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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1995-4484-2014-49-55</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-1360</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Эффективность физических упражнений у лиц с остеопоретическими переломами позвонков</article-title><trans-title-group xml:lang="en"><trans-title>EFFICACY OF PHYSICAL EXERCISES IN PATIENTS WITH OSTEOPOROTIC VERTEBRAL FRACTURES</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Евстигнеева</surname><given-names>Л.П.</given-names></name><name name-style="western" xml:lang="en"><surname>Evstigneeva</surname><given-names>Lyudmila P</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кожемякина</surname><given-names>Е.В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kozhemyakina</surname><given-names>E V</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Негодаева</surname><given-names>Е.В.</given-names></name><name name-style="western" xml:lang="en"><surname>Negodaeva</surname><given-names>E V</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гусельникова</surname><given-names>Г.А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gusel'nikova</surname><given-names>G A</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белкин</surname><given-names>A.А.</given-names></name><name name-style="western" xml:lang="en"><surname>Belkin</surname><given-names>A A</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Викулова</surname><given-names>Д.Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Vikulova</surname><given-names>D N</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белкин</surname><given-names>Н.В.</given-names></name><name name-style="western" xml:lang="en"><surname>Belkin</surname><given-names>N V</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лесняк</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lesnyak</surname><given-names>O M</given-names></name></name-alternatives><email xlink:type="simple">levstigneyeva@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ Свердловской области «Областная клиническая больница №1», Екатеринбург, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Regional Clinical Hospital № 1, Yekaterinburg, Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ГБОУ ВПО «Уральский государственный &#13;
медицинский университет» Екатеринбург, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ural State Medical University, Yekaterinburg, Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>АНО «Клинический институт мозга», &#13;
Екатеринбург, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Institute of the Brain, Yekaterinburg, &#13;
Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>01</day><month>03</month><year>2014</year></pub-date><volume>52</volume><issue>1</issue><fpage>49</fpage><lpage>55</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Евстигнеева Л.P., Кожемякина Е.V., Негодаева Е.V., Гусельникова Г.A., Белкин A.A., Викулова Д.N., Белкин Н.V., Лесняк О.М., 2014</copyright-statement><copyright-year>2014</copyright-year><copyright-holder xml:lang="ru">Евстигнеева Л., Кожемякина Е., Негодаева Е., Гусельникова Г., Белкин A., Викулова Д., Белкин Н., Лесняк О.М.</copyright-holder><copyright-holder xml:lang="en">Evstigneeva L.P., Kozhemyakina E.V., Negodaeva E.V., Gusel'nikova G.A., Belkin A.A., Vikulova D.N., Belkin N.V., Lesnyak O.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/1360">https://rsp.mediar-press.net/rsp/article/view/1360</self-uri><abstract><p>Переломы позвонков при остеопорозе (ОП) сопровождаются снижением качества жизни (КЖ) и функциональными ограничениями. Физические упражнения часто рекомендуются таким пациентам с целью уменьшения боли, улучшения КЖ и функционального состояния. Цель – оценить влияние физических упражнений на КЖ, функциональные показатели, равновесие у пациентов с остеопоретическими переломами позвонков.