Physiotherapy

PHYSIOTHERAPY :

STRONG, STEADY, AND STRAIGHT: PHYSICAL ACTIVITY AND EXERCISE RECOMMENDATIONS FOR OSTEOPOROSIS

Fractures of the hip and spine are frequently seen in older adults. Especially in people with osteoporosis, falls may be an important contributor. Some people become afraid of falling and adopt maladaptive behaviors as they think it gives them more stability.

Often, people become afraid to exercise and therefore participate less in sports and exercise activities. Also, healthcare providers may be unsure whether it is safe to prescribe exercise and avoid giving recommendations about exercise.

To enhance the safety of the training program, some precautions can be taken. First and foremost, exercise recommendations should be tailored to the individual, bearing in mind other comorbidities. The sessions should ideally be supervised by a healthcare practitioner to ensure proper technique and progressions are made. Like any exercise program, a gradual but progressive build-up is required. But, the higher the dose and the longer the duration of the intervention, the greater change is observed, especially in people over 70 years of age.

From the trials and studies we discussed here, some other precautions can be taken. In the LIFTMOR-M trial which was based on the same trial we discussed above, but conducted in middle-aged and older men with low bone mineral density, the high-intensity progressive resistance and impact training program was compared with machine-based isometric axial compression training.

In the small sample of 40 participants, there were no incident vertebral fractures nor progression of prevalent vertebral fractures in the high-intensity training over the 8 months. But, 5 incident fractures of thoracic vertebrae occurred and one wedge fracture progressed for those in the isometric axial compression group.