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

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

Dynamics of balance indicators, activities of daily living, and quality of life of elderly suffering from Parkinson’s disease and frailty after proximal humerus fracture following physiotherapeutic functional training

“…These diseases are independent indications for rehabilitation measures, primarily to improve motor control and balance (preventing falls and improving daily life activity). Nevertheless, their comorbidity and polymorbidity introduce into the recovery process individual-specific features directed at leveling the signs of each pathological condition and improving social functioning, which has become the direction and subject of our previous research [ 13 , 14 ]. It substantiates the relevance of the presented work and determines its theoretical and practical value.…”