Osteoporosis

Range of Motion offers Exercise Physiologist designed one-on-one exercise sessions for individuals with this condition. Book a complimentary consultation or contact us to find out more.

The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Based on guidelines provided by the American College of Sports Medicine.

Condition Overview:

Osteoporosis is a progression of osteopenia, a progressive loss of bone mineral density and mass with age. This becomes an issue, as bone strength and the ability to resist a fracture (two key functions of bone) are closely correlated with bone mass.

Osteopenia is classified as greater than one standard deviation below young-normal levels, while osteoporosis is greater than 2.5 standard deviations below young-normal levels.

A natural loss in bone mineral density is experienced with age, though menopause in women can accelerate this loss due to the estrogen withdrawal. This hormone change increases the rates of bone resorbtion, causing a negative relationship between bone formation and resorbtion. This leads to greater levels of osteoporosis and associated fractures in this demographic.

Aside from an estrogen deficiency, several additional factors increase losses in bone mineral density:

  • Female
  • Increased age
  • Caucasian/Asian
  • Family history
  • Low body weight
  • Premature menopause
  • Prolonged premenopausal amenorrhea
  • Low testosterone levels in men
  • Lack of physical activity
  • Chronic smoking
  • Excessive alcohol consumption
  • Low dietary calcium
  • Certain medications (bone loss as a side effect)

Fractures are a major problem in individuals with low bone mineral density. This is due to two main reasons. Firstly, wedge fractures in the thoracic spine can cause a deformity whereby the shoulders are rounded forwards. This shifts the centre of gravity outside the base of support (feet) increasing the risk of a fall. The second reason for the increase in fractures is quite simply the reduced strength of bone, so if a fall does occur, a fracture is more likely.

Short Term Response to Exercise:

The major limitation to exercise is the presence of a previously attained fracture. This causes an obvious impairment in functional capacity and locomotor ability. Changes in posture can also cause an increased falls risk.

Long Term Response to Exercise:

The initial benefit of exercise for an elderly osteoporotic population is the reversal of deconditioning caused by the condition itself. The condition itself does not cause any adverse effects on the exercise response.

Aside from these general effects, the benefits of exercise are twofold:

  1. Resistance based exercise can slow the age related decline in bone mass, thus reducing the progression from healthy bone mineral density, to osteopenia, and then osteoporosis.
  2. Increases in muscle strength and proprioception can improve balance and stability, thus reducing the chance of falls, and therefore fractures.

Condition Management:

Aside from exercise there are several strategies for the treatment and prevention of low bone mineral density. Medications can be used to slow the resorbtion of bone, while hormone replacement therapy can combat the deleterious effects of hormone loss during menopause. Calcium and vitamin D supplementation can also slow the loss of bone mineral density.

Treatment Methodologies:

Range of Motion designs specific exercise programs unique to the individual based on The Range of Motion Model of Health. Modifications to this basic framework are made based on the specific recommendations outlined below.

Aerobic Exercise:

  • 40-70% max heart rate.
  • Three to five days per week.
  • 20-30 minutes per session.

Resistance:

  • 75% of one repetition max for 3-10 repetitions.
  • Two to three days per week.

Flexibility:

  • Not to discomfort.
  • 20 seconds per stretch.
  • Three days per week.

Visit Arthritis and Osteoporosis WA.

Book a complimentary consultation or contact us to find out more.

Bloomfield, S. A., Smith, S. S., (2003). Osteoporosis. In: Durstine, J. L., Moore, G. E. (2003), ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities 2nd Ed. (pp 222-229) American College of Sports Medicine, Human Kinetics.