NON-MEDICAMENTAL METHODS OF OSTEOPOROSIS TREATMENT

Cover Page


Cite item

Full Text

Abstract

Physical activity and exercises play an important role in the prevention and treatment of osteoporosis. Clinical studies demonstrated the effectiveness of exercises manifesting themselves in small increase of bone mineral density and reduction of the risk of falls. In patients with vertebral fractures, the exercises improve the quality of life, posture, and mobility. The exercise effect depends on the type of exercises and on the study population. For patients with osteoporosis, it is reasonable to combine aerobic exercises with resistance training and exercises aimed at training of balance. In order to avoid adverse events, exercises should be started gradually. Patients with vertebral fractures may additionally undergo orthoses and physiotherapy.

About the authors

L. P. Evstigneeva

Sverdlovsk Regional Clinical Hospital No.1; 185 Volgogradskaya ul., Yekaterinburg, 620102, Russian Federation

Author for correspondence.
Email: levstigneyeva@mail.ru
PhD, Executive of Rheumatology Department, Sverdlovsk  Regional Clinical Hospital No.1 Россия

References

  1. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301(5):513-21.
  2. Papaioannou A, Kennedy CC, Ioannidis G, Sawka A, Hopman WM, Pickard L, Brown JP, Josse RG, Kaiser S, Anastassiades T, Goltzman D, Papadimitropoulos M, Tenenhouse A, Prior JC, Olszynski WP, Adachi JD; CaMos Study Group. The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int. 2009;20(5):703-14.
  3. Михайлов ЕЕ, Беневоленская ЛИ. Эпидемиология остеопороза и переломов. В: Беневоленская ЛИ, ред. Руководство по остеопорозу. М.: БИНОМ; 2003. с. 10-53. (Mikhaylov EE, Benevolenskaya LI. Epidemiology of osteoporosis and fractures. In: Benevolenskaya LI, editor. Osteoporosis handbook. Moscow: BINOM; 2003. p. 10-53. Russian).
  4. Михайлов ЕЕ, Беневоленская ЛИ, Баркова ТВ. Эпидемиологическая характеристика переломов конечностей в популяционной выборке лиц 50 лет и старше. Остеопороз и остеопатии. 1998;(2):2-6. (Mikhaylov EE, Benevolenskaya LI, Barkova TV. [Epidemiological characteristic of extremities fractures in population excerpts of persons of 50 and elder]. Osteoporoz i osteopatii. 1998;(2):2-6. Russian).
  5. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2(2):1143-211.
  6. Риггз БЛ, Мелтон III ЛДж. Остеопороз. Пер. с англ. М. – СПб.: БИНОМ – Невский диалект; 2000. (Riggs BL, Melton LJ. Osteoporosis: etiology, diagnosis, and management. Moscow – Saint Petersburg: BINOM – Nevskiy dialekt; 2000. Russian).
  7. Taylor AF, Saunders MM, Shingle DL, Cimbala JM, Zhou Z, Donahue HJ. Mechanically stimulated osteocytes regulate osteoblastic activity via gap junctions. Am J Physiol Cell Physiol. 2007;292(1):C545-52.
  8. Cheung AM, Giangregorio L. Mechanical stimuli and bone health: what is the evidence? Curr Opin Rheumatol. 2012;24(5):561-6.
  9. Ardawi MS, Rouzi AA, Qari MH. Physical activity in relation to serum sclerostin, insulin-like growth factor-1, and bone turnover markers in healthy premenopausal women: a cross-sectional and a longitudinal study. J Clin Endocrinol Metab. 2012;97(10):3691-9.
  10. Cooper C, Dere W, Evans W, Kanis JA, Rizzoli R, Sayer AA, Sieber CC, Kaufman JM, Abellan van Kan G, Boonen S, Adachi J, Mitlak B, Tsouderos Y, Rolland Y, Reginster JY. Frailty and sarcopenia: definitions and outcome parameters. Osteoporos Int. 2012;23(7):1839-48.
  11. Rochefort GY, Pallu S, Benhamou CL. Osteocyte: the unrecognized side of bone tissue. Osteoporos Int. 2010;21(9):1457-69.
  12. Gast U, Belavý DL, Armbrecht G, Kusy K, Lexy H, Rawer R, Rittweger J, Winwood K, Zieliński J, Felsenberg D. Bone density and neuromuscular function in older competitive athletes depend on running distance. Osteoporos Int. 2013;24(7): 2033-42.
  13. Callréus M, McGuigan F, Ringsberg K, Akesson K. Self-reported recreational exercise combining regularity and impact is necessary to maximize bone mineral density in young adult women: a population-based study of 1,061 women 25 years of age. Osteoporos Int. 2012;23(10):2517-26.
