Biomechanics of the osteoporotic spine, pain, and principles of training.

INTRODUCTION: A fracture is a clinical manifestation of osteoporosis and is one of the main causes of functional limitations and chronic pain in patients with osteoporosis. Muscle and coordination training are recommended to the patients as general measures. We inquired whether sling training is better than traditional physiotherapy in relieving pain and improving abilities of daily living. METHODS: Fifty patients with osteoporosis were divided into two groups. Group A performed conventional physiotherapy, while Group B performed sling training exercises. Data were collected before and after the intervention and after 3 months. The registered parameters were stamina, posture, and pain. Posture, torques, and the associated strength of spinal muscles were studied in a biomechanical model in order to estimate the forces acting on the spine. Furthermore, the factors that exerted a positive impact on the success of therapy were registered. RESULTS: Forty-four patients (88%) completed the study. Positive effects of the training were noted in both groups, but significantly better effects were observed in the group that performed sling training. A reduction of pain independent of the number of fractures, significantly reduced torques, and reduced muscle strength were registered. CONCLUSIONS: Specific training programs helped to increase muscle strength and straightening the back thereby reducing the force needed on a permanent basis and decreasing torque in the spine. Sling training was more effective in that than traditional physiotherapy.

Impact of pregnancy on back pain and body posture in women.

[Purpose] The purpose of this single-center investigation was to study the impact of pregnancy on back pain and body posture. [Subjects] The subjects were 26 pregnant females. [Methods] Data were generated with a spine scanner (Diers(®) formetric 4D), trunk strength measurement (Diers(®) myoline), a numeric pain scale (0 to 10), and a biomechanical model. Parameters were compared during each trimester. [Results] The alteration in pain level at rest and lumbar lordosis angle in the females revealed a statistical trend during pregnancy. Spearman's test showed positive correlations between body weight and trunk inclination during the second trimester, and between body weight and the kyphosis angle in the third trimester. The trunk inclination and the kyphosis angle revealed a negative correlation in the third trimester. Based on our analysis, the highest moments and muscle strength must be expended in the third trimester. The actual muscle strength is greatest in the second trimester. [Conclusion] Pain at rest must be given greater attention in pregnant females, and their increasing lumbar kyphosis must be counteracted. Exercising the deep segmental muscles may serve as a preventive measure.