Exercise therapy for compression fracture of the thoracic spine: description of exercises, performance features

Exercise therapy for compression fracture of the thoracic spine is the main part of the treatment of this injury, all subspecies of which, marginal or compression, are among the most complex types of damage to the structures of the musculoskeletal system.

Therapeutic procedures of exercise therapy begin after a compression fracture of the thoracic spine from the second day after providing assistance, which in most cases is a prolonged skeletal traction after paravertebral blockade. For a complete recovery of the body after such an injury, approximately 12-18 months are needed.

In 90% of cases of fractures of this type, compression fractures of 9-11 vertebrae occur. They get similar damage when falling from a height, with unsuccessful landings on the buttocks and legs. The cause of the fracture can also be a strong direct blow to the back in the area below the shoulder blades.

Often there is also a lumbar spinal fracture, which is treated identically to a thoracic fracture. Recovery techniques are similar in both cases.

Forms

Is exercise therapy performed for compression fracture of the spine in children?

Physical education methods for treating adults and children are no different from each other. The described techniques are performed by patients of all age categories. At different periods of therapy for these injuries, the following forms of exercise therapy are used:

• dynamic and static exercises designed for bed rest;
• breathing exercises;
• independent performance of gymnastic complexes of an individual orientation;
• morning work-out;
• gymnastic training, for example, using certain devices and objects, in the gymnastics hall under the guidance of a specialist;
• short walks, health path, dosed walking;
• exercises in the gym;
• dosed swimming;
• occupations with permitted varieties of applied sports.

The physical therapy instructor or attending physician is obliged to draw up special sets of exercises, taking into account the individual characteristics of the patient’s injury and body, to train independently and correctly perform the permitted exercises, to warn about contraindications and prohibitions. The patient, in turn, must follow these recommendations, and if unwanted symptoms of exercise therapy appear during a compression fracture of the spine (in the 2nd rehabilitation period), consult a treating specialist.

The price of failure to comply with the prescribed therapy movements, excessive or insufficient physical activity, the implementation of prohibited movements or exercises - an increase in the rehabilitation period and the occurrence of various complications. These are neurological disorders, narrowing of the spinal canal, kyphosis, and vertebral instability.

Principles and Rules

Exercise exercises for compression fracture of the thoracic spine should be carried out in compliance with the following rules:

1. For each period of therapy, there is a selection of forms of exercise therapy.
2. Classes should be held daily. The only exceptions are those days when the patient has pain or is feeling ill again. However, despite this, even in the first period of rehabilitation therapy, breathing exercises, in particular abdominal breathing, as well as exercises for the feet and joints of the hands, must be performed at least 3 times a day
3. The systematic nature of the classes, which suggests that the exercises should be complicated gradually, according to the principle from simple to complex, from a small number of repetitions to significant ones. In addition, the diversity and intensity of physical activity gradually increase over the course of one day.
4. The effectiveness of exercise therapy for compression fracture of the spine is possible only with an active attitude to the patient's loads. Therefore, the attending physician must draw up an individual lesson plan, clearly show and explain how a certain movement is performed, and also explain how the acceleration of restoration of impaired functions should occur.
5. The initial positions of exercise therapy are lying on the stomach, lying on the back, reclining, on all fours (knee-carpal and knee-elbow rests), standing in the main stance, kneeling.
6. When a pain syndrome occurs, the exercises should be stopped, while the specialist analyzes the causes in connection with which pain has arisen. Next, you need to make certain adjustments, for example, to teach the patient the correct movement, reduce the frequency of the exercise, cancel the exercise altogether.

Any type of exercise therapy for compression fracture of the thoracic spine should not practice jumping, sitting exercises, jumping, long running, especially slow.

Respiratory exercise therapy

Respiratory gymnastics is the first stage of exercise therapy after a fracture of the spine in the thoracic region. In the first few days, only diaphragmatic breathing is carried out 5-6 times for 5 minutes. Further, the duration of the exercise increases to 7 minutes, and chest breathing is introduced into the respiratory complex, in combination with raising the knees alternately, and complete breathing with a strong exhalation.

Joint gymnastics

This type of exercise therapy for compression fracture of the lumbar spine or thoracic spine is performed 3 times a day. The repetition of each exercise starts from 4 times and then gradually increases to 10. The complex of such classes includes the following:

• for hands and fingers;
• for toes and feet;
• slow bending of the arms at the elbows, without lifting them from the bed (possibly heavier);
• alternating and simultaneous raising of the legs with an increase in amplitude to an angle of 45 degrees;
• simultaneous and alternate bending of the legs in the knee joints;
• abduction towards straight legs;
• breeding of the knees to the sides (the legs are bent and the feet rest on the bed).

During traction, pronation of the arms and other exercises for the shoulder joints are prohibited, and special attention should be paid to this.

Tasks of exercise therapy at the initial stage of recovery

After the patient is allowed to turn on his stomach, and until the moment when he is allowed to get up and walk, exercise therapy solves the following problems:

• strengthening the muscular corset of the body;
• restoration and development of elasticity of ligaments, fascia and tendons;
• preparing the body to strengthen the motor regime.

Respiratory gymnastics as an independent form of health-improving physical education is canceled, however, such exercises are included in a special gymnastic complex, which should be performed first 5-6 times a day for 20-25 minutes with such a frequency of repetition of exercises: dynamic - 6 times, respiratory - 3 times static - 4 times.

Further, the number of classes decreases, but their duration increases to 40 minutes, and the number of repetitions of dynamic classes increases to 12, static - to 6. At the same time, one movement is added to the recovery complex every day.

