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Im Gegensatz zu gesunden Menschen reichen bei Patient*innen mit Osteoporose häufig schon Bagatellunfälle aus, damit ein Wirbelkörper frakturiert. Entscheidend für die Behandlung sind anschließend die Beschwerden, die Frakturform sowie die Fehlstellung. Sowohl in der konservativen Versorgung als auch postoperativ spielt Physiotherapie eine entscheidende Rolle.

Ob Traumata oder Osteoporose – die Ursachen von Wirbelkörperfrakturen sind vielfältig. So auch ihre Nachbehandlung. Nicht immer ist eine OP indiziert. Kommt es aber dazu, haben in der Physiotherapie Patientenedukation, Schulung von selbstständigen Transfers und die Aktivitäten des täglichen Lebens oberste Priorität.

GCH1 mutations have been linked to decreased striatal dopamine and development of dopa-responsive dystonia (DRD) and Parkinsonism. Sensory and sensorimotor integration impairments have been documented in various forms of dystonia. DRD patients with confirmed GCH1 mutations have demonstrated normal short-latency afferent inhibition (SAI), a measure of sensorimotor inhibition, under chronic dopaminergic replacement therapy (DRT), but reduced inhibition after a single l-dopa dose following 24 h withdrawal. Studies have revealed normal SAI in other forms of dystonia but reductions with DRT in Parkinson's disease. Longitudinal changes in sensorimotor inhibition are unknown.We analyzed sensorimotor inhibition using two different measures: SAI and somatosensory-motor inhibition using dual-site transcranial magnetic stimulation (ds-TMS). SAI was measured using digit stimulation 25 ms prior to contralateral primary motor cortex (M1) TMS. DS-TMS was measured using TMS over the somatosensory cortex 1 or 2.5 ms prior to ipsilateral M1 stimulation. A total of 20 GCH1 mutation carriers and 20 age-matched controls were included in the study. SAI and ds-TMS were evaluated in GCH1 mutation carriers both OFF and ON DRT compared to controls. Furthermore, longitudinal changes of SAI were examined in a subset of the same individuals that were measured ∼five years earlier.Neither SAI nor ds-TMS were significantly different in GCH1 mutation carriers relative to controls. No effects of DRT on SAI or ds-TMS were seen but SAI decreased over time in mutation carriers OFF DRT.Our longitudinal results suggest changes in SAI that could be associated with plasticity changes in sensorimotor networks.

Introduction: The exact evaluation of hip morphology is essential for surgical planning. A wide range of morphometric measures of the acetabulum is deduced from conventional anterior-posterior (ap) pelvic radiographs. Full-length weight-bearing radiographs (FLWBR) also depict the acetabulum and are commonly used for osteotomy planning of the lower limb. This study aimed to determine whether FLWBR can be used to evaluate acetabular morphology. Methods: Radiographs of patients receiving a hip workup that included a conventional ap pelvic X-ray and FLWBR were utilized for radiographic measurements. The following parameters were measured: extrusion index of the femoral head, anterior wall index, posterior wall index, lateral center edge angle (LCE), acetabular index, pubic arc angle (subpubic angle), and centrum-collum-diaphyseal angle (CCD). Results: FLWBR depicted a significantly reduced anterior coverage (p = 0.049) and increased posterior coverage (p p = 0.015), and higher pubic-arc angle (p = 0.02) compared to conventional ap pelvic radiographs. There were no significant differences regarding the CCD angle (p = 0.28), extrusion index (p = 0.31), and LCE (p = 0.16). Discussion: The CCD angle of the femur can be measured on conventional ap radiographs and full-length weight-bearing X-rays for lower limb deformity analysis. However, FLWBR will depict an anteverted acetabular morphology, rendering conventional ap radiographs necessary for planning pelvic osteotomies.