1 / 133

osteoporosis

osteoporosis. Z. Bonakdar Rheumatologist. Osteoporosis is a skeletal disorder characterized by low bone mass with microarchitectural disruption and fragility, resulting in an increased risk of fracture.

mae
Télécharger la présentation

osteoporosis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. osteoporosis Z. Bonakdar Rheumatologist

  2. Osteoporosis is a skeletal disorder characterized by low bone mass with microarchitectural disruption and fragility, resulting in an increased risk of fracture. • Decreased bone mass can occur because peak bone mass is low, bone resorption is excessive, or bone formation during remodeling is decreased.

  3. Bone tissue is in a continual process of building, breaking down and rebuilding. During periods of human growth the rate of bone formation exceeds that of bone loss. The reverse is true as age increases. Bones reach their maximum strength and density (peak bone mass) between the ages of 20 and 30 years. • Factors affecting peak bone mass include diet, calcium intake, physical activity and genetics.

  4. After the age of about 40–50 years, the rate of bone loss increases and bone mass is lost. Bone mineral density later in life is determined by the bone mass accumulated during youth and the subsequent rate of bone loss.

  5. Bone accretion occurs during adolescence and peak bone mass is normally achieved after puberty and into the third decade of life. • Bone mass declines with age, about 0.3- 0.6% in cortical bone and 0.8- 1.2% in trabecular bone annually. • At menopause, an acceleration of bone loss occurs over approximately 5 to 8 years, with an annual 2 to 3 percent loss of trabecular and 1 to 2 percent loss of cortical bone.

  6. Over lifetime, women lose approximately 50 percent of trabecular and 30 percent of cortical bone, where as men lose two thirds of these amounts. • After 50 years of age, there is an exponential rise in fractures such that 40 percent of women and 13 percent of men develop one or more osteoporotic fractures.

  7. It is estimated that one in two women and one in four men over the age of 60 will have a fracture due to osteoporosis in their lifetime. • Of all reported osteoporotic fractures, 46% are vertebral, 16% are hip and 16% are wrist fractures.

  8. It has been predicted from epidemiological modelling that a 10% increase in peak bone mass could significantly delay the onset of osteoporosis and reduce the risk of osteoporotic fractures later in life. • One model showed that a 10% increase in peak bone mineral density was predicted to delay the development of osteoporosis by 13 years. • Another study using modeling from epidemiological studies predicted that a 10% increase in peak bone mass would reduce the risk of fragility fractures after the menopause by 50%.

  9. Additionally, it suggests that peak bone mineral density (BMD) may be the single most important factor in delaying the development of the disease. • Consistent data from randomized controlled trials show that exercise training programs can prevent or reverse almost 1% of bone loss per year in both pre- and post-menopausal women.

  10. Three frequent types of osteoporotic fracture Fractures of the vertebral Fractures of the proximal hip Fractures of the distal radius Life time risk above age 50 years Female Male 15.6% 5% 17.5% 6% 16% 2.5%

  11. The percentage of patients with osteoporosis increases progressively with age, of US women, 13% in their 50s, 27% in their 60s, 47% in their 70s, and 67% in their 80s meet the diagnostic criteria for osteoporosis. • Bone mass is a major determinant of fracture risk: For every 10% decline in bone mass, there is an approximate doubling of fracture risk in the population.

  12. Prevalence of Osteoporosis and Low Bone Mass in People Aged 50 and Over

  13. Assessment of fracture risk should include evaluation of both: • BMD • Clinical risk factors

  14. Nutrition • Calcium and vitamin D prepubertal children 800 mg/day adolescents 1300 mg/day women and men 1000 mg/day women and men over 50 years 1500 mg/day women and men 400 IU/day women and men over 50 years 800-1000 IU/day • Tea contains fluoride and phytoestrogens with positive role in bone health • Excess caffeine > 4 cups should be avoided • Excess dietary sodium > 2100 mg/day or 90 mmol/day should be avoided

  15. Nutrition • Excessive alcohol should be avoided • Cigarette smoking should be stopped • Excessive vitamin A should be avoided • High protein diet should be avoided • Vitamin K may be efficacious in slowing bone loss but has not been shown to be superior to Ca and vitamin D • Population with highphytoestrogen intakes have lower rates of fracture • Multinutrient supplement 600 mg magnesium, 15 mg zinc, 120 mg vitamin C, 80 mg vitamin K, 3 mg boron- all nutrients believed to be important for bone health

  16. Physical activity and falls prevention • Impact exercises (high impact aerobics, running, jump training) lead to an improvement in BMD • For older men and women at risk of falling, tailored programs, contain exercises to improve strength and balance should be considered Hip protectors Exercise Environmental modifications

  17. Three types of exercise for osteoporosis are: • Weight-bearing(Walking- Hiking- Dancing- Stair climbing) • Resistance(dumbbells and barbells, elastic band resistance, body-weight resistance or weight-training machines ) • Flexibility(Regular stretches-T'ai chi-Yoga)

  18. Body Vibration [WBV]

  19. In a study of healthy, postmenopausal women, a 24-week whole body vibration program was shown to improve muscle strength, balance and hip bone density. • The Bone Mass Density (BMD) of the hip increased by 1% . • Research indicates that the highest muscle reflex response may occur between 30Hz and 40Hz. • The duration of the vibration exercise programs was between 20-30 minutes.