Материал и методы. В исследование включено 78 женщин с переломами позвонков и хронической болью в спине (40 в основной и 38 в контрольной группе). Средний возраст в основной группе составил 70,7±8,1 года, в контрольной – 67,6±7,0 года (p=0,35). Изучаемые показатели перед началом исследования статистически значимо не различались между группами. Занятия физическими упражнениями в основной группе проводились по 40 мин 2 раза в неделю в течение 12 мес. Пациентам контрольной группы было рекомендовано придерживаться физической активности, которая была до начала исследования. Оценка изучаемых показателей в начале исследования и через 12 мес проводилась с помощью опросника QUALEFFO-41, компьютерной системы диагностики нарушения равновесия и теста «Встань и иди».Результаты. Через 12 мес в основной группе получено статистически значимое улучшение КЖ, как по общему баллу (41,2) по сравнению с контролем (57,3; р&lt;0,0001), так и по значениям всех доменов, а также показателей равновесия в тестах «Подъем из положения сидя» и «Приставной шаг». При проведении теста «Встань и иди» через 12 мес в основной группе отмечалось статистически значимое уменьшение времени выполнения теста с 12,1±3,8 до 10,8±2,5 с (р=0,028) и отсутствие динамики в контроле (11,1±3,4 и 11,1±2,8 с соответственно).Выводы. Физические упражнения улучшают КЖ, функциональную активность и равновесие у пациентов с остеопоретическими переломами позвонков. </p></abstract><trans-abstract xml:lang="en"><p>Vertebral fractures in osteoporosis (OP) patients are accompanied by a decrease in quality of life (QoL) and functional limitations. Physical activity is often recommended for such patients to reduce pain, improve QoL, and functional status.Objective. To assess the impact of exercises on QOL, functional performance, and balance in patients with osteoporotic vertebral fractures.Material and Methods. The study included 78 women with vertebral fractures and chronic back pain (40 patients in the study group and 38 patients in the control group). The average age of patients in the study group was 70.7 ± 8.1 years; in the control – 67.6 ± 7.0 years (p = 0.35). The studied parameters did not significantly differ for two groups at the beginning of the study. In the study group, physical exercises were conducted for 40 minutes twice a week during 12 months. Patients in the control group were recommended to follow the same physical activity as it was prior to the study. Evaluation of the studied parameters at study baseline and 12 months later was carried out using the QUALEFFO-41 questionnaire, a computer system for disequilibrium diagnostics and the «Stand up and walk» test.Results. After 12 months, a statistically significant improvement in QoL was observed among patients of the study group, both in the total score (41.2) compared with the control (57.3, p&lt;0.0001), and in values of all domains, as well as results of the «Rise from a sitting position» and «Chasse step» balance tests. After 12 months, the study group showed a statistically significant reduction of time required to execute the «Stand up and walk» test from 12.1 ± 3.8 to 10.8 ± 2.5 s (p = 0.028), while no changes were observed in the control group (11.1 ± 3.4 and 11.1 ± 2.8 s respectively). Exercises improve QoL, functional activity and balance in patients with osteoporotic vertebral fractures.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеопороз</kwd><kwd>переломы позвонков</kwd><kwd>физические упражнения</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoporosis</kwd><kwd>vertebral fractures</kwd><kwd>physical exercises</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">&lt;div&gt;&lt;p&gt;Михайлов ЕЕ, Беневоленская ЛИ, Мылов НМ. Распространенность переломов позвоночника в популяционной выборке лиц 50 лет и старше. Вестник травматологии и ортопедии им. Н.