The deep core stability back muscles training in rehabilitation of patients with osteoporotic vertebral fractures

Abstract

The aim of the study is to estimate the effectiveness of kinesiotherapy based on deep core stability muscles training in the program of rehabilitation in patients with osteoporotic vertebral fractures (VF). Sixty patients (M-12, F-48) aged 43-81 years (average age 62.75 ± 12.5) with primary osteoporosis and at least one non-traumatic VF were included in the study. The rehabilitation program focused on training of deep core stability back muscles and consisted of 4 kinesiotherapy methods (Dr. Wolff and CBS simulators, kinesiohydrotherapy in the pool and complex physical exercises by Gorinevskaya-Dreving) was prescribed for 21 days to all patients. Isometric core strength test (Back-Check) was performed at baseline, at the end of the rehabilitation treatment and at 21 days follow-up visit. At baseline relative flexion strength (REL FS), relative extension strength (REL ES), left lateral flexion strength (LLAT FS), right lateral flexion strength (RLAT FS) were lower than recommended indexes: 113.01 ± 34.03% of 150% ( P = 0.001), 75 ± 12.78% of 100% ( P = 0.006), 85 ± 12.78% ( P = 0.04) and 79.73 ± 9.2% of 100% ( P = 0.003) accordingly. Ratio relative flexion/extension strength (FLE:EXT S) also was in imbalance in 38 of 45 patients. Lateral flexion ratio (LLAT:RLAT FS) showed imbalance only in 6 patients. The all isometric core strength test indexes improved significantly: REL FS up to 132.57 ± 47.08% ( P = 0.0001), REL ES up to 86.45 ± 9.4% ( P = 0.03), LLAT FS up to 90.7 ± 9.55% (p = 0.07), RLAT FS up to 89.4 ± 2.5% ( P = 0.03) after the rehabilitation course. The muscle strengths stay better than the baseline indexes at the follow-up measurement: REL FS = 121.5 ± 39.9% ( P = 0.002), REL ES = 79.78 ± 10.5% ( P = 0.02), LLAT FS = 87.1 ± 11.07% ( P = 0.06), RLAT FS = 80.14 ± 8.62% ( P = 0.09). The basic dysfunction of deep core muscles and imbalance flexion/extension strength in osteoporotic patients with VF were estimated. Complex rehabilitation with kinesiotherapy showed the high prolong effect on improving back muscle strength in patients with VF.