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

Kh. V. Petruniv, E. Lapkovskyi
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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
老年人膝关节置换术后肌肉减少症的矫正效果
本研究的目的是评估开发的物理治疗方案对老年全膝关节置换术后远期肌少症参数的有效性。材料和方法。在这项研究中,80名老年人接受了调查。对照组由13名男性和15名女性组成,他们没有接受下肢关节全内假体手术,没有肌肉减少的迹象。对照组包括11名男性和16名女性,均行全膝关节置换术,诊断为肌肉减少症,根据初步检查结果推荐的积极康复干预依从性较低。主要患者组为男性9例,女性16例,均行全膝关节置换术,确诊为肌肉减少症,初步检查结果推荐积极康复干预,治疗(康复)配合度高。为他们制定并实施了为期6个月的物理治疗计划,其中包括以下内容:治疗练习,功能训练,下肢和下背部按摩,手术肢体的运动学胶带;饮食建议;病人教育。通过握力指标、埃德蒙顿虚弱量表和SarQoL问卷的动态来评估该计划的有效性。结果和讨论。老年膝关节置换术合并肌肉减少症患者表现为力量低(根据握力值)、主观身体无力、日常生活活动困难(根据埃德蒙顿虚弱量表问卷),导致生活质量下降(根据SarQoL问卷)。开发的物理治疗方案在力量指标、身体虚弱状态和生活质量参数上的效果均优于初始指标(p <0.05)。老年膝关节置换术合并肌肉减少症患者的康复依从性较低,尽管已经意识到这种多病的风险,但在类似的随访期间缺乏改善。结论。患有全膝关节置换术和肌肉减少症的老年患者需要制定物理治疗方案,考虑并纠正每种情况的具体情况,存在身体状态障碍和日常生活活动能力受损,从而提高这类患者的生活质量
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