Assessment of balance in osteoporotic postmenopausal women: effect of spinal proprioceptive extension program

To assess the balance in osteoporotic patients with kyphosis and the effect of intervention with a spinal proprioceptive extension exercise on the risk of fall in these patients. This study included 20 postmenopausal osteoporotic women with kyphosis and ten controls. Patients had to be physically active, and older than 60 years. Clinical assessment was performed by physical activity score fall efficacy scale and pain scale. Balance assessment was done by computerized dynamic posturography [CDP]. Each patient underwent a program of back extension exercise using one kg of weight suspended between T10 to L4 through fitted harness. Patients were instructed to use this harness two hours twice daily for 4 weeks. Then they were reassessed clinically and by CDP. There was a significantly decreased balance score in osteoporotic kyphotic women compared to controls. There was a significant inverse correlation between balance score and the fall efficacy scale [r=-0.53] and positive correlation between balance score and the physical activity score [r=0.55]. In clinical reassessment, patients showed a significant increase in the physical activity score [5.55 +/- 0.75] compared to pre-intervention values [4.4 +/- 0.68]. Also they had a significant decrease in the fall efficacy scale and pain scale compared to their baseline data. In balance reassessment, patients showed a significant increase in the balance score [75.5 +/- 8.50] compared to their baseline data [63.7 +/- 9.72] [p<0.001]] Osteoporotic postmenopausal women with kyphosis had significantly greater balance abnormalities which plays an important role in increasing their risk of falls. This study suggests that proprioceptive back extension exercise could reduce the risk of fall and improve the pain and physical activity in these patients

Comparison between repetitive peripheral magnetic stimulation [RPMS] and botulinum toxin -A injection in management of spasticity

To compare between the use of repetitive peripheral magnetic stimulation and botulinum toxin-A injection in management of spasticity in patients with paraparesis. Twenty three patients suffering from spastic paraparesis due to traumatic spinal cord injury were included in this study. Assessment included spasm frequency scale [SFS], adductor tone scale, Modified Ashworth scale [MMAS], clonus score, Medical research council scale for muscle power testing. Patients were divided into two groups, group A [10 patients]: received botulinum toxin type A injection and group B [13 patients]: received repetitive peripheral magnetic stimulation [RPMS] one session daily for 3 successive days. All patients were reassessed at 4, 7 and 30 days from the start of therapy. There was no significant difference in the neurological baseline data after 4 and 7 days in group A patients. However, after 30 days, there was a statistically significant decrease in the spasticity scales. After four days therapy, there was highly significant difference [p<0.01] in the neurological scales with decreased spasticity scales in group B compared to group A. After seven days, there was highly significant difference [p<0.01] between group A and B with decreased spasm frequency and clonus score scales in group A. After 30 days, there was a highly significant difference [p<0.01] between group A and B with decreased adductor tone, modified ashworth, spasm frequency scales, clonus and functional independence measure scores in group A. RPMS and botulinum toxin A injection can be used complementary to each other as RPMS has immediate and short term effects on spasticity while botulinum toxin A has delayed and long term effects on muscle tone