  14. Allison SJ, Folland JP, Rennie WJ, Summers GD, Brooke-Wavell K. High impact exercise increased femoral neck bone mineral density in older men: a randomised unilateral intervention. Bone. 2013;53(2):321-8.
  15. Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, Harbour RT, Caldwell LM, Creed G. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011;(7):CD000333.
  16. Latham N, Anderson C, Bennett D, Stretton C. Progressive resistance strength training for physical disability in older people. Cochrane Database Syst Rev. 2003;(2):CD002759.
  17. Hongo M, Itoi E, Sinaki M, Miyakoshi N, Shimada Y, Maekawa S, Okada K, Mizutani Y. Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(10):1389-95.
  18. Bonaiuti D, Shea B, Iovine R, Negrini S, Robinson V, Kemper HC, Wells G, Tugwell P, Cranney A. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002;(3):CD000333.
  19. Stengel SV, Kemmler W, Pintag R, Beeskow C, Weineck J, Lauber D, Kalender WA, Engelke K. Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. J Appl Physiol (1985). 2005;99(1): 181-8.
  20. Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, Rowe BH. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;(2):CD007146.
  21. Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR. Exercise to prevent falls in older adults: an updated metaanalysis and best practice recommendations. N S W Public Health Bull. 2011;22(3-4):78-83.
  22. Kelley GA, Kelley KS, Kohrt WM. Effects of ground and joint reaction force exercise on lumbar spine and femoral neck bone mineral density in postmenopausal women: a meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2012;13:177.
  23. Kelley GA, Kelley KS, Kohrt WM. Exercise and bone mineral density in men: a meta-analysis of randomized controlled trials. Bone. 2013;53(1):103-11.
  24. Kemmler W, von Stengel S, Bebenek M, Engelke K, Hentschke C, Kalender WA. Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporos Int. 2012;23(4):1267-76.
  25. Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone. 2002;30(6):836-41.
  26. Dusdal K, Grundmanis J, Luttin K, Ritchie P, Rompre C, Sidhu R, Harris SR. Effects of therapeutic exercise for persons with osteoporotic vertebral fractures: a systematic review. Osteoporos Int. 2011;22(3):755-69.
  27. Giangregorio LM, Macintyre NJ, Thabane L, Skidmore CJ, Papaioannou A. Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev. 2013;1:CD008618.
  28. Liu CJ, Latham N. Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin. Arch Phys Med Rehabil. 2010;91(9):1471-3.
  29. Gold DT, Shipp KM, Pieper CF, Duncan PW, Martinez S, Lyles KW. Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial. J Am Geriatr Soc. 2004;52(9):1471-8.
  30. Sinaki M, Mikkelsen BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil. 1984;65(10):593-6.
  31. Sinaki M. Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: case series. Pain Pract. 2013;13(1):68-75.
  32. Giangregorio LM, MacIntyre NJ, Heinonen A, Cheung AM, Wark JD, Shipp K, McGill S, Ashe MC, Laprade J, Jain R, Keller H, Papaioannou A. Too Fit To Fracture: a consensus on future research priorities in osteoporosis and exercise. Osteoporos Int. 2014;25(5):1465-72.
  33. Fujita T, Nakamura S, Ohue M, Fujii Y, Miyauchi A, Takagi Y, Tsugeno H. Effect of age on body sway assessed by computerized posturography. J Bone Miner Metab. 2005;23(2):152-6.
  34. Abreu DC, Trevisan DC, Costa GC, Vasconcelos FM, Gomes MM, Carneiro AA. The association between osteoporosis and static balance in elderly women. Osteoporos Int. 2010;21(9):1487-91.
  35. Burke TN, França FJ, Meneses SR, Cardoso VI, Pereira RM, Danilevicius CF, Marques AP. Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J. 2010;128(4):219-24.
  36. Da Silva RB, Costa-Paiva L, Morais SS, Mezzalira R, Ferreira Nde O, Pinto-Neto AM. Predictors of falls in women with and without osteoporosis. J Orthop Sports Phys Ther. 2010;40(9): 582-8.
  37. Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;(11):CD004963.
