4. Strong and Dense Bones
Muscle pump
Weight bearing exercise
running, jumping
Wollf theory
Prof. Julius Wolff (1892): “The Law of Bone Remodeling”
The bones became stronger in reponse to increased exercise,
wich would make the bones less likely to fracture.
Exercise
Bonnick SL. The Osteoporosis Handbook
5. A report from Sweden examined the bone density in thighs:
A
64 world- class athletes:
• 11 weight lifters
• 25 runners
• 15 soccer players
• 9 swimmers
• 4 throwers.
B
24 healthy men who
exercised for fitness
C
15 men who did not exercise
all these athletes had a higher
bone density than the nonathletes
The nonathletes who exercise had a
higher bone density than nonexercising
group.
The other interesting finding:
a difference among the athletes bone
density depending on the sport.
The weight lifters had the greatest
bone density, followed by the runners
and soccer players and swimmers came
last. Bonnick SL. The Osteoporosis Handbook
6. Exercise prescription:
FITT= Frequency Intensity Time Type
Frequency:
• Weight-bearing aerobic activities 3-5 d.w-1
• Resistance exercise: 2-3 d.w-1
Intensity:
• Weight bearing aerobic activities: moderate, high
Osteoporosis: Moderate.
• resistance exercise: dumbell, barbel, elastic band, machine
8-10 major muscles, 8-12 repetition, 1-3 set
Time
• 30-60 min.d-1 of combination of weight bearing aerobic and resistance activities.
Type
• Weight bearing aerobic activities: tennis, stair climbing/desending, walking with
intermittent jogging
• Activities that involve jumping: volleyball, basketball
• Resistance exercise: weight lifting
ACSM’s Guidelines for Exercise Testing and Prescription. 8th edition. 2010
7. Primary
(healthy people)
Secondary
(Osteoporosis)
Tertiary
(Severe Osteoporosis +
bone fracture)
Age Children-adolescent-
young adult
50 yo
(menopause)
70 yo
Post menopause
Target Prevent osteoporosis Prevent bone fracture Prevent recurrent fractures
Exercise Weight bearing Specific, individual, under
supervision.
Rehabilitation, gradually.
12. Strengthening exercise Exercise is site specific
If you want strong spine you must exercise the
spine
If you want strong legs you must exercise the legs
Strengthening wrist
Strengthening hip
Strengthening back
Bonnick SL. The Osteoporosis Handbook
13. Back Extension Exercises
Sinaki M:
• Designed specifically for the woman with osteoporosis.
• Excellent exercises, even for the woman who is still limited
somewhat by pain from recent spinal fracture.
• Very safe even for a fragile spine
• The benefits are reduction in pain and increase in the strength of
the muscles that support the spine.
• Back fatique and weakness are reduced too.
Bonnick SL. The Osteoporosis Handbook
14. Isometric Abdominal Exercises
• The abdominal muscles also help to support the back
• Many familiar exercises for the stomach mucles infolve trunk
flexion, eq: sit-ups
(Women with Osteoporosis: partial sit-up).
Partial sit-up Pelvic tilt
16. The Four Exercise DON’Ts for the Woman with Osteoporosis
DON’T perform any exercise or activity
• Impact loading of the spine.
No jumping, no high-impact aerobics, no jogging, no running.
• to bend forward from the waist with the back rounded (spinal flexion)
No sit –ups, to toe touches, no crunches, no rowing machines.
• makes falls.
No trampolines, step aerobics.
• move leg sideways or across body against resistance:
(abduction and adduction)
18. “Senam Pencegahan Osteoporosis Seri-1”
Suwarno S. Tesis 2001
46 healthy young women, 25-35
yo
never done any exercise before
• A significant increase of the ulna and vertebral lumbal.
3 times a week of this exercise for 3,5 months
Bone Mineral Density (BMD)
19. “Senam Osteoporosis”
• 34 women post menopause
• The average age of the subjects was 64.3 years
• Training 3 times a week for 1-4 years
• The mean BMD of the lumbar spine prior to exercise was -2.42
• Post exercise measurement the mean BMD was -2.10
• A significant increase of Lumbal bone mineral density.
20. “Senam Osteoporosis”
53 post-menopausal women who were
joining the Senam Osteoporosis group.
three times a week
1-hour-exercise program
for various durations from 2008 to 2011
exercises were done using 1-kilogram
dumbell
After- before:
- hand grip strength test
- wrist BMD examination
a significant increase of hand grip strength
and wrist BMD (p=0.000 for both analysis)
21. Conclusion:
• Osteoporosis is preventable and treatable through many ways ,
one of them is exercise.
• The most important is strengthening exercise.
• Exercise is site specific.
• Exercise should be program individually.
