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A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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Europa Medicophysica 2004 September;40(3):223-232

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English

Steps for targeting exercise towards the skeleton to increase bone strength

Warden S. J. 1, 2, Fuchs R. K. 3, Turner C. H. 1, 4

1 Department of Orthopedic Surgery Indiana University School of Medicine, Indianapolis, IN, USA 2 Department of Physical Therapy School of Health and Rehabilitation Sciences Indiana University, IN, USA 3 Department of Anatomy and Cell Biology Indiana University School of Medicine, Indianapolis, IN, USA 4 Biomechanics and Biophysical Research Center Indiana University School of Medicine, Indianapolis, IN, USA


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Osteoporosis is a dis­ease of ­bone fra­gil­ity result­ing most­ly ­from low ­bone ­mass and a con­com­i­tant ­increase in the ­risk for frac­ture. Exercise is a com­mon­ly pre­scribed inter­ven­tion for oste­o­por­o­sis ­because ­bone tis­sue is mechan­o­sen­si­tive. The abil­ity of mechan­i­cal stim­u­li to influ­ence ­bone biol­o­gy has ­been ­known for ­over a cen­tu­ry, but it has ­been ­only in the ­past sev­er­al ­decades ­that ­great ­gains ­have ­been ­made in ­terms of under­stand­ing fac­tors ­that influ­ence ­this ­response. By under­stand­ing ­these fac­tors, ­steps can be devel­oped to max­imize the oste­o­gen­ic ­effects of exer­cise on the skele­ton and poten­tial­ly ­reduce the inci­dence of ­bone frac­tures. This ­paper out­lines ­these ­steps. They ­include: 1) start­ing exer­cise ­when ­young ­while the skele­ton is ­most respon­sive to mechan­i­cal stim­u­li; 2) select­ing exer­cis­es ­that are dynam­ic and ­high-­impact to max­imize oste­o­gen­ic respons­es, ­such as jump­ing for the low­er extrem­ity and rac­quet ­sports for the ­upper extrem­ity; 3) exer­cis­ing the spe­cif­ic skel­e­tal ­regions you ­want to strength­en as the ­bone ­response to mechan­i­cal load­ing is high­ly ­site-spe­cif­ic; 4) exer­cis­ing brief­ly, yet ­often to off­set the desen­si­ti­za­tion of skel­e­tal mechan­o­trans­duction path­ways; and 5) con­tin­u­ing to exer­cise as you age to pre­vent ­bone ­loss and ­reduce the ­risk of ­falls. Following ­these ­steps ­will ­help to pro­mote skel­e­tal ­health at all ­ages and may ­reduce an indi­vid­u­als ­risk for frac­ture by aug­ment­ing ­bone ­mass and ­size dur­ing ­youth, ­while reduc­ing age-relat­ed ­bone ­loss and the ­risk for ­falls in adult­hood.

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