ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2023, 8(1): 214–221
https://doi.org/10.26693/jmbs08.01.214
Physical Therapy and Ergotherapy

Effectiveness of Correction of Sarcopenia Signs in Elderly People with Knee Arthroplasty

Petruniv Kh. V., Lapkovskyi E. Y.
Abstract

The purpose of the study was to evaluate the effectiveness of the developed physical therapy program on the parameters of sarcopenia in elderly people with total knee arthroplasty in the remote period after surgery. Materials and methods. During the research, 80 elderly people were examined. The control group consisted of 13 men and 15 women who did not undergo total endoprosthetic surgery of the joints of the lower limbs, without signs of sarcopenia. The comparison group consisted of 11 men and 16 women with total knee arthroplasty and diagnosed sarcopenia with low therapeutic (rehabilitation) compliance with the active rehabilitation intervention recommended based on the results of the initial examination. The main group consisted of 9 men, 16 women with total knee arthroplasty and diagnosed sarcopenia with a high level of therapeutic (rehabilitation) alliance regarding the active rehabilitation intervention recommended by the results of the initial examination. For them, a 6-month long physical therapy program was developed and implemented, which included the following elements: therapeutic exercises, functional training, massage of the lower limbs and lower back, kinesiological taping of the operated limbs; dietary recommendations; patient education. The effectiveness of the program was evaluated by the dynamics of the grip strength indicators, the Edmonton Frail Scale, and the SarQoL questionnaire. Results and discussion. In elderly patients with knee arthroplasty and sarcopenia, low strength (according to the value of grip strength), subjective physical weakness, difficulties in performing activities of daily living (according to the Edmonton Frail Scale questionnaire), were revealed, which led to a deterioration in the quality of life (according to the SarQoL questionnaire). The developed physical therapy program revealed a statistically significantly better effect on strength indicators, the state of physical weakness and quality of life parameters in comparison with the initial indicators for all studied parameters (р <0.05). Low rehabilitation compliance in elderly patients with knee arthroplasty and sarcopenia, despite being aware of the risks of this polymorbidity, was associated with a lack of improvement over a similar follow-up period. Conclusion. Elderly patients with the consequences of total knee arthroplasty and sarcopenia require the development of physical therapy programs taking into account and correcting the specifics of each condition, the presence of physical status disorders and impaired performance of activities of daily life, which increases the quality of life of this contingent of patients

Keywords: rehabilitation, senile asthenia, geriatrics, endoprosthesis of lower limb joints

