Exercise for Patients With Osteoporosis: Management of Vertebral Compression Fractures and Trunk Strengthening for Fall Prevention

Wiley - Tập 4 Số 11 - Trang 882-888 - 2012
Mehrsheed Mehrsheed

Tóm tắt

AbstractMaintenance of bone health and quality requires mechanical strain, but the mechanical force needs to be within the bone's biomechanical competence. In osteoporosis, compression of vertebral bodies can be insidious. Therefore, absence of pain does not necessarily indicate absence of vertebral microfracture and deformity. Further, patients with previous vertebral fractures are at risk for further vertebral fractures and their associated morbidity. Exercise is a part of the comprehensive management of patients with osteoporosis and has been associated with improvement of quality of life and lowered risk of future fracture. The exercise prescription needs to match the needs of the patient. If exercise is not prescribed properly, then it may have negative consequences. In general, an exercise program, therapeutic or recreational, needs to address flexibility, muscle strength, core stability, cardiovascular fitness, and gait steadiness. As with pharmacotherapy, therapeutic exercises need to be individualized on the basis of musculoskeletal status and an individual's exercise interest. In osteoporosis, axial strength and stability are of primary importance. In particular, a spinal extensor strengthening program should be performed with progressive measured resistance as tolerated. To address falls and fractures, an exercise program should also include balance and lower extremity strength training. Proper dosing of oral cholecalciferol and calcium supplements can enhance the effect of strengthening exercises. Finally, a coordinated approach, such as the Spinal Proprioception Extension Exercise Dynamic (SPEED) program, can improve back extensor strength, the level of physical activity, and locomotion, and reduce back pain and fear and risk of falls.

Tài liệu tham khảo

10.1097/00002281-199607000-00017 Genant H.K., 1988, Osteoporosis: Etiology, Diagnosis, and Management, 181 10.1007/s00198-003-1446-8 10.1016/S8756-3282(02)00739-1 Sinaki M., 1982, Postmenopausal spinal osteoporosis: Physical therapy and rehabilitation principles, Mayo Clin Proc, 57, 699 Sinaki M., 1984, Postmenopausal spinal osteoporosis: Flexion versus extension exercises, Arch Phys Med Rehabil, 65, 593 10.1016/S0025-6196(12)61748-0 Howe T.E., 2011, Exercise for preventing and treating osteoporosis in postmenopausal women, Cochrane Database Syst Rev 10.1016/S0025-6196(12)60371-1 Sinaki M., 2012, Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: Case series, Pain Pract 10.3109/ort.1960.31.suppl-43.01 10.1097/00007632-198813060-00010 10.1007/BF03339659 Rudins A., 1991, Significance of back extensors versus back flexors in trunkal support [abstract], Arch Phys Med Rehab, 72, 824 Macnab I., 1977, Backache 10.1056/NEJM198606263142605 10.1172/JCI112462 10.1007/s001980070080 10.1097/00002060-200105000-00002 10.1007/BF01623170 Healey J.H., 1985, Structural scoliosis in osteoporotic women, Clin Orthop Relat Res, 216 Sinaki M., 2010, Spinal Proprioceptive Extension Exercise Dynamic (S.P.E.E.D.) Program for relief of back pain and iliocostal friction syndrome: A painful challenge of spinal osteoporosis [abstract], J Bone Miner Res, 25, S343 Sinaki M., 2012, Successful management of headaches related to occipito‐cervico‐thoracolumbar malposture of osteopenia/osteoporosis: Significance of axial proprioception in headaches [abstract], ASBMR, S354 10.1007/s001980050063 10.4065/80.7.849 10.1016/j.pmr.2007.04.002 10.1097/00002060-199609000-00013 10.4065/79.5.639 10.1016/8756-3282(95)00171-9 10.4065/73.12.1151 Sinaki M., 2000, Physical Medicine and Rehabilitation, 894 10.1007/s00198-007-0398-9 10.1007/s00198-007-0383-3 10.1007/s00198-011-1624-z Borgo M.J., 2010, Back progressive resistive exercise program to reduce risk of vertebral fractures, J Miner Stoffwechs, 17, 66 10.1053/j.trap.2011.05.001 Huntoon E., 2004, Thoracic osteoporotic fracture without upper back pain, Am J Phys Med Rehabil, 83, 729, 10.1097/00002060-200409000-00009 Sinaki M., 1993, Basic Clinical Rehabilitation Medicine, 209 Riggs B.L., 1995, Osteoporosis: Etiology, Diagnosis, and Management, 435 1993, PTS: Posture Training Support [pamphlet]
Thông tin
Thông tin xuất bản

Wiley

Tập 4 Số 11

882-888

Thông tin tác giả