The evaluation of functional abilities of patients with osteoporotic vertebral fractures as a basis for rehabilitation programs developing

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. Due to the demand for special rehabilitation programs for patients with osteoporotic vertebral fractures (VFs), it is of interest to study the functional abilities of those patients. The scientific hypothesis suggests that osteoporotic VFs would cause muscle weakness, muscle dysfunction and conditional (basic motor) disturbances.

Objective: to estimate muscle strength, motor function and coordination disorders in patients with VFs in the setting of systemic osteoporosis as a basis for rehabilitation programs developing.

Methods. 120 patients aged 43−80 with primary osteoporosis were enrolled. Study group comprised of 60 subjects (56 women, 4 men) with at least 1 VF confirmed by X-ray. Control group included 60 subjects (56 women, 4 men) with osteoporosis but without any osteoporotic fracture. The examination program consist of back muscles tenzodynamometry, balance tests and stabilometry.

Results. Muscle strength deficiency was estimated in study group in trunk flexors (TF) — 40.9% and in trunk extensors (TE) — 18.1% with an adequate function of the left lateral flexors (LLF) and in right lateral flexors (RLF). Patients with VFs had the lower muscle strength vs controls of TE (15.64 ± 9.8 vs 27.73 ± 9.9 kg, p = 0.00002), TF (14.61 ± 8.98 vs 21.28 ± 8.38 kg, p = 0.0006), LLF (13.10 ± 7.2 vs 24.06 ± 8.9 kg, p = 0.005) and RLF 13.44 ± 7.43 vs 24.26 ± 7.65 kg, p = 0.0003). Patients with VFs lose their balance faster during one-leg-standing test with open eyes (5.0 [1.0; 10.0] vs 7.5 [5.0; 10.5] sec in control group, p = 0.03) and with closed eyes (2.0 [0; 3.0] vs 3.5 [3.0; 5.0] sec, p = 0.04). Fukuda-Unterberger test showed greater side dislocation in study group — 40º [25; 45] vs controls 30º [10; 45], (p = 0.02). According to stabilometry study group was characterized vs control group by lower balance coefficient with open eyes (77.2 ± 7.6 vs 85.7 ± 9.4%, p = 0.002) and with closed eyes (67.1 ± 9.8 vs 73.4 ± 9.9%, p = 0.03), greater sagittal displacement (6.8 [2.1; 37.7] vs 4.8 [1.8; 10.7] mm, p = 0.025) and deviation in the saggital plane (1.2 [-1.07; 1.5] vs -1.2 [-1.5; 1.2] mm, p = 0.01), and also less pressure center velocity (9.51 ± 4.4 vs 7.1 ± 2.7 mm/sec, р = 0.009).

Conclusions. VFs in osteoporotic patients are associated with reduction of trunk muscles strength and negatively affect static and dynamic balance function. The obtained data should be taken into account when developing rehabilitation programs for patients with osteoporosis who have suffered compression VFs.

Full Text

Restricted Access

About the authors

L. A. Marchenkova

National Medical Research Center of Rehabilitation and Balneology

Author for correspondence.
Email: marchenkovala@nmicrk.ru
ORCID iD: 0000-0003-1886-124X
SPIN-code: 9619-8004

PhD

Russian Federation, Moscow, Russian Federation

E. V. Makarova

National Medical Research Center of Rehabilitation and Balneology

Email: info@eco-vector.com
ORCID iD: 0000-0003-3767-8475
SPIN-code: 1305-6152
Russian Federation, Moscow, Russian Federation

M. A. Eryomushkin

National Medical Research Center of Rehabilitation and Balneology

Email: info@eco-vector.com
ORCID iD: 0000-0002-3452-8706
SPIN-code: 5602-6899

DSc., Prof.

Russian Federation, Moscow, Russian Federation

M. Yu. Герасименко

Russian Medical Academy of Continuous Professional Education (FSBEI FPE RMACPE)

Email: info@eco-vector.com
ORCID iD: 0000-0002-1741-7246
SPIN-code: 7625-6452

DSc., Prof.

Russian Federation, Moscow, Russian Federation

E. M. Styazkina

National Medical Research Center of Rehabilitation and Balneology

Email: info@eco-vector.com
ORCID iD: 0000-0003-4612-5119
SPIN-code: 3171-6314

PhD

Russian Federation, Moscow, Russian Federation

E. I. Chesnikova

National Medical Research Center of Rehabilitation and Balneology

Email: info@eco-vector.com
ORCID iD: 0000-0002-2603-6170
SPIN-code: 7662-1754
Russian Federation, Moscow, Russian Federation

