Immobilization, Exercise, and Osteoporosis

Summary

• Decreased weight-bearing and immobilization are known stimuli to bone resorption and result in accelerated bone loss.

• A progressive, sound, strengthening exercise program for axial and appendicular musculature can decrease the risk of falls. Proprioceptive dynamic posture training can improve balance.

• Spinal supports and gait-assistive devices can improve posture, prevent falls, restore confidence, increase activity, and improve balance.

• Back supports are used in an attempt to support and correct posture as much as possible.

• The use of protective hip pads can decrease the impact of falling on the greater trochanteric area and decrease the risk of fracture.

Much of what is known about the relationship between the intensity of mechanical loading and bone mass has been deduced from animal studies. Only in those studies that subjected bone to defined loading regimens in vivo could the related architectural and mineral changes be investigated. In humans, several studies, especially in weightlifters and gymnasts, have demonstrated that exercise can increase muscle strength and bone mass. Therefore, weight-bearing and progressive, safe, weightlifting exercises are required for healthy individuals and are superior to endurance exercises for the prevention of bone loss.

The results of studies on the effect of exercise on bone mass in older individuals have been more controversial. Muscle mass decreases by 30% and muscle strength decreases by about 50% between the ages of 30 and 70 years. Musculoskeletal complications can increase when the effect of immobility is added to the process of aging. Exercise can increase bone mass by about 2–4%, with maximum gain achieved in sedentary people.