student
Tula, Russian Federation
UDC 61
The article presents a clinical case of a 68-year-old patient with a polymorbid profile, including type 2 diabetes mellitus in the stage of subcompensation with distal polyneuropathy, postmenopausal osteoporosis, osteoarthritis of the knee joints, and arterial hypertension with signs of target organ damage. The referral was caused by the development of acute back pain syndrome against the background of minimal trauma. At the examination, a compression fracture of the body of Th12 vertebra against the background of osteoporosis was verified. A comprehensive interdisciplinary approach to patient management is described, including the correction of antidiabetic and antihypertensive therapy, the initiation of specific anti-osteoporotic therapy, and a step-by-step rehabilitation program of physical therapy. Special attention is paid to the role of controlled increase in physical activity as a central element that allowed breaking the vicious circle of "pain-hypodynamia-progression of diseases." Diagnostic difficulties and shortcomings of previously provided care are considered.
polymorbidity, type 2 diabetes mellitus, osteoporosis, spinal compression fracture, arterial hypertension, therapeutic physical training.
1. Tkacheva O.N., Kotovskaya Yu.V., Runihina N.K. i dr. Klinicheskie rekomendacii "Starcheskaya asteniya". Rossiyskiy zhurnal geriatricheskoy mediciny. 2020;(1):11-46. DOI:https://doi.org/10.37586/2686-8636-1-2020-11-46
2. Safonova Yu.A., Zotkin E.G., Toropcova N.V. Kachestvo zhizni i sindrom ustalosti u pozhilyh pacientov s sarkopeniey. Sovremennaya revmatologiya. 2021;15(6):41-47. DOI:https://doi.org/10.14412/1996-7012-2021-6-41-47
3. Curtis E., Litwic A., Cooper C., Dennison E. Determinants of Muscle and Bone Aging. J Cell Physiol. 2015;230(11):2618-2625. DOI:https://doi.org/10.1002/jcp.25001
4. Ivannikova E.V., Dudinskaya E.N., Onuchina Yu.S. Metabolizm myshechnoy tkani u lic pozhilogo vozrasta. Rossiyskiy zhurnal geriatricheskoy mediciny. 2022;(2):96-102. DOI:https://doi.org/10.37586/2686-8636-2-2022-96-102
5. Clynes M.A., Gregson C.L., Bruyère O., Cooper C., Dennison E.M. Osteosarcopenia: where osteoporosis and sarcopenia collide. Rheumatology (Oxford). 2021;60(2):529-537. DOI:https://doi.org/10.1093/rheumatology/keaa755
6. Naumov A.V., Hovasova N.O., Moroz V.I. i dr. Lokomotivnyy sindrom: novoe predstavlenie o hrupkosti v pozhilom vozraste. Rossiyskiy zhurnal geriatricheskoy mediciny. 2021;(3):372-378. DOI:https://doi.org/10.37586/2686-8636-3-2021-364-370
7. Onuchina Yu.S., Gur'eva I.V. Vzaimosvyaz' sarkopenii i saharnogo diabeta tipa 2. Endokrinologiya: novosti, mneniya, obuchenie. 2018;7(4):32-41. DOI:https://doi.org/10.24411/2304-9529-2018-14004
8. Benavent-Caballer V., Rosado-Calatayud P., Segura-Ortí E., Amer-Cuenca J.J., Lisón J.F. Effects of three different low-intensity exercise interventions on physical performance, muscle CSA and activities of daily living: a randomized controlled trial. Exp Gerontol. 2014;58:159-165. DOI:https://doi.org/10.1016/j.exger.2014.08.004
9. Dawson A., Dennison E. Measuring the musculoskeletal aging phenotype. Maturitas. 2016;93:13-17. DOI:https://doi.org/10.1016/j.maturitas.2016.04.014
10. Edwards M.H., Dennison E.M., Aihie Sayer A., Fielding R., Cooper C. Osteoporosis and sarcopenia in older age. Bone. 2015;80:126-130. DOI:https://doi.org/10.1016/j.bone.2015.04.016
11. Merchant R.A., Morley J.E., Izquierdo M. Editorial: Exercise, Aging and Frailty: Guidelines for Increasing Function. J Nutr Health Aging. 2021;25(4):405-409. DOI:https://doi.org/10.1007/s12603-021-1590-x
12. Pasco J.A., Mohebbi M., Holloway K.L., Brennan-Olsen S.L., Hyde N.K., Kotowicz M.A. Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study. J Cachexia Sarcopenia Muscle. 2017;8(3):482-489. DOI:https://doi.org/10.1002/jcsm.12177
13. Kurmaev D.P., Bulgakova S.V., Zaharova N.O. Bioimpedansnyy analiz sostava tela i fazovyy ugol v diagnostike sarkopenii i starcheskoy astenii (obzor literatury). Uspehi gerontologii. 2022;35(2):294-301. DOI:https://doi.org/10.34922/AE.2022.35.2.014
14. Isaeva B.I., Alieva-Harharova K.M. Osteosarkopeniya kak sputnik stareniya. Medicinskiy sovet. 2023;17(9):130-136. DOI:https://doi.org/10.21518/ms2023-147
15. Yoshimura N., Muraki S., Iidaka T., et al. Prevalence and coexistence of locomotive syndrome, sarcopenia, and frailty: the third survey of Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study. J Bone Miner Metab. 2019;37(6):1058-1066. DOI:https://doi.org/10.1007/s00774-019-01012-0
16. Rodrigues F., Domingos C., Monteiro D., Morouço P. A Review on Aging, Sarcopenia, Falls, and Resistance Training in Community-Dwelling Older Adults. Int J Environ Res Public Health. 2022;19(2):874. Published 2022 Jan 13. DOI:https://doi.org/10.3390/ijerph19020874