Full text: PDF (Ukr) 274K

References
  1. Katz JN, Arant KR, Loeser RF. Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA. 2021;325(6):568-578. PMID: 33560326. PMCID: PMC8225295. https://doi.org/10.1001/jama.2020.22171
  2. Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Orthop Traumatol Surg Res. 2018;104(1S):S41-S46. PMID: 29183821. https://doi.org/10.1016/j.otsr.2017.04.017
  3. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370(9597):1508-1519. PMID: 17964352. https://doi.org/10.1016/S0140-6736(07)60457-7
  4. Hurley M, Dickson K, Hallett R, Grant R, Hauari H, Walsh N, et al. Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Syst Rev. 2018;4(4):CD010842. PMID: 29664187. PMCID: PMC6494515. https://doi.org/10.1002/14651858.CD010842.pub2
  5. Petermann-Rocha F, Balntzi V, Gray SR, Lara J, Ho FK, Pell JP, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022;13(1):86-99. PMID: 34816624 PMCID: PMC8818604. https://doi.org/10.1002/jcsm.12783
  6. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2019: Highlights. United Nations; New York, NY, USA: 2019. Available from: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf
  7. Fernandes LV, Paiva AEG, Silva ACB, de Castro IC, Santiago AF, de Oliveira EP, et al. Prevalence of sarcopenia according to EWGSOP1 and EWGSOP2 in older adults and their associations with unfavorable health outcomes: a systematic review. Aging Clin Exp Res. 2022;34(3):505-514. PMID: 34398438. doi:10.1007/s40520-021-01951-7
  8. Nascimento CM, Ingles M, Salvador-Pascual A, Cominetti MR, Gomez-Cabrera MC, Viña J. Sarcopenia, frailty and their prevention by exercise. Free Radic Biol Med. 2019;132:42-49. PMID: 30176345. https://doi.org/10.1016/j.freeradbiomed.2018.08.035
  9. Wiedmer P, Jung T, Castro JP, Pomatto LCD, Sun PY, Davies KJA, et al. Sarcopenia - Molecular mechanisms and open questions. Ageing Res Rev. 2021;65:101200. PMID: 33130247. https://doi.org/10.1016/j.arr.2020.101200
  10. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. PMID: 30312372 PMCID: PMC6322506. https://doi.org/10.1093/ageing/afy169
  11. Aravitska MG. Analiz indyvidualnykh shlyakhiv pokrashchennya komplayensu khvorykh ozhyrinnyam yak aspekt vyznachennya tsiley reabilitatsiyi [Analysis of Individual Ways of Compliance Improvement in Obese Patients as an Aspect of Determining Rehabilitation Goals]. Ukr Zh Med Biol Sportu. 2019;6(22):362-369. [Ukrainian].
  12. https://doi.org/10.26693/jmbs04.06.362
  13. Didokha IV, Aravitska MG. Vplyv zasobiv fizychnoyi terapiyi na riven kineziofobiyi, somatychni markery sarkopeniyi ta pokaznyky ryzyku padinnya u osib pokhylogo viku z khvoroboyu Parkinsona [Effects of physical therapy on the level of kinesiophobia, somatic markers of sarcopenia and indicators of fall risk in elderly persons with Parkinson's disease]. Art of Medicine. 2021;2(18):50-58. [Ukrainian]. https://doi.org/10.21802/artm.2021.2.18.50.
  14. 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 [Еffect of physical therapy on fall-risk and physical status in older adults with frailty and metabolic syndrome]. Ukr Zh Med Biol Sportu. 2020;5(6):282-91. [Ukrainian]. https://doi.org/10.26693/jmbs05.06.282
  15. Naseeb MA, Volpe SL. Protein and exercise in the prevention of sarcopenia and aging. Nutr Res. 2017;40:1-20. PMID: 28473056. https://doi.org/10.1016/j.nutres.2017.01.001
  16. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 10th ed. Philadelhia, PA: Lippincott Williams & Wilkins; 2018.
  17. WHO. Healthy diet [web source]. Available from: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
  18. PROSEDOS. Powered by Gray's Institute [web source]. Available from: https://procedos.com/
  19. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton frail scale. Age Ageing. 2006;35(5):526-9. PMID: 16757522. PMCID: PMC5955195. https://doi.org/10.1093/ageing/afl041
  20. Beaudart C, Biver E, Reginster J-Y, Rizzoli R, Rolland Y, Bautmans I, et al. Development of a selfadministrated quality of life questionnaire for sarcopenia in elderly subjects: the SarQoL. Age Ageing. 2015;44(6):960-6. PMID: 26433796. PMCID: PMC4621234. https://doi.org/10.1093/ageing/afv133
  21. Sobhani A, Sharifi F, Fadayevatan R, Kamrani AAA, Moodi M, Khorashadizadeh M, et al. Low physical activity is the strongest factor associated with frailty phenotype and frailty index: data from baseline phase of Birjand Longitudinal Aging Study (BLAS). BMC Geriatr. 2022;22(1):498. PMID: 35689187. PMCID: PMC9188172. https://doi.org/10.1186/s12877-022-03135-y
  22. Coll PP, Phu S, Hajjar SH, Kirk B, Duque G, Taxel P. The prevention of osteoporosis and sarcopenia in older adults. J Am Geriatr Soc. 2021;69(5):1388-1398. PMID: 33624287. https://doi.org/10.1111/jgs.17043
  23. Zhao H, Cheng R, Song G, Teng J, Shen S, Fu X, et al. The Effect of Resistance Training on the Rehabilitation of Elderly Patients with Sarcopenia: A Meta-Analysis. Int J Environ Res Public Health. 2022;19(23):15491. PMID: 36497565. PMCID: PMC9739568. https://doi.org/10.3390/ijerph192315491