Modern Rehabilitation in Osteoporosis, Falls, and Fractures

Dionyssiotis, Yannis; Skarantavos, G.; Papagelopoulos, Panayiotis J.

doi:10.4137/cmamd.s14077

Cited by 27 publications

(29 citation statements)

References 90 publications

(165 reference statements)

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“…On the other hand, strains above the upper threshold of the remodelling window will increase formation over resorption. 16,31 Nevertheless, this explanation is quite simple considering the complex pathophysiology with regard to hormonal influences, the injury and the neurogenic factor in body composition of paraplegics. 3 All paraplegics were in the chronic stage, which suggests that the neurogenic factor coexists as an influential regulator.…”

Section: Discussionmentioning

confidence: 99%

Impact on bone and muscle area after spinal cord injury

Dionyssiotis¹,

Stathopoulos²,

Trovas³

et al. 2015

BoneKEy Reports

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Spinal cord injury (SCI) causes inactivation and consequent unloading of affected skeletal muscle and bone. This crosssectional study investigated correlations of muscle and bone in spinal cord-injured subjects compared with able-bodied subjects. Thirty-one complete SCI paraplegics were divided according to the neurological level of injury (NLoI) into group A (n ¼ 16, above thoracic 7 NLoI, age: 33 ± 16 years, duration of paralysis (DoP): 6 ± 6 years) and group B (n ¼ 15, thoracic 8-12, age: 39±14 years, DoP: 5.6±6 years), compared with 33 controls (group C). All were examined with peripheral quantitative computed tomography at 66% of tibia length (bone and muscle area, bone/muscle area ratio). In ablebodied subjects, muscle area was correlated with bone area (Po0.001, r ¼ 0.88). Groups A and B differed significantly from the control group in terms of bone and muscle area (Po0.001). In paraplegics, less muscle per unit of bone area (bone/muscle area ratio) was found compared with controls (Po0.001). Bone area was negatively correlated with the DoP in the total paraplegic group (r ¼ À 0.66, Po0.001) and groups A and B (r ¼ À 0.77, P ¼ 0.001 vs r ¼ À 0.52, P ¼ 0.12, respectively). Muscle area and bone/muscle ratio area correlations in paraplegic groups with DoP were weak. Paraplegic subjects who performed standing and therapeutic walking had significantly higher bone area (P ¼ 0.02 and P ¼ 0.013, respectively). The relationship between bone and muscle was consistent in able-bodied subjects and it was predictably altered in those with SCI, a clinical disease affecting bone and muscle.

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Section: Discussionmentioning

confidence: 99%

Impact on bone and muscle area after spinal cord injury

Dionyssiotis¹,

Stathopoulos²,

Trovas³

et al. 2015

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“…Zaleca się również, aby chory po złamaniu szyjki kości udowej wykonywał ćwiczenia kinezyterapeutycznych dłużej niż 15-30 minut w sesji. Stopniowe obciążanie kończyny można rozpocząć po 18 dniach, a ćwiczenia o większej intensywności, takie jak trening siłowy, mogą być stopniowo wdrażane po miesiącu rehabilitacji szpitalnej [19].…”

Section: Edukacja Pacjentaunclassified

The physiotherapeutic procedures in patients with or without osteoporotic fractures

