Issue №3-20, 2020

Efficiency of a new complex rehabilitation method using mechano– and kinesiotherapy for balance disorders correction in patients with osteoporotic compression vertebral fractures

¹ Makarova E.V., ¹ Marchenkova L.A., ¹ Eremushkin M.A., ¹ Styazhkina E.M., ¹ Razvalyaeva D.V.

¹ National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation

ABSTRACT

The aim of the study: Evaluate the impact of physical rehabilitation complex on balance function inpatients with osteoporosis (OP) and vertebral compression fractures (VCFs).Materials and methods: A prospective controlled study of 40–80 years old men and women with OP and VCFs was conducted.Patients were divided into two groups by simple randomization. The intervention group (1) received an intensiverehabilitation course. The control group (2) received therapeutic exercise using the Gorinevska-Dreving method. Beforerehabilitation all patients were tested: 1) stabilometry; 2) Tests: single leg stand, Fukuda test). Re-examination after rehabilitationand one month after the course.Results: The study enrolled 90 people (65.4±9.1 years). In group № 1 after the course of rehabilitation there was a significantimprovement in indicators: balance function coefficient (BFC) with open and closed eyes (84.1±8.6%, p=0.01 and73.8±9.6%, p=0.01); frontal shifts (FS) (1.9 [0.7; 2,4], p=0,01), the area of statokinesiogram (ASKG) (131,9±210,4 mm2,p=0,04); center of pressure velocity (CPV) (12,2±10,1 mm/sec, p=0,001); in the Fukuda test the displacement in degreeshas decreased (32.8±14.5, p=0.03), in the test «Single leg stand» the time for right and left leg with open eyes has improved(17.8±31.8 sec, p=0.001, 17.1±30.1 respectively). In group № 2 there was an improvement in CPV (2.1 [1.9;5.2],p=0.001); FS movement rate (10.1±3.9 mm/sec, p=0.05). After a month in group № 1 the positive dynamics by parameterswas preserved: BFC with open and closed eyes, FS, CPV movement speed, SKG area, displacement in meters anddegrees in the Fukuda test, standing time on the right and left legs with open and closed eyes.Conclusions: A physical rehabilitation complex aimed at training back muscles and coordination has improved balancefunction in patients who have experienced OP and VCFs. Pathological shift of CPV forward in frontal area was correctedand stability was improved. Stabilometry and coordination tests served as reliable methods to evaluate balance functionin this group of patients.

KEYWORDS: osteoporosis, vertebral fractures, balance, rehabilitation, coordination training.

For citation: Makarova E.V., Marchenkova L.A., Eremushkin M.A., Styazhkina E.M., Razvalyaeva D.V. Efficiency of a new complex rehabilitation method using mechano– and kinesiotherapy for balance disorders correction in patients with osteoporotic compression vertebral fractures. Bulletin of rehabilitation medicine. 2020; 97 (3): 160-166. https://doi.org/10.38025/2078-1962-2020-97-3-160-166

References:

