Seventy-six patients with osteoarticular tuberculosis were divided into two groups, one of which was required to maintain strict bed rest and the other of which was allowed unrestricted motor activity. A study of blood electrolyte composition in the two groups revealed that bed rest for these patients results in decreased plasma potassium calcium, and magnesium content, but that these indices improved after the patients were allowed to move freely. The study suggests that patients with osteoarticular tuberculosis who are on bed rest be carefully observed for alterations in blood electrolytes and that proper electrolyte balance be maintained

Zakutaeva, V. P.

English

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^	 IAN 1081
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STRATIO`
BER 1980
I
.ASA TECili4ICAL 3EMORANDUM
	 tiASA TM-76325
r
EFFECT OF LONG-TERM HYPOKI:4ESIA OH THE ELECTROLYTIC COMPOSITION OF
THE BLOOD IN PATIENTS WITI: OS TILOARTICULAR TUBERCULOSIS
V. P. Zakutaeva
(NA5A-1m-7bs25) EFFECT UP LONG-TEhl1	 N61-15bdU
HY ►'UKINESiA ON THL ELECT10 t1..VT1 C CuMPUSITIUN
OF Til l; dLUUU IN PATIENTS 111TH USILUAUTILULAa
r013EbiCULUSIS (Natiutidl AeLWAduticS dnU Sl.I"	 Uaclas
AdaiaistI:d tiou) 7 P uC AU1 1nF Au1 CSLL UbV 65/52 29671
Translation of "Vliyanie dlitel'noy gipokinezii u bol'nyk:1 kostno-
sustavn;m, tuberkulezom na elektrolitnyy sostav krovi", Zdravoo"chran-
enie Kirgizii, 2io. 3, May-June 1 979, pp. 32-35
— A "
NASA TECHNICAL MEMORANDUM
	
NASA TM-76325
EFFECT OF LONG-TER14 HYPOKINESIA ON THE ELECTROLYTIC COMPOSITION OF
THE BLOOD IN PATIENTS WITH OSTEOARTICULAR TUBERCULOSIS
V. P. Zakutaeva
a
N81-156 50
(NASA—T14-76325) EFFECT OF LONG—TERK
1	 HYPOKINESIA ON THE ELECTROLYTIC COMPOSITION
OF THE BLOOD IN PATIENTS NZTH OSTBOARTICULAR
TUBERCULOSIS (National Aeronautics and Space
Administration) 7 p HC A02/MF AU1 CSCL 06P G5/52
Unclas
29671
Translation of "Vliyanie dlitel'noy gipokinezii u bol'nykh kostno-
sustavnym tuberkulezom na elektrolitnyy sostav krovi", Zdravoo',thran-
enie Kirgizii, No. 3, May-June 1973, pp. 32-35
L 4 ,- _	 V/l a
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NATIONAL AER014AUTICS AND SPACE ADMINISTRATION
	