References

  1. Melnichenko GA, Belaya ZhE, Rozhinskaya LYa, et al. Russian federal clinical guidelines on the diagnostics, treatment, and prevention of osteoporosis. Problems of Endocrinology. 2017;63(6):392−426. (In Russ). doi: 10.14341/probl2017636392-426.
  2. Lesnyak OM, Baranova IA, Belova KYu, et al. Osteoporosis in Russian Federation: Epidemiology, socio-medical and economical aspects (review). Traumatology and orthopedics of Russia. 2018;24(1):155−168. (In Russ). doi: 10.21823/2311-2905-2018-24-1-155-168.
  3. Tarantino U, Iolascon G, Cianferotti L, et al. Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology. J Orthop Traumatol. 2017;18(Suppl 1):3–36. doi: 10.1007/s10195-017-0474-7.
  4. WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millennium. The burden of musculoskeletal conditions at the start of the new millennium. World Health Organ Tech Rep Ser. 2003;919:i-x, 1-218, back cover.
  5. Peterka RJ, Black FO. Age-related changes in human posture control: sensory organization tests. J Vestib Res. 1990−1991;1(1):73−85.
  6. Slade SC, Carey DL, Hill AM, Morris ME. Effects of falls prevention interventions on falls outcomes for hospitalised adults: protocol for a systematic review with meta-analysis. BMJ Open. 2017;7(11):e017864. doi: 10.1136/bmjopen-2017-017864.
  7. Genant HK, Jergas M, Palermo L, et al. Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1996;11(7):984−996. doi: 10.1002/jbmr.5650110716.
  8. Grokhovsky SS, Kubryak OV, Filatov IA. Architecture of network medical systems for an estimation of function of balance (stabilometry) and complex estimation of human's condition. Information-measuring and control systems. 2011;9(12):68−74. (In Russ).
  9. Pankova IA, Krivoshey IV, Kubryak OV. Measures for improving the effectiveness of rehabilitation process using stabilometric plates. Kremlin Medicine. Clinical Bulletin. 2017;(4-2):153−156. (In Russ).
  10. Eryomushkin MA. Dvigatel’naya aktivnost’ i zdorov’ye. Ot lechebnoy gimnastiki do parkura. Moscow: Sport; 2016. 240 p. (In Russ).
  11. Ponomarenko GN. Fizicheskaya i reabilitatsionnaya meditsina: natsional’noye rukovodstvo. Ed. by G.N. Ponomarenko. Moscow: GEOTAR-Media; 2017. 512 p. (In Russ).
  12. Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care. 2004;7(4):405–410. doi: 10.1097/01.mco.0000134362.76653.b2.
  13. Bayramoğlu M, Sözay S, Karataş M, Kilinç S. Relationships between muscle strength and bone mineral density of three body regions in sedentary postmenopausal women. Rheumatol Int. 2005;25(7):513−517. doi: 10.1007/s00296-004-0475-8.
  14. Armamento-Villareal R, Aguirre L, Napoli N. Changes in thigh muscle volume predict bone mineral density response to lifestyle therapy in frail, obese older adults. Osteoporos Int. 2014;25(2):551−558. doi: 10.1007/s00198-013-2450-2.
  15. Levinger I, Phu S, Duque, G. Sarcopenia and osteoporotic fractures. Clinic Rev Bone Miner Metab. 2016;14(1):38−44. doi: 10.1007/s12018-016-9204-6.
  16. Beaudart C, McCloskey E, Bruyère O, et al. Sarcopenia in daily practice: assessment and management. BMC Geriatr. 2016;16(1):170. doi: 10.1186/s12877-016-0349-4.
  17. Cederholm T, Cruz-Jentoft AJ, Maggi S. Sarcopenia and fragility fractures. Eur J Phys Rehabil Med. 2013;49(1):111–117.
  18. Tarantino U, Piccirilli E, Fantini M, et al. Sarcopenia and fragility fractures: molecular and clinical evidence of the bone-muscle interaction. J Bone Joint Surg Am. 2015;97(5):429−437. doi: 10.2106/JBJS.N.00648.
  19. Verkhoshansky YuV. Osnovy spetsial’noy silovoy podgotovki v sporte. 3rd ed. Moscow: Soviet Sport; 2013. 216 р. (In Russ).
  20. Mikhayloff PR, Gromov VA. Relation of indicators between development of muscle power of flexor and extensor trunks, as a factor of pain prevention in the lumbar spine department. Ekstremal'naya deyatel'nost' cheloveka. 2017;(2):21−24. (In Russ).
  21. Zhou Z, Zheng L, Wei D, et al. Muscular strength measurements indicate bone mineral density loss in postmenopausal women. Clin Interv Aging. 2013;8:1451–1459. doi: 10.2147/CIA.S48447.
  22. Lyons JG, Heeren T, Stuver SO, Fredman L. Assessing the agreement between 3-Meter and 6-Meter walk tests in 136 community-dwelling older adults. J Aging Health. 2015;27(4):594–605. doi: 10.1177/0898264314556987.
  23. Haines T, Kuys SS, Morrison G, et al. Balance impairment not predictive of falls in geriatric rehabilitation wards. J Gerontol Biol Sci Med Sci. 2008;63(5):523–528. doi: 10.1093/ gerona/63.5.523.
  24. McGrath RP, Kraemer WJ, Vincent BM, et al. Muscle strength is protective against osteoporosis in an ethnically diverse sample of adults. J Strength Cond Res. 2017;31(9):2586−2589. doi: 10.1519/JSC.0000000000002080.
  25. Abreu DC, Trevisan DC, Costa GC, et al. The association between osteoporosis and static balance in elderly women. Osteoporos Int. 2010;21(9):1487–1491. doi: 10.1007/s00198-009-1117-5.
  26. Mendy A, Vieira ER, Albatineh AN, et al. Low bone mineral density is associated with balance and hearing impairments. Ann Epidemiol. 2014;24(1):58−62. doi: 10.1016/j.annepidem.2013.10.012.
  27. Kubryak OV, Grokhovsky SS, Doborodny AV. Issledovanie oporny`x reakcij cheloveka (posturografiya, stabilometriya) i biologicheskaya obratnaya svyaz` v programme STPL. Moscow: Mera-TSP; 2018. 121 p. (In Russ).

Supplementary files

There are no supplementary files to display.


Copyright (c) 2020 Eco-Vector



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: 77 - 9245 от 22.06.2001
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80650 от 15.03.2021
г.



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies