osteoporosis. Z. Bonakdar Rheumatologist. Osteoporosis is a skeletal disorder characterized by low bone mass with microarchitectural disruption and fragility, resulting in an increased risk of fracture.
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Z. Bonakdar Rheumatologist
Osteoporosis is a skeletal disorder characterized by low bone mass with microarchitectural disruption and fragility, resulting in an increased risk of fracture.
Bone tissue is in a continual process of building, breaking down and rebuilding. During periods of human growth the rate of bone formation exceeds that of bone loss. The reverse is true as age increases. Bones reach their maximum strength and density (peak bone mass) between the ages of 20 and 30 years.
After the age of about 40–50 years, the rate of bone loss increases and bone mass is lost. Bone mineral density later in life is determined by the bone mass accumulated during youth and the subsequent rate of bone loss.
Bone accretion occurs during adolescence and peak bone mass is normally achieved after puberty and into the third decade of life.
Over lifetime, women lose approximately 50 percent of trabecular and 30 percent of cortical bone, where as men lose two thirds of these amounts.
It is estimated that one in two women and one in four men over the age of 60 will have a fracture due to osteoporosis in their lifetime.
It has been predicted from epidemiological modelling that a 10% increase in peak bone mass could significantly delay the onset of osteoporosis and reduce the risk of osteoporotic fractures later in life.
Additionally, it suggests that peak bone mineral density (BMD) may be the single most important factor in delaying the development of the disease.
exercise training programs can prevent or reverse almost 1% of bone loss per year in both pre- and post-menopausal women.
Fractures of the vertebral
Fractures of the proximal hip
Fractures of the distal radius
Life time risk above age 50 years
The percentage of patients with osteoporosis increases progressively with age, of US women, 13% in their 50s, 27% in their 60s, 47% in their 70s, and 67% in their 80s meet the diagnostic criteria for osteoporosis.
prepubertal children 800 mg/day
adolescents 1300 mg/day
women and men 1000 mg/day
women and men over 50 years 1500 mg/day
women and men 400 IU/day
women and men over 50 years 800-1000 IU/day
In a study of healthy, postmenopausal women, a 24-week whole body vibration program was shown to improve muscle strength, balance and hip bone density.
High Blood Pressure. Regular physical activity can reduce blood pressure in those with high blood pressure levels. Physical activity also reduces body fatness, which is associated with high blood pressure.
Noninsulin-Dependent Diabetes. By reducing body fatness, physical activity can help to prevent and control this type of diabetes.
Obesity. Physical activity helps to reduce body fat by building or preserving muscle mass and improving the body's ability to use calories. When physical activity is combined with proper nutrition, it can help control weight and prevent obesity, a major risk factor for many diseases.
Back Pain. By increasing muscle strength and endurance and improving flexibility and posture, regular exercise helps to prevent back pain.
Osteoporosis. Regular weight-bearing exercise promotes bone formation and may prevent many forms of bone loss associated with aging.
Psychological Effects. Regular physical activity can improve your mood and the way you feel about yourself. Researchers also have found that exercise is likely to reduce depression and anxiety and help you to better manage stress.
Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break a sweat. One way to tell if you're working at a moderate intensity is if you can still talk but you can't sing the words to a song.
Daily chores such as shopping, cooking or housework don't count
towards your 150 minutes. This is because the effort needed to do
them isn’t hard enough to get your heart rate up.
Intensive and fast skipping (with a rope)
Any rapid burst of hard exercise
Overall, anaerobic exercise uses up fewer calories than aerobic exercise. The cardiovascular benefits of aerobic exercises are greater than the cardiovascular benefits of anaerobic exercises. However, anaerobic exercise is better at building strength and muscle mass.
Rugby American football
Basket ball Martial arts
Three types of exercise for osteoporosis are:
Sports like bicycling and swimming are great for your heart and
lungs. However, these are not weight-bearing exercise for
At least half an hour of moderate to vigorous exercise five times a
For best results, do resistance exercises two or three times a week.
Resistance helps with osteoporosis because it strengthens muscle
and builds bone.
Flexibility is another important form of exercise for osteoporosis.
Having flexible joints helps prevent injury.
Low back pain (LBP) is extremely common both in the general population and in those seeking healthcare. Point prevalence estimates for LBP are at least 20% of the general population; yearly prevalence estimates are at least 40%; and lifetime prevalence is around 60%.
In contrast to earlier claimsof a relatively benign natural history for acute back pain, it is now clear that LBP is commonly both highly recurrent and frequently persistent.
For the internist or family physician, the problem of low back pain (LBP) is one of the most commonly assessed complaints.
Lower back pain may be classified by the duration of symptoms as acute (less than 4 weeks), sub acute (4–12 weeks), chronic (more than 12 weeks).
The majority of lower back pain stems from benign musculoskeletal problems, and are referred to as non specific low back pain; this type may be due to muscle or soft tissues sprain or strain.
When directional preference precedes the prescription of exercises, clinical outcomes (pain relief and ability to return to work) may be better than when non-individualized exercise regimens are prescribed.
In contrast to the limited evidence of benefit from exercise for acute LBP, exercise therapy has been shown to have modest benefits in patients with subacute (4 to 12 weeks) and chronic LBP (>12 weeks).
In general, exercise therapies for LBP include:
Osteoarthritis is a degenerative joint disease, occurring primarily in older individuals, characterized by erosion of the articular cartilage, hypertrophy of bone at the margins (osteophytes), subchondral sclerosis, and a range of biochemical and morphologic alterations of the synovial membrane and joint capsule.
Risk factors for developing osteoarthritis include age, joint location, obesity, genetic predisposition, joint malalignment, trauma, and gender.
The National Health and Nutrition Examination Survey found the prevalence of this disease to be less than 0.1 percent in those aged 25 to 34 years old versus a rate of over 80 percent in people over age 55.
with an increased risk of osteoarthritis in the indicated joints:
Regular exercise can improve physiological impairments associated with OA including muscle strength, joint range of motion, proprioception, balance and cardiovascular fitness.
Quadriceps weakness is common among patients with knee OA, and that quadriceps weakness may be a risk factor for the development of knee OA, presumably by decreasing stability of the knee joint and reducing the shock-attenuating capacity of the muscle .
In one study, medial taping of the patella reduced the pain of those with patellofemoral compartment OA by 25%.