CLINICAL EXAMPLES OF REHABILITATION OF DISORDERS OF THE MUSCLE-MUSCLE SYSTEM IN PATIENTS WITH OBESITY
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14321Keywords:
rehabilitation, lumbar spine, knee joint, pain, adiposityAbstract
SUMMARY. All over the world, the number of people who are obese and overweight has been increasing in recent years. Obesity increases the risk of lower back diseases. Obese people feel significantly more stress on the spine compared to people of normal weight during exercise.
The aim – to identify the peculiarities of disorders of the lumbar spine in obese persons and to carry out correction of the detected disorders in them.
Material and Methods. Body weight correction was carried out in 3 obese patients with pain in the knee joints who consulted a nutritionist.
Results. Patient K., 39 years old, has obesity of the first degree. The patient complains of pain in the knees, which she associates with excess body weight. The results of computed tomography indicate the presence of Schmorl's hernias at the level of Th12-S1, protrusions of the intervertebral discs L2-L4, L5-S1, herniation of the intervertebral disc L4-L5, retrolisthesis of the L3 body of the 1st century, antelisthesis of the L5 body of the 1st century. Body weight correction was started (in a month it decreased by 6.5 kg). The state of health has improved, the pains in the knee joints have decreased.
Patient B., 58 years old, 3rd degree obesity. Two years ago, the pain in the right knee joint increased. The diagnosis was made: Deforming arthrosis of both knee joints III-IV century. (medial), patellofemoral arthrosis of the II-III century. both knee joints, slight synovitis of both knee joints. Conservative treatment was prescribed, which proved ineffective. In 2021, operative treatment was carried out - primary total endoprosthesis of the right knee joint. It is recommended to reduce body weight. To date, the patient has reduced her body weight by 38 kg (31.6 %). There is no pain in the knee joints.
Patient P., 61 years old, 3rd degree obesity. Pains in the lumbar region of the spine and the left hip joint are disturbing. In 1 month after treatment with a nutritionist, body weight decreased by 8 kg. Pain in the lumbar spine and left hip joint decreased. In February 2023, an operation was performed: Total cementless arthroplasty of the right hip joint, De-puy Synthes arthroplasty. After the operation, the patient gained back his body weight. Pains in the joints and lumbar spine continue to bother.
Conclusion. Obese people who have pain in the knee or hip joints should have a computed tomography or magnetic resonance imaging of the lumbosacral spine. Treatment should begin after consultation with a dietician or nutritionist with a mandatory correction of body weight.
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