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

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.