Development of systems for physical rehabilitation and evaluation of their effectiveness in postmenopausal women with osteoporosis depending on the age and number of vertebral fractures
Keywords:system of physical rehabilitation, functional tests, postmenopausal women, osteoporosis, vertebral fractures
Background. The sedentary lifestyle, which is typical for most people, regardless of age, leads to the development of many diseases, in particular to the pathology of the locomotor system, premature aging and death. According to European and American guidelines, optimal treatment of osteoporosis involves the combination of drug and non-drug treatment methods, among the latter, physical rehabilitation also plays an important role. Today, literary sources provide numerous systems of therapeutic exercises, which are developed for persons with osteoporosis, including postmenopausal women. However, these systems have been developed for patients with systemic osteoporosis in general, and have not been adapted for patients with vertebral fractures (VF) in particular. The objective is to develop programs of physical rehabilitation for women of older age groups with systemic osteoporosis and vertebral fractures in the subacute period and to assess their effectiveness depending on the age of the patients and the number of VF. Materials and methods. The analysis and generalization of literary data were conducted to develop programs of physical rehabilitation. To evaluate the effectiveness of our systems for physical rehabilitation in the Ukrainian Scientific Medical Center for Osteoporosis Problems, we examined 53 postmenopausal women aged 50–84 years, who were divided into two groups depending on age: group I — patients aged 50–69 years, group II — 70–84 years. For analysis, static and dynamic types of functional tests (FT) were used. The examined women tested the developed system of physical rehabilitation for two weeks, daily — within 30 minutes. Results. The analysis of FT indices in women of two age groups after the end of exercises with the use of developed system for physical rehabilitation has shown a significant improvement of most indicators of dynamic and static FT. When analysing FT indices in postmenopausal women depending on the number of VF, the probable differences were not revealed in the above mentioned parameters of comprehensive treatment with the inclusion of new systems of therapeutic exercises and by its completion. We have confirmed a significant improvement of the FT in patients, regardless of the number of VF. When analysing FT indicators depending on the number of VF (one or two and more), the probable differences were not found in patients with systemic osteoporosis before and after comprehensive treatment with the inclusion of new developed systems for therapeutic exercises. Conclusions. The developed programs of physical rehabilitation improved the indicators of the functional state of the organism regardless of age, the number of VF and are safe that is confirmed by the stability of the assessment of basic hemodynamic parameters in women with systemic osteoporosis and VF, which allows recommending them for the use in treatment and prevention institutions.
Kachan EY, Terekhina RN, Wiener-Usmanova IA, Trofimova SV. Role of moderate physical activity at advanced age: medical and social aspects of occupations by the Finnish walking with sticks . Uchenye zapiski universiteta imeni PF Lesgafta. 2013;(95):68-71. (in Russian).
Tabor E, Zagórski P, Martela K, Glinkowski W, Kuźniewicz R, Pluskiewicz W. The role of physical activity in early adulthood and middle age on bone health after menopause in epidemiological population from Silesia Osteo Active Study . Int J Clin Pract. 2016 Oct;70(10):835-842. doi: 10.1111/ijcp.12874.
Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women . Osteoporos Int. 2013 Jan;24(1):23-57. doi: 10.1007/s00198-012-2074-y.
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s guide to prevention and treatment of osteoporosis . Osteoporos Int. 2014 Oct;25(10):2359-81. doi: 10.1007/s00198-014-2794-2.
Shakhlina L. Physical rehabilitation in complex treatment of sports injuries . Theory and Methods of Physical Education and Sports. 2015;2015(2):131-135. (in Russian).
Ratov IP. Dvigatel'nye vozmozhnosti cheloveka (netraditsionnye metody ikh razvitiia i vosstanovleniia [Human motor abilities (non-traditional methods of their development and recovery)]. Minsk: Minsktipproekt.1994. 116 p.
Ashmarin BA. Teoriia i metodika fizicheskogo vospitaniia: Uchebnoe posobie dlia studentov fakul'tetov fizicheskogo vospitaniia pedagogicheskikh institutov [Theory and methods of physical education: A manual for students of faculties of physical education of pedagogical institutes.]. Moskow: Fizkul'tura i sport; 2002. 360 p.
Bonaiuti D, Shea B, Iovine R, et al. Exercise for preventing and treating osteoporosis in postmenopausal women . Cochrane Database Syst Rev. 2002;(3):CD000333. doi: 10.1002/14651858.CD000333.
