Rehabilitation capabilities of multifunctional mechanotherapeutic complexes “toning tables” in the process of recovery of patients after a coronavirus infection COVID-19
Federal State Budgetary Institution “National Medical Research Center for Rehabilitation and Balneology” of the Ministry of Health of Russia, Moscow
Methods of passive-active mechanotherapy have proven themselves well in the treatment of various forms of dorsopathy, chronic diseases of the ligamentous-articular apparatus, the treatment of patients with pelvic dysfunction, as well as forms of active prevention of osteoporosis and muscular atrophy in the older age group. Since the mid-90s of the twentieth century, methods of automated mechanotherapy using “toning tables” complexes have been introduced into a number of clinical institutions and resort centers in Russia.
Developed at one time in the USA, then transformed in England, the Stauffer method (Dr. Stauffer) was effectively used not only for rehabilitation and treatment, but also received its development in the industry of sports. The complex, consisting of 8 or 6 couches or “toning tables”, allows you to provide almost the entire range of possible movements: passive, passive with accompaniment or recollection, pasino-active, active with resistance, active with accompaniment. Couches or toning tables are formed according to the basic principles of automated mechanotherapy with the ability to regulate the strength, speed and volume of movements of various muscle groups. The ability to provide a wide range of different movements of the lower and upper extremities, as well as the lumbar and pelvic regions make these systems almost universal.
An important feature of these rehabilitation systems is that the patient is on the couch in a lying or sitting position. This makes it possible to start rehabilitation activities as early as possible – immediately after the patient has started to sit on the bed. And even if he can’t move on his own yet, classes in passive mode with various elements of movements accelerate his verticalization and the ability to start moving independently. This was shown by our studies in patients after a stroke.
In the conditions of a pandemic, COVID-19 has set tasks for specialists of various health care profiles related not only to rapid diagnosis and treatment, but also to the provision of high-quality medical care, including rehabilitation measures both during and after the transfer of a new coronavirus infection.
The effectiveness of the methods used directly depends on the early start of rehabilitation actions in the hospital, continuation in polyclinic conditions and then at the stage of sanatorium treatment.
As is well known, the first place in the rehabilitation of patients with COVID-19 is the restoration of respiratory function and the elimination of muscle dysfunction.
In these areas, the use of multifunctional mechanotherapy couches “toning tables” is particularly relevant.the process of rehabilitation and restoration of motor function can be started at an early stage;
– the rehabilitation process can be started with passive movements, which the mechanical trainers carry out automatically in the patient in a given speed mode;
– the process of restoring and maintaining motor function, initiated at an early stage, helps prevent the development of muscular atrophy, maintain mobility of the articular apparatus, improve trophic by activating venous and lymphatic outflow, prevents and reduces the risks of thrombosis in the vessels of the lower extremities;
– reduces the level of cognitive and depressive reactions by working in a small group of patients united by common goals and objectives.
– patients with limited mobility move to couches (“toning tables”) in a wheelchair and with the help of an instructor can quickly master and restore the functional state of the muscle groups of the lower extremities. This is especially true in patients who have been on bed rest for a long time.
What is especially important, in patients with impaired lung function, classes in passive mode can be carried out simultaneously, or without interrupting inhalation therapy (oxygen, singlet oxygen or other inhalation mixtures).
The next stage of rehabilitation takes place in a polyclinic or in a rehabilitation center. Here the complex of “toning tables” can be installed either in the general hall of therapeutic physical culture (physical therapy), or in a separate office. Along with patients after a coronavirus infection, other groups of patients can be rehabilitated on these complexes: patients after a stroke or myocardial infarction, patients after reconstructive operations on large joints (knee, hip), patients recovering from injuries, patients of the older age group with pathologies such as diabetes mellitus, osteoporosis, sarcopenia, and a number of others.
One of the most important features of this complex is the possibility of personalizing the rehabilitation program, a gradual transition and combination of different types of movements, their dosage by speed and time, a combination of different groups of exercises. A special advantage is the ability to combine classes on mechanotherapy couches (“toning tables”) with other physiotherapy procedures at the same time. This undoubtedly gives a faster result on the one hand, and on the other – reduces the burden on the medical staff. Examples of the possibilities of combined application can be the following:
А combination of classes on “toning tables” with simultaneous exposure to low-frequency electric currents (DDT, faradic currents, Kotz currents, CHANCE). This allows you to reduce the pain syndrome during exercises, activate the microcirculation of muscles and ligamentous-articular apparatus. To reduce spastic conditions, improve the function of the articular and tendon-ligamentous apparatus, it is possible to use such methods of heat treatment as local application of heat carriers – paraffin, parafango, ozokerite, exposure to infrared, including polarized light sources (infrared emitters, Bioptron lamp, etc.)
Sanatorium-resort stage. At the sanatorium-resort stage, the complex of automated mechanotherapeutic simulators “toning tables” has the widest possible application possibilities. One of the main problems of the sanatorium industry today is the shortage of medical personnel. As it is known, various forms of physical therapy are particularly popular with patients, but the lack of personnel or their lack significantly slows down and restricts the use of various methods of physical therapy in the sanatorium-resort industry.
Automated systems ” toning tables” allow not only to facilitate the work of a physical therapy instructor, but also to increase the flow of rehabilitated patients several times. With group classes and the presence of a full complex of 8 “toning tables”, the continuous rehabilitation process in groups of 6 people makes it possible to carry out rehabilitation complex procedures for at least 48 patients in one work shift, and with two shifts, this possibility is doubled. Taking into account the increasing need for rehabilitation of the musculoskeletal system and locomotion systems after a coronavirus infection, this is very relevant.
Using a modern system of multifunctional automated mechanical trainers “toning tables”, we achieve the following results:
– eliminate weakness and dysfunction of the musculoskeletal system and locomotion systems;
– improve microcirculation of muscle tissue, enhance venous and lymphatic outflow, ensure activation of tissue metabolism, reduce inertial edema of the lower extremities;
– activate proprioception systems and improve patient mobility and stability;
– combining passive and active movements, we quickly restore the strength and speed characteristics of the most important muscle groups;
– combining active resistance movements with breathing exercises, we contribute to the active restoration of the functions of the respiratory muscles and, above all, the diaphragm and external intercostal muscles;
– active exercises in comfortable and safe lying and sitting positions allow performing exercises in a wide group of patients, expanding indications and ensuring safety in people with chronic diseases of the cardiovascular or central nervous systems.
Safety, efficiency, versatility are the qualities that make the modern complex “toning tables” necessary and in demand at all stages of medical and sports rehabilitation.