Osteoporosis

The primary goals of rehabilitation for osteoporosis are to educate the individual about the disease and to initiate an exercise program. The program established will depend on the underlying etiology, degree of bone loss, age and functional status of the individual. A comprehensive exercise program should focus on stretching, strengthening, impact aerobic exercise, and balance activities. It is important among this population to increase function and to prevent further bone loss and fractures (NIH Consensus Development Panel).

It should be noted that most research conducted on osteoporosis has investigated the effects of interventions on women, mainly in the postmenopausal stage. Therefore, care must be taken when applying these findings to other individual populations.

Exercise has been shown to have a positive effect on bone mineral density on both premenopausal and postmenopausal women (Heinonen; Kelley). An even greater benefit of exercise is noted in postmenopausal women when combined with pharmacological intervention (Going). Some exercise can prevent bone loss (de Jong) while other forms of exercise have been shown to increase bone mineral density. While walking has been shown to increase the bone density at the hip, exercises involving greater impact are needed to increase bone density at the spine (Bonaiuti; Wallace). The exercises performed will have an effect only on those bones specifically loaded. To facilitate a regular pattern of safe activity, supervised exercise is recommended in conjunction with a home program. When available, aquatic exercise should be considered. Once established, individuals should be strongly encouraged to continue exercising independently (Heinonen).

Other benefits of a comprehensive regular exercise program include improved quality of life and increased strength and balance, which may affect the rate of falls and related fractures in this population (Forwood).

An ergonomic evaluation may be beneficial to assess the presence of ergonomic risk factors within the workplace and to suggest modifications that ensure optimal employability of the individual.