MEDICAL REHABILITATION WITH COMPREHENSIVE GERIATRIC ASSESMENT IN PATIENT WITH RESTABILIZATION THORACAL SPINE
Abstract
The elderly have an increased incidence of osteopenia and osteoporosis affecting approximately 52 million people in the United States. Low bone density in older adults increases risks of hand/wrist, hip, and vertebral body fracÂtures, which can result in significant pain, immobility, and loss of functional independence. Osteoporotic compression fractures are important to diagÂnose, both because they are a significant source of morbidÂity and can herald the risk for subsequent fractures, particularly hip fractures, which have high morÂbidity and mortality rates. Osteoporosis requires treatment with a combination of medication, lifestyle modification, and exercise. Physical therapy and exercise are useful to reduce disability, improve movement, lower risk of falls, and increase bone density with weight-bearing activity.
References
Levis S, Theodore G: Summary of AHRQ’s comparative effectiveness review of treatment to prevent fractures in men and women with low bone density or osteoporosis: update of the 2007 report, J Manag Care Pharm 18:S1–S15, discussion S13, 2012.
Dionyssiotis, Yannis. (2012). Rehabilitation in Osteoporosis. 10.5772/29205.
Frontera, Walter. (2012). DeLisa's physical medicine and rehabilitation: Principles and practice: Fifth edition.
Tomé-Bermejo F, Piñera AR, Alvarez-Galovich L. Osteoporosis and the Management of Spinal Degenerative Disease (I). Arch Bone Jt Surg. 2017;5(5):272–282.
Ponnusamy KE, Iyer S, Gupta G, Khanna AJ. Instrumentation of the osteoporotic spine: biomechanical and clinical considerations. Spine J. 2011;11(1):54–63.
De Wald CJ, Stanley T. Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65 surgical considerations and treatment options in patients with poor bone quality. Spine. 2006;31(Suppl 19):S144–51
Andersen T, Christensen FB, Niedermann B, Helmig P, Høy K, Hansen ES, et al. Impact of instrumentation in lumbar spinal fusion in elderly patients:71 patients followed for 2-7 years. Acta Orthop. 2009;80(4):445–50
Dodwad SN, Khan SN. Surgical stabilization of the spine in the osteoporotic patient. Orthop Clin North Am. 2013;44(2):243–9.
Wuisman PI, Van Dijk M, Staal H, Van Royen BJ. Augmentation of (pedicle) screws with calcium apatite cement in patients with severe progressive osteoporotic spinal deformities: an innovative technique. Eur Spine J. 2000;9(6):528–3
Noelle M. Selkow, et al. (2017). Transversus abdominis activation and timing improves following core stability training : A Randomized Trial. Int J Sports Phys Ther. 2017 Dec; 12(7): 1048–1056.
Chang V,Holly LT.Bracing for thoracolumbar fractures.Neurosurg Focus.2014;37(1).doi:10.3171/2014.4.FOCUS1477.
Ageing and Life Course. [(accessed on 18 June 2019)]; Available online: http://www.who.int/ageing/about/facts/en/.
United Nations . World Populations Ageing. Department of Economic and Social Affairs Population Division; New York, NY, USA: 2013.
ToyoneT, Tanaka T, Wada Y, Kamikawa K. Changes in vertebral wedging rate between supine and standing position and its association with back pain : a prospective study in patients with osteoporotic vertebral compression fractures. Spine 2006;31:2963-6.
Frontera, W. R., Silver, J. K. 1., & Rizzo, T. D. (2015). Essentials of physical medicine and rehabilitation: Musculoskeletal disorders, pain, and rehabilitation (Third edition.). Philadelphia, PA: Elsevier Saunders.
Imhoff A.B, Beitzel K, Stamer K,et al. (2015) . Rehabilitation in Orthopedic Surgery (Second edition). Munich : Springer.
Cameron, Michelle H.(2013). Physical Agents in Rehabilitation : from Agent to Practice (Fourth Edition).St. Lois : Elsevier Saunders.
Kisner, C., & Colby, L. A. (2013). Therapeutic exercise: Foundations and techniques. (Sixth Edition). Philadelphia: F.A. Davis.
Mohamad NI, Cronin JB, Nosaka KK. Difference in kinematics and kinetics between high- and low-velocity resistance loading equated by volume: implications for hypertrophy training. J Strength Cond Res. 2012;26(1):269–275. doi: 10.1519/JSC.0b013e31821f48de.
Nicholson, VP, McKean MR, Burkett BJ (2014). Low-load high repetition resistance training improves strength and gait speed in middle-aged and older adults. J Sci Med Sport. doi : 10.1016’j-jsams.2014.07.018
Hong A Ram, Kim Sang Wan. 2018. Effect of Resistance Exercise on Bone Health. Endocrinol Metab (Seoul). Doi : 10.3803/EnM.2018.33.3.435.¬
Pawlowsky, et al. Stability of Kyphosis, Stength, and Physical Performance Gains 1 Year After a Group Exercise Program in Community-Dwelling Hyperkyphotic Older Woman. Archives Physical Medicine Rehabilitation. 2009 February; 90(2):358-361. Doi : 10.1016/j.apmr.2008.07.016.
