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Publication date: 15.06.2025
DOI: 10.24412/2782-6570-2025_04_02_6
UDC 376.2
CORRECTION OF HIP JOINT FUNCTIONALITY IN INFANTS WITH DYSPLASIA BY MEANS OF PHYSICAL REHABILITATION
V.V. Chumakov1, N.V. Lunina1,2
1Russian University of Sports “GTSOLIFK”, Moscow, Russia
2North-Caucasian Federal Research-Clinical Center of Federal Medical and Biological Agency, Essentuki, Russia
Abstract. The article considers the correction of hip joint functionality in infants with dysplasia using physical rehabilitation means. The course of application of physical rehabilitation means aimed at restoring hip joint functionality in infants with dysplasia took 11 weeks. The following were used: therapeutic exercises focused on the use of reflex, passive, active and developmental exercises in accordance with age, massage, hydrokinesitherapy, physiotherapy (laser therapy, electrophoresis). The effects of hip joint correction in infants with dysplasia are represented by reliable improvements in the studied parameters: the range of motion during adduction in the hip joint increased by 19.9% according to goniometry; pain according to the Face, Legs, Activity, Cry, Consolabilitу scale decreased by 43.8%; fold asymmetry decreased by 45%; hip shortening was leveled by 44%; the manifestations of Ortolani and Barlow symptoms decreased by 37.5% and 33.3%, respectively. The results obtained reflected the positive dynamics of correction of hip joint functionality in infants with dysplasia using physical rehabilitation means.
Keywords: hip dysplasia, infants, physical rehabilitation equipment.
Introduction. The congenital diseases of the musculoskeletal system take the first place [1], 17% of them are lower limb defects: congenital hip joints, deformities of the lower limbs, valgus or varus, cliches, hip dislocations or subluxations, limb contraction [2].
One of the most frequent ones is congenital hip subluxation, hip dislocation and delay in the formation of hip joints in children in the first year of life, as well as, recurrences of musculoskeletal pathologies. Hip dysplasia is widespread among congenital pathologies of the muscular system in the first year of life. According to various sources, children have such pathology ranging from 2 to 16 cases per 1000 newborns, there are other data saying that the pathology occurs ranging from 1 to 3 cases per 1000 births [3, 4].
Congenital hip dysplasia is a serious disease. According to the statistical data from scientific literature, the development of deforming coxarthrosis occurs with a frequency of up to 82% after conservative and surgical treatment of this pathology with the possibility of disability up to 64% of patients, which confirms the need to search for new methods of rehabilitation of this pathology. In environmentally unfavorable regions there is a tendency of increasing incidence of this disease [5].
According to the data from domestic and foreign orthopedics and family doctors, successes in treatment occur due to early screening of newborns and early diagnosis, timely individually selected comprehensive treatment in the first 2-3 months of a child’s birth from 70% to 97% of cases [6-8].
Long-term experience of scientists indicates the effectiveness of physical therapy, hydrokinesotherapy, massage and physiotherapy in rehabilitation of children with hip dysplasia [9-11]. Methodologically competent rehabilitation measures allow correcting functional disorders, which makes an issue of searching for a proper combination of ways and methods of physical rehabilitation (PR) of hip dysplasia relevant.
Objective of the study: assessment of the effects of correcting hip joint functionality in infants with dysplasia by using PR means.
Methods and organization. The study took place in the Children’s Polyclinic of the Vidnoe District Clinical Hospital (Vidnoe, Moscow Oblast). The observation involved 14 children aged 6-8 months. Inclusion criteria: confirmed diagnosis of moderate hip dysplasia, age – 6-8 months.
Hip joint functionality was estimated according to the goniometry data (degrees) in hip adduction, in fold asymmetry assessment (points), in hip shortening assessment (points), according to the Ortolani (points) and Barlow (points) symptoms, in assessing pain according to the FLACC (Face, Legs, Activity, Cry, Consolabilitу) scale (points). The data processing was carried out with math-and-stats methods. We calculated the arithmetic mean, standard deviation. The reliability of changes in the results was assessed with the Wilcoxon’s signed rank test (р≤0.05). All calculations were made in Microsoft Excel.