Н. Приорова. 1997;(3):20–7. [Mikhailov EE, Benevolenskaya LI, Mylov NM. Rasprostranennost' perelomov pozvonochnika v populyatsionnoi vyborke lits 50 let i starshe. Vestnik travmatologii i ortopedii im. N.N. Priorova. 1997;(3):20–7.]&lt;/p&gt;&lt;p&gt;Евстигнеева ЛП, Лесняк ОМ, Пивень АИ. Эпидемиология остеопоротических переломов позвоночника по данным рентгеноморфометрического анализа среди популяционной выборки жителей г. Екатеринбурга 50 лет и старше. Остеопороз и остеопатии. 2001;(2):2–6. [Evstigneeva LP, Lesnyak OM, Piven' AI. Epidemiologiya osteoporoticheskikh perelomov pozvonochnika po dannym rentgenomorfometricheskogo analiza sredi populyatsionnoi vyborki zhitelei g. Ekaterinburga 50 let i starshe. Osteoporoz i osteopatii. 2001;(2):2–6.]&lt;/p&gt;&lt;p&gt;Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis Int. 2006;17(12):1726–33. DOI: http://dx.doi.org/10.1007/s00198-006-0172-4.&lt;/p&gt;&lt;p&gt;Haczynski J, Jakimiuk A. Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit. 2001;7(5):1108–17.&lt;/p&gt;&lt;p&gt;Лесняк ОМ, Беневоленская ЛИ, редакторы. Остеопороз. 2-е изд., перераб. и доп. Москва: ГЕОТАР-Медиа; 2009. 272 с. (Серия «Клинические рекомендации»). [Lesnyak OM, Benevolenskaya LI, editors. Osteoporoz. 2-e izd., pererab. i dop. Moskva: GEOTAR-Media; 2009. 272 s. (Seriya «Klinicheskie rekomendatsii»)].&lt;/p&gt;&lt;p&gt;Liu-Ambrose TY, Khan KM, Eng JJ, et al. Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass. Osteoporos Int. 2005;16(11):1321–9. DOI: http://dx.doi.org/10.1007/s00198-005-1842-3.&lt;/p&gt;&lt;p&gt;Bennell KL, Matthews B, Greig A, et al. 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J Clin Rehabilit Tiss Engin Res. 2007;11(45):9108–11.&lt;/p&gt;&lt;p&gt;Bergstrom I, Bergstrom K, Kronhed A, et al. Back extensor training increases muscle strength in postmenopausal women with osteoporosis, kyphosis and vertebral fractures. Advances in Physiotherapy. 2011;13(3):110–7. DOI: http://dx.doi.org/10.3109/14038196.2011.581696&lt;/p&gt;&lt;p&gt;Gold DT, Shipp KM, Pieper CF, et al. Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial. J Am Geriatr Soc. 2004 Sep;52(9):1471–8. DOI: http://dx.doi.org/10.1111/j.1532-5415.2004.52409.x.&lt;/p&gt;&lt;p&gt;Papaioannou A, Adachi JD, Winegard K, et al. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int. 2003;14(8):677–82. DOI: http://dx.doi.org/10.1007/s00198-003-1423-2.&lt;/p&gt;&lt;p&gt;Giangregorio LM, Macintyre NJ, Thabane L, et al. 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A randomized controlled trial of the effects of weight-bearing exercise and resistance training on risk factors for fracture in women with osteoporosis. Current research in osteoporosis and bone mineral measurement. London: British Institute of Radiology; 1998. 128 p.&lt;/p&gt;&lt;p&gt;Bautmans I, van Arken J, van Mackelenberg M, Mets T. Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med. 2010;42(2):129–35. DOI: 10.2340/16501977-0486.&lt;/p&gt;&lt;p&gt;Nguyen ND, Eisman JA, Center JR, Nguyen TV. Risk facrs for fracture in nonosteoporotic men and women. J Clin Endocrinol metab. 2007;92(3):955–62. DOI: http://dx.doi.org/10.1210/jc.2006-1476.&lt;/p&gt;&lt;p&gt;Kemmler W, von Stengel S, Bebenek M, et al. Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporos Int. 2012;23(4):1267–76. DOI: http://dx.doi.org/10.1007/s00198-011-1663-5.&lt;/p&gt;&lt;p&gt;Sinaki M, Mikkelsen BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil. 1984;65(10):593–6.&lt;/p&gt;&lt;p&gt;Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007146. DOI:10.1002/14651858.CD007146.pub2.