sgASHINGTON, D.C. 20346	 SEPTE14BER 1980
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STANDAR6 TITLE PAGE
1. top•rt Me. 2. „Government Accession No. ?, Recipient's Catalog No,
IN
d. Title and Subtitle EFFECT OF LONG-TERI~I HYPO-
S. Report Dote
IiINHSIA ON THE ELECTROLYTIC COMPOSITION d, Performing drgenisetion Eerie
OT' THE BLOOD IN PATIENTS WITH 0STh'O-
ut • 0. Performing orgenlaatlen Report No.
V. P.	 Zakutaeva	 1	 10. K'n►1t Unit No.
0.	 Performing Org anisation Name end Addrtss	 1111. Contract •r Grant No.
Ldo Kanner Associates 	 13,
^w-3199
Type of Roper# and Period coverert
Redwood City, California 99063
Trans lation12. Sponsoring Agency None end Address'
Rational Aeronautics and Space Admini- 14, Sponsoring Agency Code
stration	 Wash ington.- D.C.
IS, Supploeentary Nero•
Translation"of "Vliyanie dlitel'noy gipokinezii a bol'nykh
kostno-sustavnym tuberkulezom na elektrolitnyy sostav
- %rovi", `
 Zdravookhranenie Kirgizii, No. 3, May-June 1978,
pp.	 32-35
Id,	 Abstr4wt
76 patients with osteoarticular tuberculosis were divided
into'two groups, one of which was required to maintain strict
bed rest and the other of which was allowed unrestricted motor
activity..	 A study `.of blood electrolyte composition in the
two groups revealed that -bed rest for these patients results
in decreased plasma'potassiu4 calcium, apd magnesium content,
but that these i.ndides improved after the patients were
allowed to move freely. 	 The study suggests that patients
with os •teoarticular;tuberculosis who are on bed rest be
carefully observed for alterations in 'blobd electrolytes and
that proper electrolyte balance , be maintained..
17. Key Werds (Selected by Author($)) 111.	 Distribution 51014mont
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license from VAAP, the Soviet c
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ErrECT OF LONG-TERM HYPO INESIA ON THE ELECTROLYTIC COMPOSITION Or
THE BLOOD IN PATIENTS WITH OSTEOARTIC:ULAR TUB"3RCULOSIS
V. P. Zakutaeva
Kirgiz Scientific Research Institute of Tuberculosis
The hypokinetic syndrome is a complex body state characterized 02*
by functional deconditioning of various organs and systems due to
prolonged restriction of motor functioning. Besides the cardio-
vascular system, which sharply reduces its activity during hypokinesia,
(V. V. Parin, w M. Bayevskiy, 0. G. Gazenko, 1965; V. S. Georgiyevskiy,
V. M. Mikhaylov 1969; L. A. Ioffe, 1971; V. P. Zakutayeva, 14. 1.
Matiks, 1975; etc.), a muscle activity defictt affects the functions
of respiration and Metabolism, (M. I. Milchasev at al., 1969; L. 1.
Cakurin et a1., 1970, etc.) and decreases the body's immunobiological
reactivity, (P. A. 5orokin, eft al., 1969; P. G. Petrova, 1971;
etc.) . Research done by _-n any authors has discovIered disordered
protein,vitamin, hormone„ and enzyme balances in the Duman body
during restricted physical activity, (P. A. Orlova, 1959; M. S.
Seregin et ate.., 1959; A. S. Vittol.o, A. S. Ushakov, 1470; Ye.
Simonov, 1. V. Fedorov, 1970; etc.) . Dra, ,aatic shuts in electrolyte
metabolism have been found in Cosmonauts exercising limited muscle
activity within the confines of space craft and in healthy persons
restricted to bedrest in simulation experiments. A distinct
tendency towards reduced blood plasma potassium content was shown
by the end of sixty days of hypodynamia, (1. I. Ivanov et al., 1959).
Bone decalcification accompanied by calciuria has been noted in
Cosmonauts and in experimental animals subjected to irmobilization,
(B. B. Yegorov et a1., 1969; Zawton, 1962; M.etlein, 1964; etc)
However, the status of electrolyte metabolism during prolonged
hypokinesia attending the bedrest necessitated by various pathological
body conditions, (myocardial infarction, paralysis, and locomotor
apparatus diseases) has not been clarified in the Literature.
The ;purpose of our work was to study blood electrolyte content
*Numbers in the margin indicate pagination in the foreign text.
{
	 1
in patients with osteoarticul.a.r tuberculosis during prolonged
bedrest. Under study were 76 patients with cptcific infection of
the locomotor apparatus, 42 of which observed strict bedrest for
from three to twelve months; 34 patients with unrestricted physical
activity and 26 healthy persons served as the control. group.
Potassium content in blood plasma, (H.) and erythrocytes, (K x ) and
plasma sodium (Na.) was determined using flame photometry.
Complexometric titration was used to ascertain blood calcium, (Ca)
and magnesium, (Mg.) . The electrolyte ratios, KIIKL. and Na'"zcD
were calculated simultaneously, where XI is intracellular potassium,
IAN
 is extracellular potassium and Na is extracellulo x,
 sodium.
As can be seen in the table, considerable shifts in electrolyte
	
