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Rehabilitation In Osteoporosis PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Rehabilitation in osteoporosis” by Dr. A.Moghari, MD.

This medical PowerPoint presentation is about rehabilitation in osteoporosis, a medical condition in which the bones become brittle and fragile due to loss of tissue, typically as a result of hormonal changes, deficiency of calcium or vitamin D, or aging. Rehabilitation in osteoporosis is focused on improving bone density, reducing the risk of fractures, and maintaining overall physical function and quality of life. This presentation is about various rehabilitation strategies for osteoporosis.

Tags : rehabilitation in osteoporosis, bones, improving bone density, reducing the risk of fractures, Orthopaedic Surgery, Orthopaedic Surgery PowerPoint presentation

Published on : Jun 20, 2023 | Views : 852 | Downloads : 9

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Slide 1-

Rehabilitation in osteoporosis Dr. A.Moghari, MD, physiatrist
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Osteoporosis is a metabolic bone disease usually occurring with increasing age and is defined as a skeletal disorder characterized by reduced bone mineral density and strength. Osteoporosis is characterized as the “silent disease” because is painless until the first occurrence of a fracture.
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The first symptom of osteoporosis is the bone fracture: distal of radius proximal humerus Vertebral collapse femoral neck fractures. This phase of the disease is characterized by acute pain.
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Vertebral fractures acute pain chronic pain associated skeletal deformity, joint incongruity, tension on muscles and tendons,
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In the acute phase (after fx) relief pain by a limited period of bed rest, local and systemic analgesia, bracing, physical therapy, education with proper exercises and instructions according to daily living activities. optimize post-injury mobility functional recovery restore pre-fracture function The goals of rehabilitation
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1. Decrease osteoporosis/improve BMD Supplement Medication Exercise 2. Decrease risk of break Hip protectors 3. Decrease risk of fall Reducing Fractures
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Physical activity targeting muscles and balance is the cornerstone of each rehabilitation program for osteoporosis and fracture prevention. It is clear that physical activity is vital in adults because it reduces the rate of bone loss during the perimenopausal period, and decelerates bone loss associated with aging. Exercise in osteoporosis
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The effect of aerobic exercise on bone density has been studied by review papers which report a decrease in bone loss at the spine and wrist. (Bonaiuti et al., 2002;Martyn-St James & Carroll, 2008; Martyn-St James & Carroll, 2006). In meta-analysis studies which reviewed the effects of walking on bone density showed it has a significant positive effect on the femoral neck .(Martyn-St James & Carroll, 2006). In a review of 35 RCT’s it was shown that in premenopausal women and in postmenopausal women intense exercise probably had a positive effect on the femoral neck and in spinal lumbar bone density, where less intensive exercise also helped (Kerr et al., 1996). Exercise and bone density
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In the design of an exercise program to increase bone mass we need to take in mind the following five principles 1. Specificity: The program must be designed to load specific bones or body regions, 2. Overload: To induce stimulation for increasing bone density 3. Reversibility: In adults, any gains in bone density during an exercise program will be lost if the program stops. However, in children and adolescents the benefits achieved by increased mechanical loading during exercise program remain even if the exercise program stops, 4. Initial Values: The response of bone to increased loading is greater when bone mass is below average. 5. Diminishing Returns: The greatest gains in bone density will be seen early in an exercise program.
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Muscle strengthening, Weight bearing combined with flexibility, Posture control, Balance and coordination Training in daily living activities
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Programs are focused on specific regions of the skeleton where fractures are most commonly expected, namely the spine, the hip and the wrist. Muscle strengthening exercises
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Back muscles
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Resistance against a wall (such as push-ups):
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Abdominal muscles strengthening:
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Extensor and abductor muscles of the hips:
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Quadriceps
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Exercises with dumbbells for the arms:
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Weight bearing exercises are exercises during which the weight of the body passes through the bones. walking, jogging, dancing, tennis, football, trampoline. The impact to the bone during this exercise should be higher than that during normal everyday activities. Weight bearing exercises
