ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 38 of 50
Up
УЖМБС 2021, 6(1): 263–270
https://doi.org/10.26693/jmbs06.01.263
Physical Therapy and Ergotherapy

Dynamics of Functional Activity of Elderly People with Parkinson's Disease and Frailty with Consequences of Femoral Neck Fracture under the Influence of Physical Therapy

Gritsulyak B. V. 1, Polataiko Yu. A. 1, Gerich R. P. 1, Danylchenko S. I. 2
Abstract

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

Keywords: rehabilitation, sarcopenia, parkinsonism, trauma, joint contracture

Full text: PDF (Ukr) 378K

References
  1. Lee J, Choi M, Yoo, Y. A Meta-Analysis of Nonpharmacological Interventions for People With Parkinson's Disease. Clinical Nursing Research. 2017; 26(5): 608-631. https://doi.org/10.1177/1054773816655091
  2. Amara AW, Memon AA. Effects of Exercise on Non-motor Symptoms in Parkinson's Disease. Clinical Therapeutic. 2018; 40(1): 8-15. https://doi.org/10.1016/j.clinthera.2017.11.004
  3. Hulbert S, Rochester L, Nieuwboer A, Goodwin V, Fitton C, Chivers-Seymour K, et al. "Staying safe" - a narrative review of falls prevention in people with Parkinson's - "PDSAFE". Disability and Rehabilitation. 2019; 41(21): 2596-2605. https://doi.org/10.1080/09638288.2018.1471167
  4. Tan L, Wang Y, Zhou L, Shi Y, Zhang F, Liu L, et al. Parkinson's disease and risk of fracture: a meta-analysis of prospective cohort studies. PLoS One. 2014; 9 (4): e94379. https://doi.org/10.1371/journal.pone.0094379
  5. Vieira de Moraes Filho A, Chaves SN, Martins WR, Tolentino GP, de Cássia Pereira Pinto Homem R. Progressive Resistance Training Improves Bradykinesia, Motor Symptoms and Functional Performance in Patients with Parkinson's Disease. Clinical Interventions in Aging. 2020; 23 (15): 87-95. https://doi.org/10.2147/CIA.S231359
  6. Byrchak V, Duma Z, Aravitska M. Effectiveness of the active physical therapy in restoring wrist and hand functional ability in patients with immobility-induced contracture of the wrist joint complicated by median nerve entrapment owing to distal forearm fracture. Journal of Physical Education and Sport. 2020; 20 (6): 3599–3606. https://doi.org/10.7752/jpes.2020.06485
  7. Hrytsulyak BV, Polatayko YuO, Herych RP. Korektsiya ryzyku padinnya pislya perelomiv stehnovoyi kistky zasobamy fizychnoyi terapiyi u patsiyentiv pokhyloho viku z parkinsonizmom ta syndromom starechoyi asteniyi [Correction of the fall-risk after femoral bone fractures by means of physical therapy in elderly patients with parkinsonism and frailty]. Klinichna ta profilaktychna medytsyna. 2020; 4(14):70-78. [Ukrainian]. https://doi.org/10.31612/2616-4868.4(14).2020.06
  8. Skybchyk VA, Bablyak SD. Syndrom starechoyi asteniyi (frailty) — suchasna problema herontolohichnoyi medytsyny [Frailty - current problem of geriatric medicine]. Hypertension. 2018; 4(60): 12-18. [Ukrainian]. doi: 10.22141/2224-1485.4.60.2018.141770
  9. Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig AK, Scafoglieri A, Jansen B, et al.; Gerontopole Brussels Study group. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. Journal of the American Medical Directors Association. 2016; 17(12): 1163.e1-1163.e17. https://doi.org/10.1016/j.jamda.2016.09.010
  10. Koval N, Aravitska M. Efektyvnist korektsiyi pokaznykiv ryzyku padinnya ta fizychnoho statusu v osib pokhyloho viku z starechoyu asteniyeyu ta metabolichnym syndromom zasobamy fizychnoyi terapiyi [Effect of Physical Therapy on Fall-Risk and Physical Status in Older Adults with Frailty and Metabolic Syndrome]. Ukrayinskyy zhurnal medytsyny, biolohiyi ta sportu. 2020; 5(6): 282–91. https://doi.org/10.26693/jmbs05.06.282 [Ukrainian]
  11. Byrchak VM, Duma ZV, Aravitska MG. Zminy psykho-emotsiynoho stanu ta funktsionalnykh mozhlyvostey peredplichchya ta zapyastka yak marker efektyvnosti fizychnoyi terapiyi patsiyentiv z postimmobilizatsiynymy kontrakturamy vnaslidok perelomiv dystalnykh viddiliv kistok peredplichchya [Changes in the psycho-emotional state and functionality forearm and wrist as a marker of efficiency of physical therapy of patients with post-mobilization contractures because of distal forearm fractures]. Art of Medicine. 2020; 2(14): 23-31. [Ukrainian]. https://doi.org/10.21802/artm.2020.2.14.23
  12. Kalashnikov AV, Malyk VD. Likuvannya perelomiv shyyky stehnovoyi kistky (ohlyad literaturnykh dzherel) [Treatment of fractures of the femoral neck (review of literature sources)]. Bulletin of morphology. 2017; 1(23): 156-162. [Ukrainian]
  13. Noreyko SB, Zenchenkov IP, Fedoryshyn RP, Savelyev М. Fizychna reabilitatsiya pry perelomi stehnovoyi kistky [Physical rehabilitation for femoral fracture]. Science and education. 2014; 4: 115-118. [Ukrainian]
  14. Ridgel AL, Phillips RS, Walter BL, Discenzo FM, Loparo KA. Dynamic High-Cadence Cycling Improves Motor Symptoms in Parkinson's Disease. Front Neurol. 2015; 2: 194. https://doi.org/10.3389/fneur.2015.00194
  15. Ramazzina I, Bernazzoli B, Costantino C. Systematic review on strength training in Parkinson's disease: an unsolved question. Clinical Interventions in Aging. 2017; 31(12): 619-628. https://doi.org/10.2147/CIA.S131903
  16. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J. 1965; 14: 61-5.
  17. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3): 179-86.