Exercise and bracing in the osteoporotic and osteopenic individual

Current Opinion in Orthopaedics

Volumn 15, Issue 5, 2004, Pages 378-382

  Lin, Julie T ^a,b  

^a HOSPITAL FOR SPECIAL SURGERY   (United States)

^b NEW YORK PRESBYTERIAN HOSPITAL   (United States)

Author keywords

Bracing; Exercise; Hip protectors; Osteoporosis; Tai chi

Indexed keywords

BONE DENSITY; BONE MINERAL; BRACE; CHEMOTHERAPY; COMPARATIVE STUDY; HIP FRACTURE; HUMAN; KINESIOTHERAPY; LUMBAR SPINE; ORTHOSIS; OSTEOPENIA; OSTEOPOROSIS; PRESCRIPTION; PRIORITY JOURNAL; PROTECTIVE EQUIPMENT; REVIEW; TAI CHI; TRAINING; TREATMENT INDICATION;

EID: 4544252012     PISSN: 10419918     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.ccx.0000139989.12638.6f     Document Type: Review

References (24)

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2. Mitchell MJ, Baz MA, Fulton MN, et al.: Resistance training prevents vertebral osteoporosis in lung transplant recipients. Transplantation 2003, 76:557-562. Resistance training can help diminish the rate of bone loss in lung transplant patients receiving glucocorticoid therapy.
3. Braith RW, Magyari PM, Fulton MN, et al.: Resistance exercise training and alendronate reverse glucocorticoid-induced osteoporosis in heart transplant recipients. J Heart Lung Transplant 2003, 22:1082-1090. The combination of resistance exercise training and alendronate increases BMD more than either alone in heart transplant patients receiving glucocorticoid therapy.
4. Villareal DT, Binder EF, Yarasheski KE, et al.: Effects of exercise training added to ongoing hormone replacement therapy on bone mineral density in frail elderly women. J Am Geriatr Soc 2003, 51:985-990. This study demonstrated that elderly women receiving HRT who participated in supervised exercise training had significant increases in lumbar spine BMD.
5. Milliken LA, Going SB, Houtkooper LB, et al.: Effects of exercise training on bone remodeling, insulin-like growth factors, and bone mineral density in postmenopausal women with and without hormone replacement therapy. Calcif Tissue Int 2003, 72:478-484. The combination of exercise and HRT in postmenopausal women produced larger increases in BMD than HRT alone.
6. Kemmler W, Engelke K, Weineck J, et al.: The Erlangen Fitness Osteoporosis Prevention Study: a controlled exercise trial in early postmenopausal women with low bone density-first-year results. Arch Phys Med Rehabil 2003, 84:673-682.
7. Papaioannou A, Adachi JD, Winegard K, et al.: Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int 2003, 14:677-682. This study demonstrated the improvement in quality of life experienced by osteoporotic women with vertebral fracture after a 6-month home-based exercise program. Quality of life is an issue that is often overlooked in outcome studies.
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10. Wolf SL, Sattin RW, Kutner M, et al.: Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003, 51:1693-1701.
11. Wolf SL, Barnhart HX, Kutner NG, et al.: Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training. J Am Geriatr Soc 2003, 51:1794-1803. This is a reprint of the original study published in 1996, which found that tai chi reduces the risk of falls by nearly 50%. It was selected this past year as the best paper in the 1990s by the Journal of the American Geriatrics Society.
12. Wolf SL, Barnhart HX, Kutner NG, et al.: Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc 1996, 44:489-497.
13. Chan K, Qin L, Lau M, et al.: A randomized, prospective study of the effects of tai chi chun exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil 2004, 85:717-722. This study demonstrates that tai chi not only may have positive effects on balance but also may positively affect BMD.
14. Tsang WW, Hui-Chan CW: Effects of exercise on joint sense and balance in elderly men: tai chi versus golf. Med Sci Sports Exerc 2004, 36:658-667. This study's findings suggest that popular leisure activities such as golf may provide similar benefits on balance as tai chi. Further studies are needed to determine what other common sporting activities confer protection against falls.
15. Tsang WW, Hui-Chan CW: Effect of 4- and 8-week intensive tai chi training on balance control in the elderly. Med Sci Sports Exerc 2004, 36:648-657. As little as 4 weeks of intensive tai chi can result in significant improvements in balance. This requires a minimal time investment by patients unwilling to make extensive time investments.
16. Pfeifer M, Begerow B, Minne HW: Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil 2004, 83:177-186. This is one of the few studies to illustrate the role of bracing in improving trunk strength, kyphosis, and function. Few data are available that clearly define the role of bracing in the osteopenic and osteoporotic individual.
17. van Schoor NM, Smit JH, Twisk JW, et al.: Prevention of hip fractures by external hip protectors: a randomized controlled trial. JAMA 2003, 289:1957-1962. This randomized controlled trial involved 561 elderly participants and is one of the trials that did not find hip protectors to be effective in preventing hip fractures.
18. Birks YF, Porthouse J, Addie C, et al.: Randomized controlled trial of hip protectors among women living in the community. Osteoporos Int. 2004, Mar 3 (Epub ahead of print). This trial examined the role of hip protectors in those at highest risk for fracture: those with a history of one hip fracture. Conclusions made from the study were that hip protectors did not protect against a second hip fracture. A major drawback to this study was its low power.
19. Schroder HM, Petersen KK, Erlandsen M. Occurrence and incidence of the second hip fracture. Clin Orthop. 1993, Apr:166-169.
20. Birks YF, Hildreth R, Campbell P, et al.: Randomised controlled trial of hip protectors for the prevention of second hip fractures. Age Ageing 2003, 32:442-444.
21. Cameron ID, Cumming RG, Kurrle SE, et al.: A randomised trial of hip protector use by frail older women living in their own homes. Inj Prev 2003, 9:138-141. This trial involved 366 elderly persons and revealed a significantly decreased risk of hip fracture while they were wearing hip protectors. This study provides more supportive evidence for the benefits of hip protectors.
22. Warnke A, Meyer G, Bender R, et al.: Predictors of adherence to the use of hip protectors in nursing home residents. J Am Geriatr Soc 2004, 52:340-345.
23. Van Schoor NM, Asma G, Smit JH, et al.: The Amsterdam Hip Protector Study: compliance and determinants of compliance. Osteoporos Int 2003, 14:353-359.
24. Haines TP, Bennell KL, Osborne RH, et al.: Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. BMJ 2004, 328:676. This falls prevention trial used multiple interventions, including a falls risk alert card, exercise program, education program, and hip protectors. A 30% decreased risk of falling was noted 45 days after the trial commenced.