The high risk of fall-risk in patients with Parkinson's disease leads to traumatic consequences, in particular, to the femoral neck fractures. Predictors of fall-risk are old age, sarcopenia, and polymorbidity. All of these conditions are independent indications for carrying out rehabilitation measures; but their combination in one patient should introduce specific features into the recovery process aimed at leveling the signs of each disease. The purpose of the study was to assess the dynamics of functional activity in older people with Parkinson's disease and frailty with the consequences of femoral neck fractures under the influence of physical therapy. Material and methods. We examined 21 elderly patients with Parkinson's disease and frailty in the recovery period after the femoral neck fracture. They were divided into two groups: group 1 practiced according to the principles of polyclinic rehabilitation with a predominance of the use of preformed physical factors and general principles of physical therapy and group 2 practiced according to a developed program of physical therapy with an emphasis on functional training aimed at improving physical qualities, movement stereotype, primarily movement and self-service, taking into account the polymorbidity of the pathology. The developed physical therapy program lasted 3 months; corrective sessions were held three times a week. The program was created taking into account the setting and consistent achievement of individual short- and long-term rehabilitation goals. The effectiveness of the program was assessed based on the results of the Barthel Activities of the daily living Index and the Lawton Instrumental activities of the daily living Scale. Results and discussion. In elderly patients with Parkinson's disease and frailty in the recovery period after the femur neck fracture, a low level of basic (according to the Bartel index) and instrumental (according to the Lawton scale) functional activities is diagnosed, which leads to restrictions in everyday activities and self-care. The developed program of physical therapy revealed a statistically significantly better effect on the indices of the basic and instrumental functional activities of the examined persons in comparison with the general polyclinic program: the increase in the general level of the basic functional activity of the Bartel index in group 1 was 15.52%, in group 2 was 35.59% (p <0.05). Improvement in the overall score of instrumental activity on the Lawton scale in group 1 was 18.70%, in group 2 it was 36.11% (p <0.05). Conclusion. Elderly patients with polymorbid pathology with traumatic bone injuries require the preparation of pathogenetically based physical therapy programs, taking into account and correcting the specificity of each disease, which increased the overall effectiveness of rehabilitation and, as a consequence, the functional activity of patients
The aim: Is to conduct a comparative analysis of electroneuromyographic parameters in patients with myofascial pain syndrome with multiple sclerosis under the conditions of using various means of physical therapy. Materials and methods: 105 patients aged 21 to 54 years were examined with MPS in MS. Neurological disorders were verified according to ENMG examinations. 64 patients were enrolled in an experimental group for which a specially designed program was included, which included reflexology and exercise for stretching muscles for 30 days. The control group included 41 patients who underwent a FT course based on therapeutic massage during the same time. Analysis of global ENMG was performed according to functional tests («muscle relaxation» and «maximum arbitrary muscle tension» with m. Tibialis anterior and m. Rectus femoris), M-responses and H-reflexes, polysynaptic responses (PSV) in withdrawal from these muscles during short-term stimulation n. plantaris (number of pulses in series 10, frequency - 20 Hz, duration of a separate stimulation signal - 1 ms, intensity - double threshold of contractile response of the muscles of the sole of the foot) and residual latency as the time of motor impulse on terminal non-myelinated nerve. Testing was performed on the same muscle groups on the left and righ. Results: Before physical therapy during electromyographic testing, a significant decrease in the amplitude of the maximum M response, a decrease in the speed of the impulse in the proximal and distal segments of the peripheral nerve, was found to be significant compared with the control, the ratio of the proximal-distal coefficient and the residual latency index significantly increased, which indicates a demyelinating character lesions of nerve conductors. After reflexotherapy with muscle stretching in 38.0% of the patients of the experimental group, the dynamics of the amplitude of the M-answers on the left and on the right has only a tendency to further increase, while in the other 62.0% of patients, the amplitude of the M-responses increases bilaterally and is 65.7% higher than in the control group. Conclusions: The use of reflexology in conjunction with stretching leads to a reduction in muscle spasticity and pain, as evidenced by electrophysiological indicators that substantiate their feasibility in the practice of physical therapy to improve the functional status of patients with MPS in MS.
<em>The aim of the study</em>: to study of electroneurophysiological characteristics of myofascial pain syndrome in athletes. <em>Material and methods.</em> 40 sportsmen, representatives of the 4 sports at the age from 17 to 24 years and 25 healthy volunteers have participated in the study. The global electromyography and the study of the blink reflex have been included in the program of electroneurop hysiological studies in order to assess the polysynaptic reflex excitability of the brainstem. <em>Results</em>. If there is a myofascial trigger point in a muscle, the increased rest activity typе its pathogenic influence on the structures of the central nervous system, and this indicant can be used for objective assessment of the pathological process. The study of the blink reflex data allows to determine the connection of polysynaptic reflex excitability level with the myofascial pain severity in athletes. <em>Conclusions</em>: it has been determined that the global electromyography allows to objectively evaluate the pathogenesis of myofascial pain, and the blink reflex study can serve as an adequate neurophysiological test that reflects the performance peculiarities of the central nervous system suprasegmental parts to assess the blink reflex severity in athletes.
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