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Bone Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
Muscle health is central to bone health because strong muscles help to support the bones. The term sarcopenia refers to loss of skeletal muscle mass. It is one of the most influential causes of functional decline and loss of independence in older women.
Women’s Heath
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
Regular weight-bearing exercise is important for ongoing bone health. A number of randomized controlled trials (RCTs) have assessed the relationship between physical activity and bone mineral density (BMD) in women. In 2011, a meta-analysis of 43 such trials in post-menopausal women showed slower bone loss of 3.2% in the vertebral column and 1% in the hip (27). Both of these are highly significant. The mechanism for reduction in risk of osteoporosis appears to be related to increasing bone strength and also lowers the risk of falls.
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Other relevant medical information should be included in the referral information, such as whether the patient has chronic obstructive pulmonary disease (COPD), diabetes or renal impairment. Patient with such conditions may have limited mobility or may be house bound and so the patient may benefit from calcium and vitamin D supplementation. Weight-bearing exercise helps to maintain good bone health. Conditions such as Parkinson’s, previous stroke or multiple sclerosis need further investigation with a falls risk assessment. A standard statement for falls referral, particularly in patients over 75 years with osteoporosis, should be included in the report.
A theoretical framework for addressing fear of falling avoidance behavior in Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2023
Merrill R. Landers, Maria H. Nilsson
An additional important treatment priority in this pattern is doing strength training and weight bearing exercises that are sufficient to improve bone health. Since people in this pattern are avoiding activity, it is possible, from a theoretical perspective, that their bone health may be less than ideal due to a lack of participation in physical activity. Additionally, as falling is one of the two main causes that hastens mortality in PD, it is important to prevent the consequences of a fall (e.g. bone fractures) in those who are at high risk for falling. Mobility aids or assistive devices (e.g. rolling walker or rollator) to decrease the risk should also be recommended for people in this pattern if it is appropriate. Moreover, there should be encouragement to use the mobility aid or assistive device to facilitate more participation in physical activity. That is, these devices should be used to help enable the person to increase their physical activity without increasing their fall risk. Lastly, as improvements in balance and gait are realized, there should be a concomitant increase in physical activity (i.e. decreased avoidance behavior). If avoidance behavior due to FOF persists despite improved gait and balance, a therapist-led, social cognitive theory (Bandura, 2004; Ellis and Motl, 2013) and/or cognitive behavioral therapy (CBT) strategy (Dobkin et al., 2019; Herning, Cook, and Schneider, 2005; Kraepelien et al., 2020; Reynolds et al., 2020) may be needed to increase self-efficacy and physical activity levels and to decrease cognitive and affective factors associated with the avoidance behavior.
A strategic physical therapy approach to restore function and maintain quality of life for a patient with multiple myeloma and vertebral fracture: A case report
Published in Physiotherapy Theory and Practice, 2023
While bone metastases may carry an increased risk of fractures, studies have suggested that exercise does not increase this risk. In fact, functional weight bearing activities have been shown to improve bone health and mitigate the risk of fractures (Sheill, Guinan, Peat, and Hussey, 2018; Watson and Mock, 2004). The comprehensive narrative review by Sheill, Guinan, Peat, and Hussey (2018) suggested improvements in bone health were greater with exercise than with bisphosphonates, which is the standard medication used to manage this condition. Their study also highlighted a system to guide decision-making when prescribing exercise. This tool can be helpful for physical therapists who are designing exercise programs for patients with bone metastases. A randomized controlled trial by Rief et al. (2014) demonstrated improved bone density over the course of 6 months in 30 patients with stable bone metastases when a guided resistance training program for paraspinal and core musculature was provided.
Chemotherapy in patients with early breast cancer: clinical overview and management of long-term side effects
Published in Expert Opinion on Drug Safety, 2022
Paola Di Nardo, Camilla Lisanti, Mattia Garutti, Silvia Buriolla, Martina Alberti, Roberta Mazzeo, Fabio Puglisi
As for bone health, many trials demonstrated that both bisphosphonates (zoledronic acid, alendronate) and denosumab (a monoclonal antibody directed against RANKL) improve bone mineral density in women with osteoporosis or subjected to treatment with drugs capable of undermining bone health [137]. The duration of anti-resorptive treatment is controversial and is usually related to the persistence of a high fracture risk. There is also evidence that the use of bisphosphonates is associated to a reduction of bone recurrence, in particular in postmenopausal women [138]. Women should also be advised to adopt a lifestyle that promotes bone health, undergoing regular physical exercise to prevent bone loss; according to ESMO and NCCN guidelines, calcium and vitamin D supplementation is warmly recommended [139,140].