the course indicates that it is preferable to carry out a full course of treatment (up to 10 procedures), which ensures the full implementation of the therapeutic effects of DP.

Summary. DP in the amount of 10 procedures is recommended to be included in the complex of physiotherapeutic treatment in patients with DA in order to achieve greater positive dynamics of domains b4200 “Increased blood pressure”, b7301 “Power of muscles of one limb”, b755 “Involuntary movement reaction functions”, d4158 “Maintaining body position, other specified,” d4500 “Walking short distances” and d598 “Self-care, other specified.”

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