Learning objectives
To provide exercise professionals with an overview of resistance training benefits, safety issues, and programming guidelines for patients who have been diagnosed with osteoporosis or at risk of getting it.
Key words
Osteoporosis, Bone Mineral Density, Resistance Exercise, Quality of life, Postmenopausal Women, Strength Training,
Osteoporosis is a major public health problem that will likely escalate as the population ages. Osteoporosis is a skeletal disease characterized by a significant decrease in bone mass, which can lead to an increase in bone fragility and susceptibility to fracture. Women are three times more likely than men to be diagnosed with osteoporosis during their lifespan. 2,6,9,17,21,24,33,50 Bone is a dynamic tissue that continually adapts to its functional demands to produce a structure that is strong enough to prevent fractures during typical activities. 3,14,23,29,32,33, Studies have clearly shown the importance of regular physical activity for optimal skeletal growth during development and maintenance of mineral mass and density in adulthood. Because this disease is characterized by a progressive decline in bone density, resistance training is often recommended as a complementary treatment. This article will review both the current body of knowledge with respect to the effects of resistance training on osteoporosis symptoms as well as the current recommendations for a resistance-training program.
Disease Background
Osteoporosis is a manifestation of bone atrophy that leads to great susceptibility to fractures, which occur even as a result of small trauma. The most common fractures occur in the spine, wrist and hip and are not uncommon in the ribs, humerus and pelvis.3, 18,20,26,3...
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...ng is preferable to lower intensities and is generally safe because the load is relative to individual capacity.
In middle-aged and older persons, especially postmenopausal women and patients treated with medications that may cause bone loss should be given an exercise prescription. Resistance exercise targeting major muscle groups is recommended 2 to 3 days per week at ~70% to 80% of 1 RM, 2 to 3 sets, and 6 to 8 repetitions per set. They should begin with lighter loads, adding weight in small increments until desired loads are achieved. Proper posture and lifting technique are crucial concerns, so that they do not injure themselves during exercises.
Exercise programs for elderly women and men should include not only weight-bearing endurance and resistance activities aimed at preserving bone mass, but also activities designed to improve balance and prevent falls.
Jones, D., & Whitaker, T. (2011). Preventing falls in older people: assessment and interventions. Nursing Standard, 25(52), 50-55.
Fatigue, decreased mobility and impaired balance from the rheumatoid and osteoarthritis pain also increases the risk of falls (Stanmore et al., 2013). Age related changes such as sarcopenia causes muscle tone and strength to decrease, especially in the lower limbs and as a result, balance and gait become impaired (Culross, 2008). These factors significantly influence the risk of falls and also affect the ability to carry out daily activities therefore, with a physiotherapists assistance, the nurse could introduce a personalised exercise regime to enhance muscle tone and strength (Culross, 2008). According to Neuberger et al (1997), exercise lessens fatigue and improves muscle tone and balance in older people. Recommending an exercise programme for Mrs Jones that incorporates strength training exercises and aerobics, could potentially improve muscle tone and strength and as a result improve mobility, balance and lessen the risk of falls (Bird, Pittaway, Cuisick, Rattray & Ahuja, 2013). The nurse could also suggest safety precautions such as advising Mrs Jones to use a mobility aid (Gooberman-Hill & Ebrahim,
There are many different diseases that can affect our skeletal system and Osteoporosis is one of them. Osteoporosis lessens bone strength and bone density (amount of bone mineral in bone tissue), which will lead to fragile bones. It mainly affect the hips, ribs, spine, and wrists. Male or female, at any age, can get this but it is mostly occurs in older women (Team, 2016). Osteoporosis is very common, there are more than 3 million cases a year. There are many causes/risk factors, symptoms, and some treatment cases. About 54 million Americans have Osteoporosis and low bone mass (Foundation, 2016).
Wolf, S. L., Barnhart, H. X., Kutner, N. G., McNeely, E., Cooler, C., Xu, T. (1996). Reducing fraility and falls in older persons: an investigation of Tai Chi and computerized balance training. Journal of American Geriatrics Society, 44, 489-497.
Osteoporosis is a condition, which advances with age, resulting in fragile, weak bones due to a decrease in bone mass. Externally osteoporotic bone is shaped like normal bone, however it’s internal appearance differs. Internally the bone becomes porous due to a loss in essential minerals, including phosphate and calcium. The minerals are loss more quickly than they can be replaced and in turn cause the bones to become less dense and weak. The bones become prone to fracture, due to their weakness. Therefore the awareness of the disease tends to occur after a fracture has been sustained. The bones most commonly affected are the ribs, wrist, pelvis and the vertebrae.
