Background Various methods of non-medicinal therapy of systemic sclerosis (SS) were offered, but any of them does not allow achieving desirable success. It is known that active participation of patient in treatment can improve efficiency of the therapy. One of promising method is biofeedback, referred on active participation of patient in the therapy.
Objectives Our aim was to improve the efficiency of complex therapy of SS patients by means of biofeedback therapy.
Methods We observed 90 SS patients. The middle age of patients was equal to 38,19±12,1 years, average duration of illness 11,2±3,4 years. The minimum degree of activity of disease (I) has been diagnosed for 47 (52,2%), medium (II) degree - in 38 (42,2%) and high (III) degree - in 5 (5,6%) patients. A chronic course of the disease was diagnosed in 39 (43,3%), subacute - in 48 (53,3%), and acute - in 3 patients (3,3%). The stage of initial changes has been diagnosed in 37 (41%), a stage of generalization of process - in 50 (55,5%), a late (terminal) stage – in 3 patients (3,5%). Depending on degree of skin changes limited SS has been diagnosed in 66 (73,3%), and diffuse SS form - in 24 (26,7%) patients.
SS patients have been divided on two groups randomly: the basic (n=60) and control (n=30). Patients of basic group received 12-14 sessions of multimodal (temperature and EEG) biofeedback training using “Reacor” rehabilitation complex.
Clinical assessment of biofeedback efficiency was assessed by dynamics of following clinical and laboratory indices: skin count by G.P.Rodnan, capillaroscopies of nails, pain by VAS, joint count, number of swelling joints, swallow index, ESR, antibodies to Scl-70, SF-36 questionnaire was applied for quality of life evaluation.
Results Reliable changes of capillaroscopy index (morphological variations of capillary tubes (χ2=6,19, p=0,013), a pain by VAS, ESR were noted in control group of SS patients after the course of conventional therapy. At the same time reliable positive dynamics of the skin count, joint count, number of swelling joints, swollen index, ESR was founded in patients of basic group after biofeedback therapy. Besides, capillaroscopy indices, namely angiectasia (χ2=8,192, p=0,004), morphological variations of capillary tubes (χ2=4,14, p=0,042) and hemorrhages (χ2=7,906, p=0,005) were reliable improved after the treatment. There is the evidence that biofeedback therapy has positive influence on microcirculation disturbances.
It was founded that indices reflecting a physical component of quality of life - physical functioning (p<0,001), role physical functioning (p<0,01), somatic pain (p<0,001), and also overall health (p<0,001), social (p<0,05) and role emotional functioning (p<0,01) were reliable raised in SS patients of basic group. The results of assessment of physical and psychological health are similar in group of SS patients receiving conventional therapy, but changes of smaller quantity of indices were reliable.
Conclusions Thus, results of the researches are the evidence of considerable efficiency of biofeedback in complex therapy of SS patients and its positive influence on quality of patients’ lives and clinical and laboratory indices of the disease. Use of biofeedback training will allow improving results of treatment of this disease essentially.
Disclosure of Interest None Declared
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