ROmedic Cabinete medicale Bucuresti Cabinete Recuperare medicală, kinetoterapie, fizioterapie, reabilitare Recuperare medicală, kinetoterapie, fizioterapie, reabilitare Bucuresti

The use of backbone functional proportionality indexes in the recovery from Lyme disease sequela

Vladimir Schor, Daniela Schor
SC.Medisport SRL, 824 B, Padurii St., Copaceni, Ilfov, Romania
vschor@medisport.ro, danielaschor@yahoo.com
Corina Țifrea
National University of Physical Education and Sport, Centre of Interdisciplinary Research,140 Constantin Noica St., Bucharest, Romania
c_tifrea@yahoo.com
Teodorescu Virgil
National University of Physical Education and Sport, Centre of Interdisciplinary Research,140 Constantin Noica St., Bucharest, Romania
anatrade_2004@yahoo.com

 

Abstract

In some of their previous works, the authors described and substantiated the method of spine functional proportionality indexes and its preventive value in cases of functional disorders of the spine. We intend to continue broadening the scope of this method, from prevention to pathology. This approach will be based, in part, on a series of case studies, looking at the effects generated by the application of the method in pathology.

We will present a case study in which the patient has sequelae of the Lyme disease particularly in the posture and in the neuromuscular control of movement. An initial assessment and two interim assessments were conducted, using the method of indexes of muscular and articular functional proportionality of the spine and computerized somatoscopic examination. The recovery protocol consisted in control exercises with visual feedback on force-amplitude curves, within 20 sessions, aimed at rebuilding the agonists-antagonists coordination by muscle groups and chains responsible for overall body posture, and the enforcement of the strength-increasing method by movement control exercises for deficient groups and chains of muscles.

The results highlight the improvement of the overall body posture, and the tendency to optimize the indexes of muscular and articular functional proportionality of the spine, giving us hope that the extension of the method from prevention to pathology is likely to be done successfully.

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Keywords: spine treatment; Lime disease; functional proportionality;

 

In papers (1), (2), (3) we have presented and substantiated the backbone functional proportionality index method and its use in backbone functional afflictions, for preventive purposes. We further want to extend the method’s applicability field from the field of prevention to that of pathology. This endeavor will be based on a number of case studies, following the effects of the method being applied in pathology.

Within this context, we would like to present a case study, where the patient suffers from Lyme disease sequela on the level of posture and neuromuscular movement control. An initial evaluation has been made, and then two subsequent intermediary evaluations using the muscular-articular backbone proportionality index method and computerized somatoscopy.

The recovery protocol applied involved visual feedback on amplitude force curves 20 sessions, aiming at the recovery of agonist antagonist cooperation and muscular chains responsible for global body posture, and the applying of the method to increase force through movement control exercises on deficient muscular groups and chains.

The results indicate the improvement of global posture improvement and the tendency to improve the muscle-articular functional proportionality, allowing us to hope that the extension of the method from the field of prevention into that of pathology has good chances to be a successful one.

 

1. In papers (1), (2), (3) we have presented and substantiated the backbone functional proportionality index method and its use in backbone functional afflictions, for preventive purposes. With the current study we aim to evaluate the possibilities of the method in case of an affliction with complex manifestations – Lyme disease. The initial picture, in the present case is characterized by neurological symptomatology that has affected the balance, walk pattern, general movement control and low values of muscular force agonist- antagonist unbalanced. The hypothesis of the paper is that in this pathological situation as well, the use of the visual feedback on rectangular force –amplitude model allows the agonist – antagonist cooperation and force improvement, with effect on the muscular-articular balance of the backbone, visible in the posture and in the clinical observation of walk pattern.

 

2. Description of patient state from the clinic and functional point of view:

Age: 30 years old, sex: male, diagnosis: Lyme disease

From the point of view of clinical signs, the patient presents: muscular cramps on the calf, muscular fatigue, accentuated on the thigh flexors during the walking efforts, walking hesitation while supporting the weight on one foot, jerky walking with large support base and reduced one-foot standing time.

 

3. We have carried out the following measurements: balance time on standing on one foot, forces, amptitudes and mechanic work on body support muscles, computarized somatoscopic examination and stabilometry, using equipment belonging to Medisport and UNEFS.

 

4. Results

 

4.1.The results of the computerized somatoscopy test

From the front:

right shoulder slightly lowered and anteriorly rotatede

left shoulder slightly elevated

right hip slightly lowered

left hip slightly elevated

from the side:

abdominal hypotonia with the accentuation of lumbar curvature

CGG (general balance) projection, 11 cm anterior in comparison to normal

From the black:

normally positioned left sholder blade

right shoulder slightly lowered and anteriorly rotated

left shoulder slightly elevated

right hip slightly lowered

left hip slightly elevated.