Grześkowiak¹,

Leszczyński²,

Lewandowski³

2013

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142 StreszczenieZłamania osteoporotyczne są jednym z najgorszych powikłań osteoporozy. Zadaniem fizjoterapii jest więc przede wszystkim niwelowanie czynników ryzyka upadków oraz poprawa jakości życia i sprawności u pacjentów, u których do złamań już doszło. Celem pracy jest przedstawienie systematyki postępowania fizjoterapeutycznego i stworzenie wytycznych dla lekarzy, którzy mają kontakt z takimi pacjentami. Zawarte w pracy treści oparto na własnych obserwacjach oraz aktualnych doniesieniach z literatury poświęconej temu problemowi. Nieodzownym elementem prowadzenia pacjentów bez złamań lub ze złamaniami jest kinezyterapia wspomagana fizykoterapią. Ponadto pacjenci muszą dostrzec sens wykonywania różnorodnych procedur fizjoterapeutycznych oraz wiedzieć, które z nich mogą wykonywać samodzielnie poza oddziałami rehabilitacyjnymi, co można osiągnąć dzięki edukacji. Fizjoterapia obejmują-ca kinezyterapię, fizykoterapię oraz edukację pacjenta stanowi nieodzowny element terapii pacjentów z osteoporozą.Słowa kluczowe: złamania osteoporotyczne, upadki, fizjoterapia. SummaryOsteoporotic fractures are one of the worst complications of osteoporosis. Decreasing the main risk factors for falls and improving the quality of life and physical fitness among patients with osteoporotic fractures are the main objectives of physiotherapy treatment. The aim of this paper is to present the characteristics of physiotherapeutic procedures and to lay down guidelines for medical doctors who are treating such patients. The contents of this article are based on the authors' own experience and observations and also on the latest reports from the literature on the subject. The main element of treating patients with or without osteoporotic fractures is therapeutic exercises supported by physical medicine. At the same time, proper education of those patients is also very important. In conclusion, therapeutic exercises, physical medicine and patients' education are the main elements of therapy for patients with or without osteoporotic fractures.Key words: osteoporotic fractures, falls, physiotherapy.Postêpowanie fizjoterapeutyczne u pacjentów z osteoporoz¹ bez z³amañ i ze z³amaniami WstępObecnie nie ma jednoznacznych dowodów na to, które z procedur postępowania fizjoterapeutycznego i w jaki sposób zalecane mogą być skuteczne w leczeniu osób z osteoporozą. Z tego też powodu w większości przypadków terapia tych pacjentów jest ukierunkowana przede wszystkim na leczenie farmakologiczne i całkowicie pomija sposoby niefarmakologiczne [1].Celem niniejszej pracy jest przedstawienie na podstawie doświadczeń własnych oraz przeglądu aktualnego piśmiennictwa metod wykorzystywanych w fizjoterapii, które mogą znaleźć zastosowanie w leczeniu osób z osteoporozą, i stworzenie swego rodzaju wytycznych dla lekarzy prowadzących takich pacjentów.

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“…Osteoporosis is a widespread chronic metabolic disease, in the course of which the bone mass continously decreases, usually occurring with increasing age, that predominantly affects postmenopausal women and older people (1). The disease usually leads to an increased risk of bone fractures, especially in the wrist, spine or hips, causing significant disability, morbidity, mortality and expenses (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…The disease usually leads to an increased risk of bone fractures, especially in the wrist, spine or hips, causing significant disability, morbidity, mortality and expenses (1,2).…”

Section: Introductionmentioning

confidence: 99%

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The efficacy of modern spinal orthoses and hip protectors used in the management of osteoporosis: a review

Colobățiu¹,

Mirel²

2016

Balneo

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Globally, osteoporosis is considered a widespread metabolic bone disease, vertebral fractures being probably one of the most common clinical manifestations encountered in osteoporotic patients. Non-pharmacologic therapies of osteoporosis include, among others, the use of different types of orthoses, such as spinal orthoses or hip protectors. To date there is a limited number of studies that evaluate the efficacy of spinal orthoses and hip protectors used in osteoporotic patients, therefore providing insufficient information to clinicians regarding these aspects. This article reviewed the use and efficacy of the most commonly prescribed spinal orthoses and hip protectors in osteoporotic patients. According to a significant number of studies, modern spinal orthoses proved to be effective in the management of vertebral fractures in osteoporotic patients. However, the efficacy of hip protectors in reducing the impact of falls onto the hip and preventing hip fractures still seems to be controversial. Osteoporosis is a condition that should be treated using a comprehensive approach that includes both pharmacological and non-pharmacological treatment options. Orthoses, such as modern spinal orthoses or back braces and hip protectors might represent an efficacious nonpharmacological option in the management of osteoporotic vertebral or hip fractures.

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Modern Rehabilitation in Osteoporosis, Falls, and Fractures

Cited by 27 publications

References 90 publications

Impact on bone and muscle area after spinal cord injury

Impact on bone and muscle area after spinal cord injury

The physiotherapeutic procedures in patients with or without osteoporotic fractures

The efficacy of modern spinal orthoses and hip protectors used in the management of osteoporosis: a review

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