Trunk extension weakness

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Trunk extension weakness - June 16, 2008 2:57:45 PM

buckeye

Posts: 175
Joined: May 24, 2007
Status: offline

Chief complaint is being unable to stand or sit upright due to fatigue. 91 years old but very active and lives alone. Osteoporosis - on medication for many years. No reported spine compression fractures. No pain complaints. Just unable to maintain upright posture for more than about 30 seconds. Gait with with one hand on same side thigh to help maintain upright posture. Extremity strengths are functional for age and symmetrical. Able to get to 'neutral' posture sitting or standing but only for very brief period of time. This is a gradual onset of several years according to the patient but history of several falls in recent weeks.

Is there some disease process that may be causing this weakness? Or is this most likely just deconditioning? Any special tests - lab, examination, etc? Medical history includes osteopenia/osteoporosis, asthma/COPD, and arthritis.

Thanks

Post #: 1

RE: Trunk extension weakness - June 16, 2008 8:53:37 PM

Sebastian Asselbergs

Posts: 1211
Joined: September 29, 1999
From: Barrie, Canada
Status: offline

Just a wild guess really: but my bet is that there is a increasing fear of loss of balance at that age (especially when they know they have osteoporosis); a spinal (pelvis/hips) forward bend comes into play and before a few years have passed, the body is so used to "hangin' in the ligaments" that the spinal erectors are just pooped at the least bit of effort....
I bet that education and easy daily repetitive extension may help. Then again - this may simply be all for him.

_____________________________

Mundi vult decipi

(in reply to buckeye)

Post #: 2

RE: Trunk extension weakness - June 17, 2008 7:49:14 AM

buckeye

Posts: 175
Joined: May 24, 2007
Status: offline

Thanks Sebastian,

Treatment design is education and muscle strength/endurance. My initial impression is the same - just concerned there is something that is being missed.

(in reply to Sebastian Asselbergs)

Post #: 3

RE: Trunk extension weakness - June 17, 2008 11:42:20 AM

Sebastian Asselbergs

Posts: 1211
Joined: September 29, 1999
From: Barrie, Canada
Status: offline

Hey, you're welcome! I hope that someone would point out to IF we are missing something - I am getting more and more over 80 patients....

_____________________________

Mundi vult decipi

(in reply to buckeye)

Post #: 4