  20. Dynamic Motion Therapy (DMT)

  21. How Physical Activity Impacts Health

  22. Reduce the risk of premature death • Reduce the risk of developing and/or dying from heart disease • Reduce high blood pressure or the risk of developing high blood pressure • Reduce high cholesterol or the risk of developing high cholesterol • Reduce the risk of developing colon cancer and breast cancer

  23. Reduce the risk of developing diabetes • Reduce or maintain body weight or body fat • Build and maintain healthy muscles, bones, and joints • Reduce depression and anxiety • Improve psychological well-being • Enhanced work, recreation, and sport performance

  24. Specific Health Benefits of Exercise • Heart Disease and Stroke. Daily physical activity can help prevent heart disease and stroke by strengthening your heart muscle, lowering your blood pressure, raising your high-density lipoprotein (HDL) levels (good cholesterol) and lowering low-density lipoprotein (LDL) levels (bad cholesterol), improving blood flow, and increasing your heart's working capacity.

  25. High Blood Pressure. Regular physical activity can reduce blood pressure in those with high blood pressure levels. Physical activity also reduces body fatness, which is associated with high blood pressure.

  26. Noninsulin-Dependent Diabetes. By reducing body fatness, physical activity can help to prevent and control this type of diabetes.

  27. Obesity. Physical activity helps to reduce body fat by building or preserving muscle mass and improving the body's ability to use calories. When physical activity is combined with proper nutrition, it can help control weight and prevent obesity, a major risk factor for many diseases.

  28. Back Pain. By increasing muscle strength and endurance and improving flexibility and posture, regular exercise helps to prevent back pain.

  29. Osteoporosis. Regular weight-bearing exercise promotes bone formation and may prevent many forms of bone loss associated with aging.

  30. Psychological Effects. Regular physical activity can improve your mood and the way you feel about yourself. Researchers also have found that exercise is likely to reduce depression and anxiety and help you to better manage stress.

  31. Regular physical activity • up to a 35% lower risk of coronary heart disease and stroke • up to a 50% lower risk of type 2 diabetes • up to a 50% lower risk of colon cancer • up to a 20% lower risk of breast cancer • a 30% lower risk of early death • up to an 83% lower risk of osteoarthritis • up to a 68% lower risk of hip fracture • a 30% lower risk of falls (among older adults) • up to a 30% lower risk of depression • up to a 30% lower risk of dementia

  32. Recommended physical activity levels • Children under 5 should do 180 minutes every day • Young people (5-18) should do 60 minutes every day • Adults (19-64) should do 150 minutes every week • Older adults (65 and over) should do 150 minutes every week

  33. Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break a sweat. One way to tell if you're working at a moderate intensity is if you can still talk but you can't sing the words to a song.

  34. Examples of moderate-intensity aerobic activities are: • walking fast • water aerobics • riding a bike on level ground or with few hills • playing doubles tennis • pushing a lawn mower Daily chores such as shopping, cooking or housework don't count towards your 150 minutes. This is because the effort needed to do them isn’t hard enough to get your heart rate up.

  35. Exercise can be divided into three broad categories: • aerobic, • anaerobic, • and agility training

  36. Aerobic exercise • Most aerobic exercises are done at moderate levels of intensity for longer periods, compared to other categories of exercise. An aerobic exercise session involves warming up, exercising for at least 20 minutes, and then cooling down. Aerobic exercise involves mainly the large muscle groups(swimming, running, cycling and walking ).

  37. Anaerobic exercise • The aim of anaerobic exercise is to build power, strength and muscle. The muscles are exercised at high intensity for short durations. • Anaerobic exercises include: Weight lifting Sprinting Intensive and fast skipping (with a rope) Interval training Isometrics Any rapid burst of hard exercise

  38. Overall, anaerobic exercise uses up fewer calories than aerobic exercise. The cardiovascular benefits of aerobic exercises are greater than the cardiovascular benefits of anaerobic exercises. However, anaerobic exercise is better at building strength and muscle mass.

  39. Agility training • Agility training aims to improve a person's ability to speed up and slow down, change directions while maintaining balance and control. • Agility includes speed, strength, balance and coordination. The following sports are known to require agility : Tennis Soccer Rugby American football Squash Hockey Badminton Volleyball Basket ball Martial arts Boxing Wrestling

  40. Yoga and Pilates • Some exercises include a combination of stretching, muscle strengthening, balance. A good example is Yoga. • Yoga exercises, or movements, improve your balance, flexibility, posture and circulation. • Pilates is similar to Yoga, but it focuses more on the core abdominal and back muscles.

  41. Exercise for Osteoporosis Three types of exercise for osteoporosis are: • Weight-bearing • Resistance • Flexibility

More Related