The PR course aimed to correct hip joint functionality in infants with dysplasia took 11 weeks. We used the following methods: therapeutic exercises focused on the use of reflex, passive, active and developmental exercises in accordance with age (daily), massage (daily), hydrokinesitherapy (3 times a week), physiotherapy (laser therapy, electrophoresis, not less than 15-20 procedures).
Results and discussion. Correction of hip joint functionality in infants with dysplasia has reflected in reliable positive dynamics of the studied indicators (table).
Table
Changes in the indicators of hip joint functionality in infants with dysplasia by using physical rehabilitation methods
|
Indicators |
Stages |
Growth rates, % |
P≤ |
|
|
Before |
After |
|||
|
Goniometry (hip adduction), degrees |
140.40±4.77 |
168.30±3.83 |
19.9 |
0.05 |
|
Pain assessment according to the FLACC scale, points |
5.70±0.82 |
3.20±0.79 |
43.8 |
0.05 |
|
Fold asymmetry assessment, points |
2.00±0.00 |
1.10±0.32 |
45 |
0.05 |
|
Hip shortening, points |
1.80±0.42 |
1.00±0.00 |
44 |
0.05 |
|
Ortolani symptoms assessment, points |
1.60±0.52 |
1.00±0.00 |
37.5 |
0.05 |
|
Barlow symptoms assessment, points |
1.80±0.42 |
1.20±0.42 |
33.3 |
0.05 |
Note: FLACC – Face, Legs, Activity, Cry, Consolabilitу.
There is a significant improvement in the movement amplitude in hip joints by 19.9%, from 140.40±4.77 to 168.30±3.83 degrees.
Pain was estimated according to the FLACC scale – it is a behavioral scale for pain assessment used for infants and children up to 7 years of age that takes into account the child’s facial expression, legs position or mobility, crying pattern, and the child’s ability to be consoled. Before the PR course, pain in infants with dysplasia was rated at 5.70±0.82 points. After PR, it decreased by 43.8% and amounted to 3.20±0.79 points.
Correction of hip joint functionality in infants with dysplasia was reflected in the leveling of fold asymmetry by 45% and hip shortening by 44% from 1.80±0.42 points to 1.00±0.00 points. There was an improvement in hip congruency assessed by Ortholani and Barlow symptoms by 37.5% and 33.3%, respectively.
Conclusion. The effects of hip joint functionality in infants with dysplasia reflected in reliable improvements of the studied indicators: increased movement amplitude in hip adduction, reduced pain, leveled fold asymmetry and hip shortening, improved hip congruency assessed by Ortholani and Barlow symptoms. The obtained results have shown positive changes in correction of hip joint functionality in infants with dysplasia using PR means.
Conflict of interest. The authors declare no conflict of interest.
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INFORMATION ABOUT THE AUTHORS:
Vyacheslav V. Chumakov – Master of the Department of Physical Rehabilitation, Massage and Health-improving Physical Culture named after I.M. Sarkizov-Serazini, Russian University of Sport “GTSOLIFK”, Moscow.
Natalya V. Lunina – Candidate of Biological Sciences, Associate Professor of the Department of Physical Rehabilitation, Massage and Health-improving Physical Culture named after I.M. Sarkizov-Serazini, Russian University of Sport “GTSOLIFK”, Moscow; Senior Researcher, North-Caucasian Federal Research-Clinical Center of Federal Medical and Biological Agency, Essentuki, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..
For citation: Chumakov V.V., Lunina N.V. Correction of hip joint functionality in infants with dysplasia by means of physical rehabilitation. Russian Journal of Sports Science: Medicine, Physiology, Training, 2025, vol. 4, no. 2(14). DOI: 10.24412/2782-6570-2025_04_02_6