  38. Евстигнеева ЛП, Кожемякина ЕВ, Негодаева ЕВ, Гусельникова ГА, Белкин АА, Викулова ДН, Белкин НБ, Лесняк ОМ. Эффективность физических упражнений у лиц с остеопоретическими переломами позвонков. Научно-практическая ревматология. 2014;(1):49-55. [Evstigneeva LP, Kozhemyakina EV, Negodaeva EV, Gusel’nikova GA, Belkin AA, Vikulova DN, Belkin NB, Lesnyak OM. Efficiency of physical exercises in patients with osteoporotic vertebral fractures. Nauchno-prakticheskaya revmatologiya. 2014;(1):49-55. Russian).
  39. Bennell KL, Matthews B, Greig A, Briggs A, Kelly A, Sherburn M, Larsen J, Wark J. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord. 2010;11:36.
  40. Papaioannou A, Adachi JD, Winegard K, Ferko N, Parkinson W, Cook RJ, Webber C, McCartney N. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int. 2003;14(8):677-82.
  41. Bergland A, Thorsen H, Kåresen R. Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial. Osteoporos Int. 2011;22(6):1863-71.
  42. Yang L, He C, Lei Z, Xie W, Lan Q. Effect of pain-free exercises on female osteoporosis patients with spinal compressive fracture. J Clin Rehab Tis Eng Res. 2007;11:9108-11.
  43. Nguyen ND, Eisman JA, Center JR, Nguyen TV. Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab. 2007;92(3):955-62.
  44. Smith AA, Summers GD, Baxendale A, Butterly RJ. A randomized controlled trial of the effects of weight-bearing exercise and resistance training on risk factors for fracture in women with osteoporosis. In: Ring EFJ, Elvins DM, Bhalla AK, editors. Current research in osteoporosis and bone mineral measurement. London: British Institute of Radiology; 1998. p. 128.
  45. Pawlowsky SB, Hamel KA, Katzman WB. Stability of kyphosis, strength, and physical performance gains 1 year after a group exercise program in community-dwelling hyperkyphotic older women. Arch Phys Med Rehabil. 2009;90(2):358-61.
  46. Bergström I, Bergström K, Grahn Kronhed AC, Brinck J, Karlsson S. Back extensor training increases muscle strength in postmenopausal women with osteoporosis, kyphosis and vertebral fractures. Adv Physiother. 2011;13(3):110-7.
  47. Bautmans I, Van Arken J, Van Mackelenberg M, Mets T. Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med. 2010;42(2):129-35.
  48. Prather H, Watson JO, Gilula LA. Nonoperative management of osteoporotic vertebral compression fractures. Injury. 2007;38 Suppl 3:S40-8.
  49. Bukata SV, Digiovanni BF, Friedman SM, Hoyen H, Kates A, Kates SL, Mears SC, Mendelson DA, Serna FH Jr, Sieber FE, Tyler WK. A guide to improving the care of patients with fragility fractures. Geriatr Orthop Surg Rehabil. 2011;2(1):5-37.
  50. Mazanec DJ, Podichetty VK, Mompoint A, Potnis A. Vertebral compression fractures: manage aggressively to prevent sequelae. Cleve Clin J Med. 2003;70(2):147-56.
  51. Francis RM, Baillie SP, Chuck AJ, Crook PR, Dunn N, Fordham JN, Kelly C, Rodgers A. Acute and long-term management of patients with vertebral fractures. QJM. 2004;97(2):63-74.
  52. Pfeifer M, Kohlwey L, Begerow B, Minne HW. Effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2011;90(10):805-15.
  53. Schmidt K, Hübscher M, Vogt L, Klinkmüller U, Hildebrandt HD, Fink M, Banzer W. Influence of spinal orthosis on gait and physical functioning in women with postmenopausal osteoporosis. Orthopade. 2012;41(3):200-5.
  54. Zambito A, Bianchini D, Gatti D, Rossini M, Adami S, Viapiana O. Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study. Osteoporos Int. 2007;18(11):1541-5.
  55. Rossini M, Viapiana O, Gatti D, de Terlizzi F, Adami S. Capacitively coupled electric field for pain relief in patients with vertebral fractures and chronic pain. Clin Orthop Relat Res. 2010;468(3):735-40.
  56. Евстигнеева ЛП, Полянская ТП. Опыт применения динамической электронейростимуляции в лечении пациентов с переломами позвонков на фоне остеопороза. Вестник восстановительной медицины. 2009;(3):37-41. (Evstigneeva LP, Polyanskaya TP. [Experience of using dynamic electro-neurostimulation in therapy of patients with osteoporotic vertebral fractures]. Vestnik vosstanovitel’noy meditsiny. 2009;(3):37-41. Russian).

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2014 Evstigneeva L.P.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies