Issue 2-20, 2020
The effectiveness of mechanotherapeutic methods for spine deep stabilization system training in patients with osteoporotic vertebral fractures
1 Makarova E.V., 1 Marchenkova L.A., 1 Eremushkin M.A., 1 Styazkina E.M., 1 Chesnikova E.I., 1 Razvalyaeva D.V.
1 National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation
ABSTRACT
The aim of the study was to estimate the effect of new physical rehabilitation complex using of mechanotherapeutic methods on spine muscle strength in patients with osteoporosis (OP) and vertebral fractures (VF).Material and methods: Study comprised of 90 osteoporotic patients aged 50-80 years old (65.4±9.1 years) with OP VFs who were randomized as 2:1 into intervention group (group1, n=60) and control group (group2, n=30). Patients in group1 received an intensive rehabilitation course including back muscle training with mechanical loads #10; sensorimotor training on double unstable platform #10; kinesohydrotherapy in a pool #15; physical exercises in a gym #10. Group 2 was prescribed only physical exercises in a gym #15. All patients undergo tenzodynamometry on BackCheck diagnostic unit(Dr. Wolff , Germany) at baseline, in 3 weeks at the end of rehabilitation course and in a month of follow-up.Results: In group 1 after the rehabilitation course muscle strength improved in trunk extensors (TE) from 15.8±10.1 to21.7±13.1 kg (p<0.001), trunk flexors (TF) from 14.5±9.1 to 18.9±10.2 kg (p<0.001), left lateral flexors (LLF) from 12.8±7.2to 17.5±9.6kg (p<0.001) and right lateral flexors (RLF) from 13.2 ± 7.1 to 17.8 ± 9.2 kg (p<0.01). Strength defi ciencysignifi cantly decreased in all muscles (p<0.001 for TE and TF, p<0.05 for LLF, p<0.01 for RLF). The achieved effect lastedfor a month of follow-up. In group 2 positive dynamics of strength was observed after 3 weeks only in TE and TF (p<0.05),however, after a month of observation, the strength of all the studied muscles did not differ from the baseline (p>0.05).Conclusion: The new 3-week complex of physical rehabilitation using of mechanotherapeutic methods lead to increase of spine muscle strength and improvement of muscle strength defi ciency in patients with osteoporotic VFs. Rehabilitationeff ect lasts for at least a month after the treatment completion.
KEYWORDS: osteoporosis, vertebral fractures, physical rehabilitation, muscle strength, spine deep stabilization system
FOR CITATION: Makarova E.V., Marchenkova L.A., Eremushkin M.A., Styazkina E.M., Chesnikova E.I., Razvalyaeva D.V. The effectiveness of mechanotherapeutic methods for spine deep stabilization system training in patients with osteoporotic vertebral fractures. Bulletin of rehabilitation medicine. 2020; 96 (2): 33-40. https://doi.org/10.38025/2078-1962-2020-96-2-33-40
References:
- Parreira P.C.S., Maher C.G., Megale R.Z. An overview of clinical guidelines for the management of vertebral compression fracture: a systematic review. Spine J., 2017: 17(12): 1932 - 1938. DOI: 10.1016/j.spinee.2017.07.174.
- 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.
- McGrath R.P., Kraemer W.J., Vincent B.M., Hall O.T., Peterson M.D. 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
- Rikkonen T., Sirola J., Salovaara K.. Muscle strength and body composition are clinical indicators of osteoporosis. Calcif Tissue Int., 2012: 91(2): 131 - 138 DOI:10.1007/s00223-012-9618-1
- Marchenkova L.A., Makarova E.V., Eremushkin M.A. Medicinskaya reabilitaciya pacientov s osteoporozom, oslozhnennym perelomami (monografiya) [Medical reahabilitation in patients with osteoporosis complicated by fractures (monografiya)]. M., Torus press, 2019 (In Russ.)
- Peterka R.J., Black F.O. Age-related changes in human posture control: sensory organization tests. J Vestib Res., 1990-1991: 1: 73-85
- White Book on Physical and Rehabilitation Medicine in Europe. Introduction, Executive Summary and Methodology. Eur J Rehabil Med., 2018: 54(2): 125 - 155.
- Bogdanova E.N., Lobanov A.A., Popov A.I. Social'no-ekonomicheskaya politika Rossijskoj Federacii v sfere ohrany zdorov'ya: vyzovy i prognozy [Socio-economical politics of Russian Federation in the sphere of healthcare: challenges and prognosis]. Ekonomika i predprinimatel'stvo, 2017: 9-3(86): 862 - 868 (In Russ.)
- Marchenkova L.A., SHakurova L.R., Tubekova M.A., Artamonova N.M. Aktual'nye voprosy lecheniya i reabilitacii pacientov s osteoporozom [Actual questions of treatment and rehabilitation of patients with osteoporosis]. Moscow, 2019: 16 p. (In Russ.)
- Mihajloff P.R., Gromov V.A. Sootnoshenie pokazatelej razvitiya sily myshc sgibatelej i razgibatelej tulovishcha kak faktor predotvrashcheniya boli v poyasnichnom otdele pozvonochnika [Correlation of muscle strength development indicators in trunk flexors and extensors as a factor for pain prevention in the lumbar spine]. Ekstremal'naya deyatel'nost' cheloveka, 2017: 2(43): 21 - 24 (In Russ.)
- Hvostova SA. Massa myshc, soedinitel'noj i zhirovoj tkani v konechnosti posle perelomov [Mass of muscles, connective and adipose tissues in the limbs after fractures]. Sovremennye problemy nauki i obrazovaniya, 2011: №2. URL: www.science-education.ru/96-4580 (In Russ.)
