PECULIARITIES OF FORMING A THERAPEUTIC ALLIANCE DURING PHYSICAL THERAPY OF PATIENTS WITH ADHESIVE CAPSULITIS AND MYOFASCIAL PAIN SYNDROME
DOI:
https://doi.org/10.32782/pub.health.2023.3.2Keywords:
physical therapy, rehabilitation, musculoskeletal system, shoulder joint, painAbstract
Topicality. The study of biopsychosocial characteristics of physical therapy is an important and relevant element of science. The purpose of the study was to investigate therapeutic alliance, formed in patients with adhesive capsulitis and myofascial pain syndrome in the thoracic spine during complex physical therapy. Materials and methods. 28 patients participated in the study. Goniometry of shoulder joint, assessment of pain at the endpoints of motion range and in trigger points were used before intervention and after the end of physical therapy. Тherapeutic alliance was assessed with the help of Working Alliance Inventory (patient form) right after the last physical therapy procedure was finished (first questionnaire) and 1.5 months later (second questionnaire). Physical therapy started after examination and consultation of an orthopedist-traumatologist. Physical therapist also consulted patients on the specifics of performing end-range mobilization and ischemic compression, namely on pain levels, importance of interaction, and measures to reduce pain during the procedures. Most of the patients received 15 scheduled end-range mobilization procedures performed by a physical therapist and ischemic compression performed by the patient within 3 weeks. Іschemic compression of one trigger points was performed with an average or above average level of pain and duration of 30 seconds. Research results. The obtained results confirmed positive dynamics of the amplitude of movements in shoulder joint, pain when reaching the maximum amplitude and in trigger points. The analysis of the first and second questionnaires revealed high indicators in questionnaire items, and also did not show any statistical difference between them. The third item of the questionnaire had the lowest result among all the questionnaire items. The results of the first survey in the domains were: goal items – 20 (18.3; 20) points; task items – 20 (18.3; 20) points; bond items – 20 (18; 20) points. The statistical indicators of the total score therapeutic alliance were 60 (52.8; 60) points. Bond items domain had slightly lower indicators. The performed analysis did not reveal any statistical differences between the results of questionnaires in therapeutic alliance domains and the total score. Conclusion. Тherapeutic alliance, that is formed between the patient and the physical therapist during рhysical therapy, which involved a combination of end-range mobilization and ischemic compression and was characterized by pain and intensive interaction, has a high level of all three domains and does not change in the long-term period.
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