&lt;/p&gt;&lt;/div&gt;&lt;br /&gt;</mixed-citation><mixed-citation xml:lang="en">&lt;div&gt;&lt;p&gt;Михайлов ЕЕ, Беневоленская ЛИ, Мылов НМ. Распространенность переломов позвоночника в популяционной выборке лиц 50 лет и старше. Вестник травматологии и ортопедии им. Н.Н. Приорова. 1997;(3):20–7. [Mikhailov EE, Benevolenskaya LI, Mylov NM. Rasprostranennost' perelomov pozvonochnika v populyatsionnoi vyborke lits 50 let i starshe. Vestnik travmatologii i ortopedii im. N.N. Priorova. 1997;(3):20–7.]&lt;/p&gt;&lt;p&gt;Евстигнеева ЛП, Лесняк ОМ, Пивень АИ. Эпидемиология остеопоротических переломов позвоночника по данным рентгеноморфометрического анализа среди популяционной выборки жителей г. Екатеринбурга 50 лет и старше. Остеопороз и остеопатии. 2001;(2):2–6. [Evstigneeva LP, Lesnyak OM, Piven' AI. Epidemiologiya osteoporoticheskikh perelomov pozvonochnika po dannym rentgenomorfometricheskogo analiza sredi populyatsionnoi vyborki zhitelei g. Ekaterinburga 50 let i starshe. Osteoporoz i osteopatii. 2001;(2):2–6.]&lt;/p&gt;&lt;p&gt;Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis Int. 2006;17(12):1726–33. DOI: http://dx.doi.org/10.1007/s00198-006-0172-4.&lt;/p&gt;&lt;p&gt;Haczynski J, Jakimiuk A. Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit. 2001;7(5):1108–17.&lt;/p&gt;&lt;p&gt;Лесняк ОМ, Беневоленская ЛИ, редакторы. Остеопороз. 2-е изд., перераб. и доп. Москва: ГЕОТАР-Медиа; 2009. 272 с. (Серия «Клинические рекомендации»). [Lesnyak OM, Benevolenskaya LI, editors. Osteoporoz. 2-e izd., pererab. i dop. Moskva: GEOTAR-Media; 2009. 272 s. (Seriya «Klinicheskie rekomendatsii»)].&lt;/p&gt;&lt;p&gt;Liu-Ambrose TY, Khan KM, Eng JJ, et al. Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass. Osteoporos Int. 2005;16(11):1321–9. DOI: http://dx.doi.org/10.1007/s00198-005-1842-3.&lt;/p&gt;&lt;p&gt;Bennell KL, Matthews B, Greig A, et al. Effects of an exercise and manual therapy program on physical impairments, function and qualityof-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord. 2010;17:11–36. DOI: 10.1186/1471-2474-11-36.&lt;/p&gt;&lt;p&gt;Bergland A, Thorsen H, Karesen R. Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial. Osteoporosis Int. 2011;22(6):1863–71. DOI: http://dx.doi.org/10.1007/s00198-010-1435-7.&lt;/p&gt;&lt;p&gt;Malmros B, Mortensen L, Jensen MB, Charles P. Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int. 1998;8(3):215–21. DOI: http://dx.doi.org/10.1007/s001980050057.&lt;/p&gt;&lt;p&gt;Yang L, He C, Lei Z, et al. Effect of pain-free exercises on female osteoporosis patients with spinal compressive fracture. J Clin Rehabilit Tiss Engin Res. 2007;11(45):9108–11.&lt;/p&gt;&lt;p&gt;Bergstrom I, Bergstrom K, Kronhed A, et al. Back extensor training increases muscle strength in postmenopausal women with osteoporosis, kyphosis and vertebral fractures. Advances in Physiotherapy. 2011;13(3):110–7. DOI: http://dx.doi.org/10.3109/14038196.2011.581696&lt;/p&gt;&lt;p&gt;Gold DT, Shipp KM, Pieper CF, et al. Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial. J Am Geriatr Soc. 2004 Sep;52(9):1471–8. DOI: http://dx.doi.org/10.1111/j.1532-5415.2004.52409.x.&lt;/p&gt;&lt;p&gt;Papaioannou A, Adachi JD, Winegard K, et al. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int. 2003;14(8):677–82. DOI: http://dx.doi.org/10.1007/s00198-003-1423-2.&lt;/p&gt;&lt;p&gt;Giangregorio LM, Macintyre NJ, Thabane L, et al. Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev. 2013 Jan 31;1:CD008618. DOI:10.1002/14651858.&lt;/p&gt;&lt;p&gt;Dusdal K, Grundmanis J, Luttin K, et al. Effects of therapeutic exercise for persons with osteoporotic vertebral fractures: a systematic review. Osteoporos Int. 2011;22(3):755-69. DOI: http://dx.doi.org/10.1007/s00198-010-1497-6.&lt;/p&gt;&lt;p&gt;Лесняк ОМ, редактор. Школа здоровья. Остеопороз. Руководство для врачей. Москва: ГЕОТАР-Медиа; 2008. 64 с. [Lesnyak OM, editor. 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