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The physiotherapy in patients with compression fractures in the lumbar spine area
LUKŠAN, Filip
This bachelor?s thesis focuses on physiotherapy of patients with compression fractures of the lumbar spine. Compression fractures of lumbar vertebrae are caused by excessive dynamic pressure on the lumbar spine. These fractures come about both by reason of direct causes such as falls from heights or injuries from automotive accidents. Osteoporosis is another aspect. It is a generalized skeletal disease which causes bone mass degradation and is therefore an indirect cause of compression fractures of the lumbar vertebrae. Women over 70 years of age are the most frequent sufferers. The aim of this bachelor?s thesis is to map out physiotherapy methods used in patients with compression fractures of the lumbar vertebrae. The paper is divided into two major sections: theoretical and practical. The theoretical section describes the anatomical structures concerned, osteoporosis types and diagnostics, types and causes of lumbar vertebrae injuries and their mechanism. A further focus is diagnosing these injuries and potential treatments, i.e., conservative and surgical. Physiotherapeutic methodologies which may be use for these conditions are the topic of another chapter in the theoretical section. They include the Vojta method, sensorimotor stimulation, proprioceptive neuromuscular stimulation, spinal exercises, large ball exercises, dynamic neuromuscular stabilization, school of the back and physical therapy. Using these physiotherapeutic methodologies can result in a reduction in pain, support of the healing process and improvement of the functional stability of the lumbar vertebrae. A total of four probands were selected for the practical section and divided into two groups: patients immediately after a fracture and patients in whom the healing has been completed. All the patients were treated conservatively, i.e., using the Jewett brace. The first group consisted of two patients hospitalized in the České Budějovice, a.s. hospital. I took their history and carried out input and output kinesiology analyses. The therapy took 3?4 weeks. Using the methodologies mapped out in the theoretical section, I prepared my own physiotherapeutic procedure governing the entire therapy period. In these patients, the focus was put on positioning in bed, using the Jewett brace, the proper walking stereotype while using the brace, achievement of self-sufficiency and independence in daily activities along with strengthening the muscle corset. This therapy helped the patients transfer to home care in the shortest time possible. The second group consisted of two patients whose fractures have been healed but continued to suffer from pain in the lumbar region. Here too, I took their history and carried out the input and output kinesiology analyses. The therapy took 3?4 weeks. It focused on the activation of the deep muscle and strengthening the surface muscle using the methods of the lumbar spine dynamic stabilization, exercise on a large ball, proprioception and learning the principles of taking care of one?s back. The contribution made by this bachelor?s thesis lies in mapping out the methodologies to be used for these conditions and preparing the author?s own physiotherapeutic procedure for these issues.
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