Efficiency of back muscles training and balance therapy in rehabilitation of patients with osteoporotic vertebral fractures.

Medical rehabilitation of patients with osteoporotic vertebral fractures (VF) remains an insufficiently developed topic and requires additional research. Aim of the study was to assess the efficiency of back muscles training and balance therapy in rehabilitation of patients with osteoporotic vertebral fractures. Prospective, interventional, open-label, controlled study in two parallel groups, performed in inpatient department settings at "National Medical Research Center of Rehabilitation and Balneology" during 2018. The study involved 120 patients (11 men and 109 women) aged 40-80 (mean age 65.4±9.1 years) who were admitted for medical rehabilitation for systemic OP and VF. The rehabilitation program in the main group included: 1) Mechanotherapy on the Back-Therapy-Center Dr. Wolf complex with biofeedback (Germany); 2) Balance therapy on a double unstable COBS platform, with biofeedback (Germany); 3) Hydrokinesiotherapy in a pool; 4) Gymnastic exercises (Gorinevskaya-Dreving method). Results. The use of the three-week program of physical rehabilitation using mechanotherapy, balance therapy and special complexes of physiotherapy exercises in the gym and in the pool in patients with osteoporotic VF significantly increases the strength of the muscle corset, helps to eliminate the existing muscle deficit in TE and TF and results in a more physiological distribution of the strength ratio between TE and TF. The rehabilitation program improves the function of static and dynamic balance, both with closed and open eyes, which can be observed in the return of the center of gravity to a physiological position and in improved reaction speed to changes in body position. Usage of mechanotherapeutic methods in rehabilitation of patients with osteoporotic VF is effective for basic motor function improvement and disability reduction.

Telemedicine platform COVIDREHAB for remote rehabilitation of patients after COVID-19.

The world's practice has shown the importance of medical rehabilitation, which allows increasing the effectiveness of treatment of patients with COVID-19, and also significantly reduce the risks of developing complications after COVID-19. Moreover, timely medical rehabilitation reduces the frequency of disability retirement. We developed and investigated the effectiveness of the telemedicine platform "COVIDREHAB" in order to enhance the effectiveness of the recovery period during self-isolation, as well as to provide access to rehabilitation for patients residing in remote areas or unable to undergo in-person medical rehabilitation. This pilot open clinical study includes 178 patients (108 women and 70 men) aged 32 to 82 years [mean age 50 (33-56) years] who had a moderate disease of COVID-19. We used the specialised platform COVIDREHAB for remote monitoring of the rehabilitation efficiency of patients who suffered from COVID-19. During the study, the supervising doctor assigned the patient a set of specialised questionnaires, which were filled in online. The questionnaires distributed to the patient included questions specifically designed for the COVIDREHAB remote platform as well as the mMRC (Modified Medical Research Council) questionnaire. Patients who completed the remote rehabilitation programme were found to have positive dynamics of indicators of the respiratory system functional state, and complaints.Pulmonary rehabilitation is an important part of case management for patients with respiratory diseases and plays an active role in improving lung function and general well-being of patients. Patients who completed the comprehensive medical rehabilitation program using the information and analytical system COVIDREHAB, were found to have positive dynamics of indicators of the respiratory system functional state, and complaints. Hence, at the end of the course the shortness of breath severity decreased (from 34.8% to 12.4%, as well as the feeling of lack of oxygen from 32% to 17.4%, p <0.05). We anticipate the online approach to rehabilitation will improve the functioning of the respiratory and cardiovascular systems, restore physical function, reduce anxiety and depression, and restore quality of life. An essential benefit of this program is the prevention of secondary complications and reduction of serious adverse effects of COVID-19 treatment."

Balance and muscle strength tests in patients with osteoporotic vertebral fractures to develop tailored rehabilitation programs.

Authors perform a cross-sectional study of functional abilities of the patients with osteoporotic vertebral fractures (VFs). Trunk muscle isometric strength and postural balance impairments were estimated. The development of osteoporotic VFs is associated with a significant decrease in strength of all the body muscles, especially the deep spinal stabilization system, i.e trunk extensor (TE), trunk flexsor (TF), where the VFs contribute to inappropriate distribution of back muscle strength with TE:TF ration of 1:1 instead of 3:2, observed both normally and in patients with uncomplicated osteoporosis. There is also a deterioration of stabilometry and functional coordination assessment tests in patients with pathological VFs, that indicate abnormalities of both static and dynamic postural balance. The obtained data should be taken into account when developing rehabilitation programmes for osteoporosis patients who have suffered compression VFs.