OSTEOPOROSIS AND EXERCISE

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OSTEOPOROSIS AND EXERCISE

• Anna Rozenberg, BSc.PT
• Physical Therapist,
• Professional Practice Leader, Department of
  Rehabilitation,
• Mount Sinai Hospital

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EXERCISE

• Exercise is one of the options for
• Prevention of osteoporosis
• women and men
• all ages
• Treatment of osteoporosis
• stay active
• prevent progression

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EFFECT OF EXERCISE ON BONE

• Increased load on the bone tissue
• Change in bone breakdown/formation ratio
• Increased bone mass so the load can be spread
  over a larger amount of bone

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EXERCISE AND OSTEOPOROSIS

• Physical activity vital for bone health
• Reduces the rate or reverses bone loss
• Other Benefits of Exercise
• heart and lungs
• improved flexibility
• improved strength
• improved balance
• reduced risk of falls
• muscle or joint pain relief

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2002 Clinical Practice Guidelines for the
Diagnosis and Management of Osteoporosis in
Canada

• Exercise in children, especially in puberty,
  leads to stronger bones
• Impact sports and exercise more efficacious at
  all ages
• In pre-menopausal women, both impact and
  non-impact exercise prevent bone loss in the
  lumbar spine
• In post-menopausal women, impact exercises may
  reduce the rate of bone loss or lead to some bone
  gain, at least in short-term
• Higher level of activity throughout middle life
  is associated with reduced risk of hip fractures
  in old age.

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TYPES OF EXERCISES

• Weight-bearing exercises
• Resistance training
• Postural exercises
• Flexibility exercises
• Balance exercises

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WEIGHT BEARING

• Most important since stimulates bone formation
• Walking - must be brisk!
• (can carry light weights)
• Dancing, racquet sports, running, hiking, low
  impact aerobics, Tai Chi, bowling
• Arms - wall push-ups, up from a chair
• 30 minutes, 3-5 times a week
• NOT SWIMMING

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RESISTANCE TRAINING

• Increase muscle strength
• Loading on the bone site where muscle attaches
• Use light weights, soup cans, elastic bands
• 1-2 times a week, begin with light weights

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RESISTANCE TRAINING

• Important muscle groups
• Hip abductors and extensors
• Thigh muscles
• Back extensors
• Shoulder muscles

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POSTURE

• Bending forwards increases back curve and the
  stress on the front of the vertebra
• Posture exercises to prevent postural deformity
  or its progression
• Think tall posture when standing, sitting,
  lifting, gardening, vacuuming use a back roll
• Examples lifting chest forward and up, relaxing
  your shoulders, pulling your chin in, abdominal
  setting

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FLEXIBILITY

• Maintain joint and muscle length
• Improve posture
• Decrease pain
• Back extension, chest, hamstrings

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BALANCE TRAINING

• Important for reducing the risk of falls and
  fractures
• Standing on one leg
• Standing with one foot in front of the other
• Toe raises
• Walking sideways
• Tai Chi

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EXERCISE PRINCIPLES

• Frequency 3-5 x week
• Duration 20 - 60 minutes
• Intensity 55-85 max. heart rate
• Max. HR 220 - Age
• Variety

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SAMPLE EXERCISE PROGRAM (Osteoporosis Prevention)

• An example of a basic exercise program could be
• Day 1, 30 min brisk walk with a friend
• Day 2, Line Dancing
• Day 3, 30 minutes weight training (light weights,
  high repetitions)
• Day 4, 30 min brisk walk to a store
• Day 5, Tai Chi class
• You could then take a day of rest from
  exercising, and repeat the cycle.
• Remember to warm up and cool down (5-10 min)

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IF YOU HAVE OSTEOPOROSIS

• Consult a physician and/or physical therapist
  before starting
• Maintain good posture at all times
• Focus on balance and fall prevention
• Avoid jarring, twisting, high impact and abrupt
  movements
• Avoid high impact aerobics, yoga
• May need to modify weight bearing exercise

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WHAT ACTIVITIES TO AVOID

• Avoid twisting and forward
• bending at the waist
• Avoid abdominal curl-ups
• and pelvic tilt exercises
• Avoid heavy lifting (bend at the knees)
• Avoid poor posture (use aids)
• Home safety

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TIPS FOR STICKING WITH A PROGRAM

• Start slowly and progress gradually
• do something you like (make it fun!)
• exercise with a friend, spouse, or a group
• keep an exercise diary
• listen to music
• incorporate into daily life
• back up plan for bad weather

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SUMMARYDOS AND DONTS

• DO
• incorporate physical activity into daily life
• frequent weight-bearing aerobic exercise
• challenge your balance
• check your posture frequently
• use correct body mechanics
• make your home a safe place

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SUMMARYDOS AND DONTS

• DONTS
• be sedentary
• become a couch slouch
• do exercises without initial guidance
• do abdominal sit ups
• place stress on your back

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COMMUNITY PROGRAMS

• Osteoporosis Society of Canada
• Baycrest Centre for Geriatric Care
• North York Seniors Centre
• Sunnybrook and Womens College Health Sciences
  Centre
• Toronto Rehabilitation Institute
• Bernard Betel Centre for Creative Living

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WEBSITES

• www.endocrineweb.com
• www.osteoporosis.ca
• www.nof.org
• www.osteoporosis.org.au
• www.mainebones.com
• www.womenshealthmatters.ca