Biomechanics of the osteoporotic spine, pain, and principles of training.
BACKGROUND
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.
Department of Internal Medicine, Klinikum Südstadt Rostock, Südring 81, 18059, Rostock, Germany. guido.schroeder1@gmx.net.
Guido
G
Schröder
Division of Endocrinology and Metabolism, Department of Internal Medicine, Rostock University Medical Center, E.-Heydemann-Str. 6, 18057, Rostock, Germany.
Andreas
A
Knauerhase
Division of Endocrinology and Metabolism, Department of Internal Medicine, Rostock University Medical Center, E.-Heydemann-Str. 6, 18057, Rostock, Germany.
Holger S
HS
Willenberg
Institute for Biostatistics and Informatics in Medicine and Aging Research, University of Rostock, E.-Heydemann-Str. 8, 18057, Rostock, Germany.
Guenther
G
Kundt
Department of Internal Medicine, Klinikum Südstadt Rostock, Südring 81, 18059, Rostock, Germany.
Detlef
D
Wendig
Department of Internal Medicine, Klinikum Südstadt Rostock, Südring 81, 18059, Rostock, Germany.
Hans-Christof
HC
Schober
D000203:Activities of Daily Living; D000368:Aged; D001696:Biomechanical Phenomena; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D026741:Physical Therapy Modalities; D013122:Spinal Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D013131:Spine / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
Biomechanics; Fracture; Osteoporosis; Sling exercises