;'3
balance were found in patients from both grou ps with osteoarticular
tuberculosis upon admission; the shirts were manifested as elevated
extracel;lular potassium content and reduced erythrocyte potassium
concentrations, causing a decreased coefficient, (KI1K.) 	 Plasma
potassium content was low.. D.svrdered potassium metabolism obviously
is a characteristic of the tubercular process, as attested by
information from some authors concerning elevated plasma potassium
during tuberculosis of the lungs, (Z. V. ,Matyushina, 1971; L. P.
Andreyev, 1976; etc.). The deficit in blood potassium for patients
with tubercular infection of the locomotor apparatus is linked to
mineral imbalance in both the entire body and in the tubercular
focal zones in osseous tissue, as proved in the experimental studies
of M. V. 5yromyatmikova,(1966).
As the tubercular process subsided and complications of the
basic di.soase were eliminated in the patients allowed to Move about
freely, potassium metabolism had begun to normalize after three
months of observation, and only the low plasma potassium content
evidenced the unresolved process in osseous tissue.
Characteristic shifts in blood mineral composition arose during
the observance of bedrest. Plasma potassium content normalized
during the first month of hypokinesia, then gradually decreased,
x
{
2
falling well below normal by the sixth month. Intracellular
potassium concentration, the level of which was beginning to differ
even from the low initial figures (P 4.01) after one month of
hypokinesia, experienced a parallel. decrease. This parallel
reduction in extra- and intracellular potassium was not materially
reflected in potassium gradient dynamics, but remained low over the
entire period of observation. A. low plasma sodium level established
itself beginning with the first month of immobilization and continued
through the whole: bedrest period. The NaE/xE ratio did not change,
which was evidence of an ion equilibrium between these two most
important electrolytes. Potassium content did not substantially
change during the entire period of hypokinesia and approximated
the low initial level.
Blood magnesium dynamics in the patients with osteoarticular
tuberculosis were of interest. Plasma magnesium concentrations
;:ore normal in the initial period for patients of both groups, and
during the entire bedrest period. Magnesium levels significantly
increased after three months of treatment for the patients with
unrestricted motor activity and one month following the and of
bedrest for the other group. The impression was created that an
elevated concentration of extracellular magnesium is a favorable
prognostic sign. Hence, this e *Oeri.ment led us to conclude that
prolonged bedrest substantially worsens the disordered electrolytic
balance in patients with osteoarticul.ar tuberculosis. A sharp
reduction in intro- and extracellular potassium and plasma sodium is
characteristic of the hypokinetic syndrome in patients on bedrest
for specific infection of the locomotor apparatus. Blood electro-
lytes drop considerably below permissible limits, corresponding in our
observations to: X  from 4.55 to 4.13, RI - from 95.85 to 89.39,
and vaB - from 137.80 to 128.53 mEq/Z (at P=0.01) 	 A low potassium
gradient was noted over the entire bedrest period, demonstrating a
plasma and intracellular electrolyte imbalance in these patients.
More pronounced blood electrolyte shifts arose after three and more
months of bedrest. A blood potassium deficit accompanied the hypo-
kinesi.a.
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The diso^.dered blood electrolyte composition did not fully
normalize even after two or more months following the patients'
transition to normal motor activity.
Shifts in blood electrolytes for the patients on bedrest
caused the general body asthenization and disordered cardiac
activity we noted earlier in the same patients, (V. P. Zakutayeva,
1976). Hence, treatment of patients with osteoarticular tuberculosis
on bedrest requires systematic observation of blood electrolyte
composition with corresponding correction of the imbalance as needed.
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Effect of long-term hypokinesia on the electrolytic composition of the blood in patients with osteoarticular tuberculosis

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