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The aim of these exercises is to: Eliminate the bent-over position (hunchback), which increases the pressure on the front part of the vertebrae and to improve stability. Decompression of the spine: Shoulder press: Leg press: Postural exercises
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During aging the body becomes more rigid which results in movement difficulties leading to falls and increasing risk of fracture. maintain the elasticity, length of the muscle, the range of movement of the joints, improve posture, reduce pain. Flexibility exercises
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Stretching the pectoralis major (stretching of the chest):
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Stretching the upper torso: Stretching muscles of the lumbar spine:
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The program of exercises becomes more efficient if combined with the use of proper body mechanics and posture in everyday activities. Exercises to improve functional ability – Osteoporosis and daily living activities
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Vibration platforms are used in rehabilitation of osteoporosis, based on the concept that non-invasive, short-duration, mechanical stimulation could have an impact on osteoporosis risk. Whole body vibration
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An important issue in rehabilitation medicine is the prevention of falls and fall related fractures. Falling results in increased mortality, morbidity, reduced functioning. Falls generally result from an interaction of multiple and diverse risk factors and situations, many of which can be corrected. Falls can also result in deterioration of physical functioning and quality of life due to injury or due to fear of falling; 16% of fallers reported that they limited their usual activity because of fear of falling and one third of fallers reduced their participation in social activities Prevention of falls and fall related fractures
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Fear of falling is reported by one in four older people in the community and can lead to distress and reduced quality of life, increased medication use and activity restriction, further decline in physical functioning, greater falling risk and admission to institutional care. Important potentially modifiable risk factors: mental status and psychotropic drugs, multiple drugs, environmental hazards, vision, Lower extremity impairments, balance, gait status low activity level (exercise less than once a week),.
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Interventions to prevent falls may be planned to reduce internal or external risk factor of falling . Although exercise has many proven benefits, the optimal type, duration and intensity of exercise for falls prevention remain unclear. Older people who have had recurrent falls should be offered long-term exercise and balance training .
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Without good balance, there is always the danger of fracture. This type of exercise is the most important in falls prevention. Simple exercises for balance are walking heel to toe beside a wall or rail and balancing on one foot. Balance exercises
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These exercises help the cooperation of muscle and nerves in order to avoid falls and fractures and should be done routinely every day for at least 5 minutes. This category includes exercises such as marching, walking around a chair and throwing and catching a ball. Coordination exercises
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Marching (photo 1) and walking around a chair (photos 2 and 3).
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Exercise balls.
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Tai Chi is a promising type of balance exercise, although it requires further evaluation before it can be recommended as the preferred method for balance training. Tai Chi which consists of slow, rhythmic movements emphasizing on the trunk rotation, weight shifting, coordination, and a gradual narrowing of the lower extremities position is thought to be an excellent choice of exercise for the elderly. There is experimental evidence from both cross-sectional and longitudinal studies that Tai Chi exercise has beneficial effects on balance control and that the postural stability is improved more by Tai Chi than by other types of exercise Tai Chi
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Traditionally, spinal orthoses have been used in the management of thoracolumbar injuries treated with or without surgical stabilization. relieve pain and promote the healing process by stabilizing the spine. Orthoses in osteoporosis
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The most broadly used types of spinal orthoses use a three-point pressure system a) the TLSO type (Knight-Taylor, Jewett, CASH, Boston); Hyperextension b) the PTS type (Posture Training Support) , softer material the postural training support is worn over the shoulders similar to a mini-backpack and has a pocket into which small weights (total 1.75 lb) weights are added. c) Spinomed an abdominal pad, splint along the spine, back pad, and a system of belts with Velcro. d) Osteomed,
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Front, back and lateral view of the Spinomed
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Front, back and lateral view of the Spinomed active orthosis for men and women
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Osteomed
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Canes and walkers seat lift Hip protectors Assistive Devices
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