Risultati della terapia medica e fisioterapia di trattamento nella Spa sulla forza muscolare e sulla mobilit - PowerPoint PPT Presentation

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Risultati della terapia medica e fisioterapia di trattamento nella Spa sulla forza muscolare e sulla mobilit

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Title: Risultati della terapia medica e fisioterapia di trattamento nella Spa sulla forza muscolare e sulla mobilit


1


Risultati della terapia
medica e fisioterapia di trattamento nella Spa
sulla forza muscolare e sulla mobilità del tronco
in soggetti con bassa densità ossea
  • Primarius Katarina S. Markovic
  • Istituto per la cura e riabilitazione delle
    malattie reumatiche e cardiovascolari
  • "Niska Banja"

2
Results of Physical Treatment in the Spa and
Medicamentous Therapy on Muscle Strength and
Trunk Mobility in Subjects with Lower Bone Density
  • Katarina S. Markovic M.D.
  • Institute for treatment and rehabilitation of
    rheumatic and cardiovascular diseases Niška
    Banja

3
introduction
  • the assessment of the muscle strength and trunk
    movability are especially significant in the
    prevention of falls and fractures, in patients
    with lower bone mineral density and may be of
    great importance in making a diagnosis and
    assessment of therapy effect, as well

4
  • Spinal musculature functional damage measuring
    is obtained by isokinetical, isometrical and
    isoinertial tests
  • Isostation B200 is isoinertial dynamometer with
    three measurement axes, which monitors movements
    on fully natural base and used for examination of
    quantity of dysfunction

5
  • - construction of Isostation B200 made spine Th
    parts and pelvis movements unable
  • - results are shown graphical by
  • 1. standard graph
  • 2. motion range graph
  • 3. combined parameters graph
  • 4. repetition analyzes table
  • showing average values

6
graph shows functional amplitude of movements
7
  • global speed decreasing of extension
    suspect of osteoporosis

8
testing protocol
  • Registration of maximal rotary movement moments
  • of isometric contractions
  • give snapshoot in general muscular potential
    examined body part showing especially values of
    muscular potentional especially of left and
    right rotation, flections, extensions and left
    and right lateral flections

9
testing protocol
  • 2. measurement of movement range
  • First examine without load
  • This parameter is evaluated during dynamic
    reception examine with different loaded height

10
testing protocol
  • 3. dynamic repetition test with load
  • - muscle movement is composed of
  • a) phases of acceleration
  • b) dynamic equilibrium last very
    short only with constant movement
  • c) deacceleration phase
  • - Isostation B200 measures rotary
    moments in all phases of movement

11
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13
Rebilitation
  • increase bone density and osteoblastic bone
    forming is possible only with the exercise load
    and Physical Treatment in the Spa Therapy
  • exercise alone is inadequate to maintain the
    spina trabecular bone in perimenopausal or
    postmenopausal women

14
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16
  • Institute Niška Banja made study of correlation
    between lumbosacral bone mineral density and
    muscles kineziology parameters
  • The objective of this studies is to investigate
    how much the application of Physical Treatment in
    the Spa therapy (PTS) and medicamentous therapy,
    make intergroups differences, in muscle strength
    and trunk movability - subpopulation,
    she-patients with low bone mineral density

17
representation of the study
  • Methods 125 postmenopausal women with low bone
    mineral density, were on defined regime hydro,
    mud, kinezzy, magnet and bisphosphonate therapy,
    during the period of six months
  • Functional status of trunk musculature was
    determined by the apparatus Isostation B 200
  • The groups were made according ot T-scor, muscle
    strength and trunk movability, as well.

18
representation of the study
  • measuring of bone mineral density was performed
    on Lunar DPX densitometer, at the some time
    anteroposterior scan of lumbal verebrae L1-L4 by
    the method of two energetic absorbtiometery by
    X-rays (DXA) was performed, the results were
    interpreted according to the accepted definition
    of OP accordinig to the WHO and according to the
    T-scor

19
representation of the study
  • in the period of six months Physical Treatment in
    the Spa Therapy (PTS) was conducted twice
  • in the span of 3 months in duration from two
    weeks
  • involved the application of
  • - mud therapy (LS part of the spine)
  • - hydro therapy (bathing in the thermo-mineral
  • water 20min.)
  • - pulsed magnetic field (50Hz,10mT,30 min)

20
representation of the study
  • kinezzy exercise were performed in the hall and
    the implied stretching exercises, balance and
    strength into a lying, sitting and standing
    position
  • kinezzy exercise were also outside and are
    implied are training of breathing exercises and
    general fitness, with a change in speed of motion
    and configuration terrain

21
representation of the study
  • medicament therapy consisted of taking
  • - 1000 mg of calcium a day
  • - coated tablet of vitamin D3 (1000 i.j.)
  • - bisphosphonates (Alendronat 10 mg)

22
distribution of patients in relation to age
and bone density
Age of life osteoporosa osteoporosa osteoporosa osteopenia osteopenia
Age of life
Age of life br. br.
51 - 60 28 22,4 35 28
61 - 70 42 33,6 16 12,8
71 4 3,2 0 0
n 125 74 59,2 51 40,8
n- the total number of patients
23
results
  • a group of 25 she-patients with average
  • T-scor -2,470,04 has been on PTS for six
    months
  • PTS was included hydro therapy (15 min. in
    thermo-mineral water), mud, pulsed magnetic field
    and kinezzy therapy,
  • this group had muscle strength increase and LS
    movability of 17,92.

24

Maximum isometrically test increase
muscle strength and LS movability


25
results
  • the similar results were achieved in the group of
    50 she-patients with average
  • T-scor-2,570,09 who at the same period of
    time, beside the same Physical Treatment in the
    Spa Therapy, had calcium and vitamin D3 intake

26

Maximum isometrically test increase
muscle strength and LS movability


27
results
  • the third group consisted of 25
  • she-patients, they had the average
  • T-scor-2,680,08 and during the period of six
    months, beside PTS, calcium and vitamin D3, they
    also got bisphosphonates, as well
  • icrease if muscle strength and LS movability of
    over 35 were noticed

28

Maximum isometrically test increase
muscle strength and LS movability


29
results
  • the control group, during the period of six
    months, did not have any therapy
  • In this group of 25 she-patients with average
    T-scor-2,390,03 decrease of muscle strength and
    LS movability of 15,47, were noticed

30

Maximum isometrically test decrease
muscle strength and LS movability


31

CONCLUSION
  • there is a high possitive correlation between
    muscle strength and trunk movability, at one hand
    and application of both balneophysical and
    medicamentous therapy, at the other hand, in
    she-patients with low bone mineral density, no
    matter the age nor the level of bone density
  • values of muscle strength and trunk movability
    were average for trunk extensors 20, for
    rotators 30 and for flexors even 36

32
Acknowledgement
  • Prim. Mirka Karadžic, M.D.
  • Department of Rheumatology
  • Institute for treatment and rehabilitation of
    rheumatic diseases Niška Banja

Prof. Aleksandar Dimic, M.D. Medical Faculty
The University of Niš, Serbia
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