Osteoarthritis (OA) is the most common form of arthritis, affecting more than 27 million Americans (LeMone, Burke, Bauldoff, 2011). It is caused when the cartilage in the joints breaks down, causing the bones of the joint to rub against one another. This causes pain, stiffness, and loss of motion in the joint. Osteoarthritis is most prevalent in those 65 and older, but can affect those of any age. In addition, African Americans and Hispanics report a higher incidence of arthritis than Caucasians (LeMone, Burke, Bauldoff, 2011). Although the cause is unknown, it is believed that the increasing age of the population, prevalence of obesity and injuries add to the progression of the condition. Osteoarthritis can affect any joint in the body; however, those of the hand, hip, and knee are often the most common. This condition may be asymptomatic, or may present symptoms including soreness, stiffness and pain. The symptoms are more common in the older population, those with limited activity levels, and those who are obese. Joint cartilage thins over time, causing an increased risk for symptoms in the elderly, and obesity puts extra pressure on the joints during activity. Osteoarthritis is commonly diagnosed with the use of a physical assessment along with results of radiology testing such as X-Ray and MRI.
Although Osteoporosis cannot be cured, treatments to prevent Osteoporosis, such as exercising, may be taken into consideration. “Exercise during the age when bone growth is occurring increases bone density, while increased weight-bearing exercise after the age of peak bone density acts mainly by reducing expected bone loss.” Because both younger and older adults should always be exercising, the result for increased bone mass varies between these two different age groups (young and old).
First of all, being a woman is one of the risk factors of osteoporosis especially after the age of menopause. “30% of American women between the ages of 60 and 70 have osteoporosis” (Marieb & Hoehn, 2016).To clarify, menopause is characterized by the loss of estrogen hormone production by the ovaries. Since estrogen is necessary for osteoblast to build new bone tissues, the lack of this hormone will improve the ability of osteoblast to absorb the bone tissues. Another risk factor of osteoporosis is being Caucasian. Caucasian women are more likely to get osteoporosis. 30% of Caucasian women experience a bone fracture in their lives that is related to osteoporosis” (Marieb & Hohen, 2016) . Furthermore, genetics are another risk factor of osteoporosis. Individuals with a family history of osteoporosis are at a primary risk for developing this condition. Moreover, a bad and unhealthy lifestyle including poor diet, lack of activities and exercise, smoking, and drinking too much are also risks factors of osteoporosis. In addition, low body weight is another risk factor of osteoporosis. Individuals with low body weight and small amount of fat and muscles are more likely to get this
Osteoporosis is a disease in which the bones become so weak and brittle that even a cough can cause enough stress on the bone that it will cause the bone to facture. The most commonly broken bones are the hip, wrist, and the spine. Although it affects men and women of all races, post-menopausal Caucasian and Asian women are more commonly affected than those of other ethnicities and sexes. In fact, thirty percent of all post-menopausal women in the US and Europe will be diagnosed with Osteoporosis and at least 40 percent of those will suffer from a fracture in their lifetime.
Falls are the leading cause of injuries, disabilities, and deaths among community-dwelling older adults (Moyer, 2012). According to the Center for Disease Control and Prevention (CDC, 2016), each year one out of three community-dwelling older adults aged 65 years or above falls at least once. There is a need to identify effective interventions pertinent to the primary-care setting to prevent falls among older adults living in the community. The guideline titled “Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement” is focused on determining the effectiveness and harms of different fall-prevention interventions relevant to primary care for adults aged 65 years or above (Moyer,
...is flexibility with stretches, T'ai chi, ad yoga. All of these exercises prevents osteoporosis, builds muscle, endurance, and thickness of bones.
For the elderly there are a few precautions one can take to reduce the chance of one of these injuries. Staying active and living a healthy lifestyle can go a long way in maintaining bone density and reducing the chances or severity of osteoporosis. Being active does not mean one will not be affected by osteoporosis which is why getting a bone mineral density test is a great idea for the elderly. This test will show how brittle one’s bones are and allow for the patient to plan accordingly. There are medications one can take to influence one’s bone density, calcium supplements help keep bone dense and reduce the chances of fracture of
Sonu, P. & Manoj, M. (2014). Non-Target and Target-Oriented Functional Reach among elderly females at risk of falls. Indian Journal of Physiotherapy & Occupational Therapy. Vol,8,
One of the most important interventions to prevent falls in the elderly is screening for previous falls, assessing their gait, and reviewing current medications. In ambulatory care settings, a timed up and go test can be performed to observe postural stability, gait, stride length, sway, and step-page. A fall risk factor assessment should also be performed. If a patient has a score of three or more, interventions such as ensuring the call light is in reach, elimination of barriers, and the use of the bed alarm should be in place. Some interventions to help prevent falls are assistance with walking, using a cane or walker, managing foot problems, and wearing good supportive shoes.
A recent study by Winett and Carpinelli (2001), researched the potential health benefits that are related to resistance training. Based on previous studies, Winett & Carpinelli were fully aware that resistance training had a positive effect on cardiovascular health, however they wondered what impact it had on musculoskeletal health. Their results suggest that resistance training positively affects one’s ability to perform well and functionally, and prevent pain or disabilities. Winett & Carpinelli’s (2001) article also advocates that resistance training will positively influence blood pressure, metabolism, the gastrointestinal tract, and reduce or maintain body fat