Wee J, Sng BYJ, Shen L, Lim CT, Singh G, De SD. The relationship between body mass index and physical activity levels in relation to bone mineral density in premenopausal and postmenopausal women . Arch Osteoporos. 2013;8:162. doi: 10.1007/s11657-013-0162-z.
Vainionpää A, Korpelainen R, Vihriälä E, Rinta–Paavola A, Leppäluoto J, Jämsä T. Intensity of exercise is associated with bone density change in premenopausal women . Osteoporos Int. 2006;17(3):455-463. doi: 10.1007/s00198-005-0005-x.
What kind of sport to choose if you have health problems. Available from: https://www.depo.ua/ukr/life/kak-vybrat-vid-sporta-v-zavisimosti-ot-sushchestvuyushchih-zabolevaniy-15122014152900 . Accessed: Dec 16, 2014.
Wang LY, Liaw MY, Huang YC, et al. Static and dynamic balance performance in patients with osteoporotic vertebral compression fracture . J Back Musculoskelet Rehabil. 2013;26(2):199-205. doi: 10.3233/BMR-130369.
Senderovich H, Tang H, Belmont S. The Role of Exercises in Osteoporotic Fracture Prevention and Current Care Gaps. Where Are We Now? Recent Updates . Rambam Maimonides Med J. 2017 Jul 1;8(3). doi: 10.5041/RMMJ.10308.
Aladwan RSQ. Role of modern health techniques in prophylaxis of deficiencies in mineralisation of the bone tissue in students . Fiziceskoe Vospitanie Studentov. 2010;(5):70-73. (in Russian).
Stattin K, Michaëlsson K, Larsson SC, Wolk A, Byberg L. Leisure-Time Physical Activity and Risk of Fracture: A Cohort Study of 66,940 Men and Women . J Bone Miner Res. 2017 Aug;32(8):1599-1606. doi: 10.1002/jbmr.3161.
Angın E, Erden Z, Can F. The effects of clinical pilates exercises on bone mineral density, physical performance and quality of life of women with postmenopausal osteoporosis . J Back Musculoskelet Rehabil. 2015;28(4):849-58. doi: 10.3233/BMR-150604.
Lu YH, Rosner B, Chang G, Fishman LM. Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Top Geriatr Rehabil. 2016 Apr;32(2):81-87. doi: 10.1097/TGR.0000000000000085.
Vakulenko DV, Vakulenko LO. The way of optimization for the restoration of the bone tissue in the patient with osteoporosis. Medical Informatics and Engineering. 2010;(1):44-52. (in Ukrainian).
Olsen CF, Bergland A. The effect of exercise and education on fear of falling in elderly women with osteoporosis and a history of vertebral fracture: results of a randomized controlled trial . Osteoporos Int. 2014 Aug;25(8):2017-25. doi: 10.1007/s00198-014-2724-3.
Paolucci T, Morone G, Iosa M, et al. Efficacy of group-adapted physical exercises in reducing back pain in women with postmenopausal osteoporosis . Aging Clin Exp Res. 2014 Aug;26(4):395-402. doi: 10.1007/s40520-013-0183-x.
Caputo EL, Costa MZ. Influence of physical activity on quality of life in postmenopausal women with osteoporosis . Rev Bras Reumatol. 2014 Nov-Dec;54(6):467-73. doi: 10.1016/j.rbr.2014.02.008. (in Portuguese).
Agranovich NV, Anopchenko AS. Improving the quality of life of people of the "third age" by prolonging their physical activity. Evrazijskij souz ucenyh. 2014;7-3(7):8-11. (in Russian).
Evstigneeva LP, Lesniak OM, Kuznetsova NM, et al. Meaning of educational programs in changing the patients' knowledge about osteoporosis and their way of life (calcium diet and mobility) . Lechaschi Vrach. 2013;(5):104.
Sinaki M. Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention . PM R. 2012 Nov;4(11):882-8. doi: 10.1016/j.pmrj.2012.10.008.
National Osteoporosis Society. Exercise and osteoporosis. Available from: https://nos.org.uk/media/98591/exercise-osteo-october-2016.pdf Accessed: Oct, 2016.
Arima K, Abe Y, Nishimura T, et al. Association of vertebral compression fractures with physical performance measures among community-dwelling Japanese women aged 40 years and older . BMC Musculoskelet Disord. 2017 Apr 28;18(1):176. doi: 10.1186/s12891-017-1531-3.
How to Cite
Copyright (c) 2018 N.V. Grygorieva, V.V. Povoroznyuk, O.S. Rybina
This work is licensed under a Creative Commons Attribution 4.0 International License.