Below will be considered specific exercises and features of their implementation.

What else is used in exercise therapy after compression fracture of the spine?

Flexion and extension of the arms

Lying on his back, placing a roller under the lower back and under the neck, the patient takes a breath, slowly bends his elbows, puts his hands on his shoulders. Focusing on the exhale, you need to stretch your arms up, palms looking at each other. On an accentuated exhalation, the arms are spread apart. Then you should take a new breath and return the limbs to their original position. Gently extend your elbows and put your hands along the body, palms down.

Place your hands under the back of your head

The starting position for this lesson is lying on your back, legs bent at the knees. Taking a deep breath, spread your arms to the sides. Then, breath should be held and hands slowly laid behind the head. Next, a smooth, prolonged exhalation is made, the hands also smoothly return to the body position, passing through the sides. This lesson can be complicated by leg extension alternately.

Exercise therapy for compression fracture of the thoracic spine should be carried out very carefully.

Muscle tension

In accordance with the technique of turning on the stomach during fractures of the thoracic spine, it is necessary to carefully take the initial position - lying on the stomach with straightened arms extended forward, rest your toes against the back of the bed. Next, a breath is taken, the forehead comes off the bed and all the muscles of the body tighten for 10 seconds. After this, you should exhale, lowering your forehead, straightening your feet, and lie down, breathing quietly, 15 seconds, completely relaxing all muscle groups.

Dynamic exercises on the stomach

This dynamic exercise involves performing in two steps. Raising his head, the patient simultaneously raises his arm and leg on opposite sides of the body. After making 14 smooth movements with a small amplitude and an average pace, you should rest 5-10 seconds, and then perform another 6-8 movements at a slow pace, but with the greatest amplitude. Repeating this lesson is recommended in two cycles of 1-4 times.

Exercise therapy for compression fracture of the thoracic spine can be very effective.

"Scissors"

Everyone needs to perform the familiar exercise, both increasing the number of movements, and increasing the number of approaches between which you need to pause rest.

Perform the exercise “scissors” on the abdomen with his hands under his head, and first you need to lie with your hands along the body (palms down) and turning your head to the side. This lesson is conducted under the supervision of a doctor and only with his permission. Gymnastic activities should alternate in the following sequence: 2 dynamic - 1-2 static exercises - 1 respiratory.

How is exercise therapy performed with a compression fracture of the lumbar and thoracic spine?

In the late stages of rehabilitation

At the later stages of the recovery process after an injury, the range of activities expands significantly, and they begin to do this by turning on the movements on the all fours.

After 2 months from the moment of trauma, the patient is transferred to half-bed, and then to free mode. A complex of morning exercises should be compiled for him. Exercise therapy at such a fracture is carried out in full only on this period, in stationary conditions - 1 time per day, lasting from 45 to 60 minutes.

In addition, once a day a lesson is held in a specialized gymnastics room, where the doctor uses all available sports medical objects, mechanisms, devices and trainers to train the muscle frame.

The main objectives of exercise therapy for compression fracture of the lumbar spine at this stage of therapy are to prevent the development of posture disorders, increase the reactivity of the whole organism and complete restoration of all functions of the spinal column.

Each patient has a separate comprehensive rehabilitation plan, which includes:

• exercises in the gym;
• walks, dosed walking classes, therapeutic walking on a step platform, stairs or a health path;
• training schemes for dosed swimming.

Basic exercises in the late rehabilitation phase

The main exercises of the exercise therapy complex for compression fracture of the spine, which are carried out in the late rehabilitation period, include the following:

• diaphragmatic breathing;
• abduction, bringing up the straight leg (harness is used as a load);
• bending the arms at the elbows with a load of up to 4 kg;
• pelvic lift, emphasis - on the feet and shoulder blades (with resistance);
• synchronous raising of the lower extremities;
• raising the shoulders and head;
• pulling the leg back;
• raising the head and shoulders with simultaneous lifting of the legs for a couple of minutes;
• rolls on the toe from the heel (standing);
• tilts back;
• muscle tension
• half squat with a load of 5-6 kg on toes.

The effectiveness of exercise therapy

In order to assess the effectiveness of exercise therapy after compression fracture of the lumbar spine, as well as the thoracic, a number of control measures are carried out:

1. To assess the recovery of the back muscle system, the time during which a person is able to stay in the swallow position is measured. At the same time, in a prone position, arms are spread apart, shoulders, head and legs rise. The results are considered positive if the patient lasted at least 2 minutes.
2. To assess the muscular system of the abdomen, the patient lying on his back needs to hold his lower limbs at an angle of 45 degrees. The result is considered acceptable if the retention interval is at least 2 minutes.
3. At the end of 3 months of therapy, a test is performed, during which the patient must walk for two hours. If during this period of time he did not feel deterioration, he is allowed to sit down.
4. At the end of 4 months, an X-ray and clinical examination is carried out, according to the results of which the general condition of the spinal column is evaluated.

Contraindications

Exercise therapy is contraindicated in such cases:

• regular pain that intensifies after exercise;
• severe condition of the patient;
• with an increase in body temperature;
• violation of the normal level of blood pressure;
• the presence of neurological symptoms;
• intestinal obstruction of the paralytic type.

Compression fracture of the spine is a very serious type of injury, which means that the treatment process should be taken seriously. The list of exercise therapy methods for each stage of recovery should be made only by a specialist, based on the physical condition of the patient and on the severity of the injury.