1. WHO. Falls fact sheet. http://www.who.int/ mediacentre/factsheets/fs344/en/ (updated sept 2016).
2. Vos T. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016; 388: 1545-602. DOI:10.1016/S0140- 6736(16)31678-6.
3. Pointer S. Aihw PSTrends in hospitalised injury, Australia: 1999-1900 to 2012-2013. Injury research and statistics series no. 95. Cat. no. INJCAT 171. Canberra: AIHW, 2015.
4. Morris M.E. Preventing falls in older people. The BMJ. 2012; 345: e4919. DOI:10.1136/bmj.e4919.
5. Axer H., Axer M., Sauer H. et al. Falls and gait disorders in geriatric neurology. Clinical Neurology and Neurosurgery. 2010; V.112: 265-274
6. Cameron I.D., Gillespie L.D., Robertson M.C. et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane database of systematic reviews. 2012; 12: CD005465.
7. Sinaki M., Brey R.H., Hughes C.A., et al. Balance disorder and increased risk of fall in osteoporosis and kyphosis: Significance of kyphotic posture and muscle strength. Osteoporosis International. 2005; 16: 1004-1010. DOI:10.1007/s00198- 004-1791-2.
8. Oliver D., Daly F., Martin F.C., et al. Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age and Ageing. 2004; 33: 122-130. DOI:10.1093/ageing/ afh017.
9. Schwendimann R., Buhler H., De Geest S., et al. Characteristics of hospital inpatient falls across clinical departments. Gerontology. 2008; 54: 342-348. DOI:10.1159/000129954.
10. Haines T., Kuys S.S., Morrison G., et al. Balance impairment not predictive of falls in geriatric rehabilitation wards. The Journals of Gerontology Series A Biological Sciences and Medical Sciences. 2008; 63: 523-528. DOI:10.1093/ gerona/63.5.523.
11. Kim S.Y., Lee J.K., Sim S. Hearing impairment increases the risk of distal radius, hip, and spine fractures: A longitudinal follow-up study using a national sample cohort. PLOS One. 2018; 13(2): e0192820. Published on-line 2018 DOI:10.1371/journal. pone.0192820PMCID: PMC5811044.
12. Staggs V.S., Mion L.C., Shorr R.I. Assisted and unassisted falls: different events, different outcomes, different implications for quality of hospital care. The Joint Commission Journal on Quality and Patient Safety. 2014; 40: 358-364. DOI:10.1016/S1553- 7250(14)40047-3.
13. Nigamadyanov N.R., Lukyanov V.I., Valiullina S.A., Mamontova N.A. Komp'yuternaya stabilometriya v diagnostike postural'nyh narushenii u detei s neoslozhnennymi kompressionnymi perelomami pozvonochnika [Computer stabilometry in the diagnosis of postural disorders in children with uncomplicated compression fractures of the spine]. Vestnik vosstanovitel'noi mediciny. 2016; 3(73): 30-34 (In Russ.).
14. Marchenkova L.A., Makarova E.V., Eremushkin M.A. Medicinskaya reabilitaciya pacientov s osteoporozom, oslozhnennym perelomami (monografiya) [Medical rehabilitation of patients with osteoporosis complicated by fractures (monography)]. M. Torus press. 2019 (In Russ.).
15. Genant H. K., Wu C. Y., van Kuijk C., Nevitt M.C. Vertebral fracture assessment using a semiquantitative technique. vfptqhj. 1993; 8: 1137-1148, Proc. of SPIE Vol. 6512 651219-8.
16. Eryomushkin M.A. Physical activity and health. Ot lechebnoj gimnastiki do parkura [From therapeutic exercises to parkour]. Moscow: Sports. 2016; 240 p. ISBN 978-5-9907239-7-9 (In Russ.).
17. Ivanova G.E., Isakova E.V., Krivoshei I.V., Kotov S.V., Kubryak O.V. Formirovanie konsensusa specialistov v primenenii stabilometrii i bioupravleniya po opornoi reakcii [Consensus-building in the application of stabilometry and biofeedback by support reaction]. Vestnik vosstanovitel'noi mediciny. 2019; 1(89): 16-21 (In Russ.).
18. Tsyikunov M.B., Nigamadyanov N.R., Lukyanov V.I., Ivanova G.E., Bezobrazov V.D. Diagnostika postural'nyh narushenii metodom komp'yuternoi stabi-lometrii u detei s patologiei pozvonochnika [Diagnosis of postural disorders using computer stabilometry in children with pathology of the spine]. Vestnik vosstanovitel'noi mediciny. 2017; 4(80): 10-16 (In Russ.).
19. 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 [Muscular and strength deficiency in patients with osteoporotic compression vertebral fractures: osteoporosis as a risk factor for sarcopenia]. Kurskij nauchno-prakticheskij vestnik «Chelovek i ego zdorov'e». 2019; 2: 27-38. (In Russ.).
20. Makarova E.V., Marchenkova L.A., Eremushkin M.A., Styazhkina E.M., Chesnikova E.I., Razvaliaeva D.V. Effektivnost' mekhanoterapevticheskih metodov pri korrekcii deficita sily myshc glubokoj stabilizacionnoj sistemy pozvonochnika u pacientov s perelomami pozvonkov na fone osteoporoza [The Effectiveness of mechanotherapeutic methods for spine deep stabilization system training in patients with osteoporotic vertebral fractures]. Vestnik vosstanovitel'noi mediciny. 2020; 2(96): 33-40 (In Russ.).
21. Makarova E.V., Marchenkova L.A., Eremushkin M.A., Shakurova L.R., Styazkina 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 [Coordination disorders in patients with osteoporotic compression vertebral fractures]. Vestnik vosstanovitel'noi mediciny. 2019; 2: 13-20 (In Russ.).

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.