- Bqczyk G., Samborski W., Jaracz K. Evaluation of the quality of life of postmenopausal osteoporotic and osteopenic women with or without fractures. Arch Med Sci., 2016: 12(4): 819 - 827 DOI: 10.5114/aoms.2015.55012
- Eremushkin M.A., Styazhkina E.M., Chesnikova E.I., Marchenkova L.A., Gusarova S.A. Effektivnost' reabilitacii posle kompressionnyh perelomov poz-vonkov na fone osteoporoza [Efficiency of the rehabilitation after spinal compression fractures on the background of an osteoporosis]. Vestnik voss-tanovitelnoj mediciny, 2019: 1(89): 42 - 45 (In Russ.)
- Pfeifer M., Sinaki M., Geusens P., Boonen S., Preisinger E., Minne H. ASBMR Working Group on Musculoskeletal Rehabilitation. Musculoskeletal Rehabilitation in Osteoporosis: A Review. J Bone Miner Res., 2004: (19): 1208 - 1214
- Dionyssiotis Y., Skarantavos G., Papagelopoulos P. Modern Rehabilitation in Osteoporosis, Falls, and Fractures. Clin Med Insights Arthritis Musculoske-let Disord., 2014: 7: 33 - 40 DOI: 10.4137/CMAMD.S14077
- Dimitriou R., Calori G.M., Giannoudis P.V. Improving Patients’ Outcomes After Osteoporotic Fractures. Int J Clin Rheumatol., 2012: 7(1): 109 - 124
- Tarantino U., Iolascon G., Cianferotti L., Masi L., Marcucci G., Giusti F., Marini F., Parri S., Feola M., Rao C., Piccirilli E., Zanetti E.B., Cittadini N., Alvaro R., Moretti A., Calafiore D., Toro G., Gimigliano F., Resmini G., Brandi M.L. 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
- Genant H.K., Jergas M., Palermo L., Nevitt M., Valentin R.S., Black D., Cummings S.R. Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group., Journal of Bone and Mineral Research, 1996: 11: 984 - 996
- Genant H. K., Wu C.Y., van Kuijk C., Nevitt M.C. Vertebral fracture assessment using a semiquantitative technique. Journal of Bone and Mineral Research. 1993: 8: 1137 - 1148. Proc. of SPIE Vol. 6512 651219-8
- Eremushkin M.A. Dvigatel'naya aktivnost' i zdorov'e. Ot lechebnoj gimnastiki do parkura [Physical activity and health. From exercises to parkour]. Moscow, Sport, 2016: 240 c. ISBN 978-5-9907239-7-9 (In Russ.)
- Marchenkova L.A., Makarova E.V., Eremushkin M.A., SHakurova L.R., Styazhkina E.M., Chesnikova E.I., Razvalyaeva D.V., Kotenko N.V., Novikov A.V., Shedrina M.A. Issledovanie osobennostej deficita myshechnoj sily i vliyayushchih na nih faktorov u pacientov s kompressionnymi perelomami tel pozvonkov na fone sistemnogo osteoporoza [Study of features of muscle strength deficit and factors affecting them in patients with compression fractures of vertebral bodies against the background of systemic osteoporosis]. Kurskij nauchno-prakticheskij vestnik Chelovek i ego zdorov'e, 2019: 2: 27 - 38 (In Russ.)
- Makarova E.V., Marchenkova L.A., Eremushkin M.A., Shakurova L.R., Styazhkina E.M., Chesnikova E.I., Novikov A.V., Malysheva T.B Izmeneniya sostava tela i narusheniya koordinacii u pacientov s kompressionnymi perelomami tel pozvonkov na fone osteoporoza [Changes in body composition and coordination disorders in patients with compression fractures of vertebral osteoporotic]. Vestnik vosstanovitelnoj mediciny, 2019: 2: 13 - 20 (In Russ.)
- Kolyagin Y.I., Kolyshenkov V.A., Salamadina M.O., Pakhomova A.E. Sovremennye apparatnye tekhnologii v reabilitacionnom processe s mioadap-tivnymi sindromami osteohondroza pozvonochnik [Modern hardware technologies in the rehabilitation process with myoadaptive syndromes of spinal osteochondrosis]. Vestnik vosstanovitelnoj mediciny. 2019: 2: 35 - 39 (In Russ.)
- Marchenkova L.A., Makarova E.V., Vasil'eva V.A., Eremushkin M. A., Styazhkina E.M., Razvalyaeva D.V., Chesnikova E.I., Gerasimenko M.YU. Vliyanie bazovoj terapii kal'ciem i vitaminami D3 i V6 na myshechnuyu silu, funkcii dvizheniya i balansa u pacientov s osteoporozom, prohodivshih medicin-skuyu reabilitaciyu [The effect of basic therapy with calcium and vitamins D3 and В6 on muscle strength, movement and balance functions at patients with osteoporosis undergoing medical rehabilitation]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury, 2020: 97(1): 25 - 34 (In Russ.)
- Marchenkova L.A., Makarova E.V., Salamadina M.O. Formirovanie dolgosrochnoj strategii lecheniya osteoporoza kak osnova effektivnoj reabilitacii pacientov s patologicheskimi perelomami: novye nauchnye dannye i prakticheskie resheniya [Forming a long-term strategy for treating osteoporosis as the basis for effective rehabilitation of patients with pathological fractures: new scientific data and practical solutions]. Vestnik vosstanovitelnoj mediciny, 2019: 2: 80 - 83 (In Russ.)

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