 

4.2. Computerized functional diagnosis.

In Table 1 you can see the results of the muscular-articular computerized measurements regarding backbone muscular support. We would also like to mention that the movements were performed with difficulty, jerkily, which is characteristic for the sequelar neurologic effect of the affliction.

Table 1. Initial muscular-articular evaluation (3.02.2014):

Tested segment

F(daN)

L(cm)

Lm(J)

Directly – abdominal

Indirectly - lumbar

5.5

26

14.47

Directly- ½ anterior scapular belt, anterior thorax.

Indirectly – front and back muscles of the body – sitting position

9.31

49

45.45

Directly- posterior scapular belt ½

Indirectly – front and back muscles of the body – from the sitting position.

8.47

39

32.85

 

5. Means and methods used in recovery

We have made 2 series of 10 kinetotherapy sessions including movement control exercises with visual curved on force – amplitude curves on an ErgoControl type system and walking exercises where stressed was laid on the improvement of balance on standing on one foot.

 

6. Results after 20 recovery sessions

The results of the intermediary evaluations show the progressive improvement of measured parameters as can be seen in tables 2 and 3.

 

Table 2. muscle –articular intermediary evaluation (27.02.2014):

Tested segment

F(daN)

L(cm)

Lm(J)

Directly – abdominal

Indirectly – lumbar

15.6

41

64.93

Directly- anterior scapular belt ½, anterior thorax

Indirectly – posterior body muscle

181

61

110.29

Directly- body posterior scapular belt ½

Indirectly – posterior body muscles

179

58

104.37

 

Table 3.Intermediary muscular-articular evaluation (26.03.2014):

Tested segment

F(daN)

L(cm)

Lm(J)

Directly – abdominal

Indirectly - lumbar

20.8

49

103.5

Directly- anterior scapular belt ½, anterior thorax

Indirectly – body’s posterior musculature

21.5

66

140.7

Directly- body’s posterior scapular belt ½

Indirectly – body’s posterior muscles

213

56

118.2

 

Evolution of somatic functional evolution of the body

Table 4. segmentary – intersegmentary muscular – articular functional proportionality ratio

Segmentary and intersegmentary report

Optimal values

Optimal values

3.02.2014

Personal values

27.02.2014

Personal values

26.03.2014

Anterior-posterior thorax

0.85 - 0.95

0.73

0.94

0.84

Thorax – lumbar

0.85 – 0.95

0.31

0.59

0.73

 

Risk scale and pathology and backbone accident

<0.50 = high risk

0.50-0.75 = average risk

0.75-0.95 = low rsk

 

Initial personal level

Lumbar – high

Anterior- posterior thorax– average

 

After 2 series of 10 recovery meetings, through kinetotherapy and backbone level accident, the improvements were the following:

 

lumbar – average

anterior-posterior thorax – low

 

These results can also be found on the level of body where considerable improvements can be observed, especially in case of CGG projection (see image 1)

 

Click pentru a mări imaginea

Image 1. Scheme of global body posture (seen from the side) – superimposition at the initial and final stage.

 

7. Conclusions

 

7.1 After 2 series of 10 kinetotherapy meetings, we notice:

  • Increase of muscular force and amplitude on the level of anterior and posterior scapular belt ½ .

  • Abdominal muscles require force increase to continue the increase of balance and support of backbone;

  • the tendency is to balance the muscular-articular functional proportionality ratios from 0.73 – 0. 84 for the thorax area and from 0.31 – 0.73 for the thorax-lumbar index, framing ….

  • Improvement of one-leg standing with eyes opened from 0 to 21 and then 30 seconds;

  • Clinically, we have observed walk correction, from a jerky-type, unsecure waling to one-foot support, with large support area and low standing time on one foot, to a secure, flowing walk;

  • At the computerized somatoscopic evaluation we have observed the improvemen of body global posture with CGG projection only 5 cm in comparison to 11 cm at the initial time.

 

7.2. We can conclude that the use of the backbone functional proportionality index method and the visual feedback working methods on rectangular force-amplitude angle in the recovery of Lyme disease sequella, allows the improvement of antagonist –antagonist cooperation and force development with effects on backbone muscular-articular functional balance, also visible in posture and in the clinical observations regarding walking pattern.

 

 

8. Bibliography

[1] Schor, D., 2012. Computerized Biomechanical Optimization and Diagnosis of the standing-movement function of the backbone. Thesis, UNEFS, Bucharest

[2] Schor, V., Schor, D., 2002. Post-traumatic Antalgic Muscular Remission through Movement Control Exercises, International Scientific Conference, A.N.E.F.S., June

[3] Schor V., Schor, D., 2002. Maximum Force Increase through Movement Control Exercises. International Scientific Conference, A.N.E.F.S., June

 
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