Effect of Rehabilitation Program on the Quality of Life Of People with Forearm or Hand Gunshot Wounds Using Physiotherapy Methods

Abstract

The actualization of the rehabilitation problem of persons with gunshot wounds of the forearms and hands is associated with a large proportion of gunshot wounds of the upper limbs in the structure of combat trauma, the complexity of their treatment, many complications and a high degree of disability. Purpose. To investigate the impact of rehabilitation program on quality of people`s life with forearm or hand gunshots using physiotherapy methods. Approach. The study was involved 76 men with gunshot wounds of the bones of the forearm and hand. The research was conducted on the basis of the military clinical hospital in Kyiv. Patients were randomly divided into 2 groups: the main group (MG, n=38) and the control group (CG, n=38). For the MG, was introduced an algorithm for the application of physical therapy measures, which was developed on the basis of the model of the International Classification of Functioning (ICF), Restriction of Life and Health. For rehabilitation of patients in the CG was used a standard program of the medical institution. In order to assess the effectiveness of rehabilitation interventions, examinations of patients were performed before the application of physical therapy measures and 6 months after the rehabilitation course. The research methods to comprehensively assess to the quality of patients` life: measurement of the functional independence on a scale FIM (Functional Independence Measure), assessment of the capacity of the upper limb on the scale DASH (Disability of the Arm, Shoulder and Hand Outcome Measure); Hamilton's alarm scale (The Hamilton Anxiety Rating Scale (HARS)), depression self-esteem scale PHQ-9 (Patient Health Questionnaire). Results. After the course of rehabilitation, the patients of the MG felt significantly fewer restrictions associated with dysfunction of the upper limbs, compared with the CG, which was reflected in the indicators of the scales FIM and DASH. Increasing activity in everyday life had a positive effect on the mental state of people with gunshot wounds of the upper limbs, in particular under the influence of rehabilitation measures in patients of the MG significantly reduced anxiety symptoms and depressive symptoms. Conclusions. Using of the developed algorithm of physical therapy measures based on the model of the ICF, RLH significantly improved various aspects of quality of patients` life with gunshot wounds of the forearm and hand and was more effective than the standard approach.