GREATER MUSCLE TORQUE OF THE TRUNK EXTENSORS PREVENTS POSTMENOPAUSAL BONE LOSS IN THE LUMBAR SPINE
Masayuki Iki (Fukui Med. School, Matsuoka, Japan. Present address: Kinki Univ., Sayama, Japan), Etsuko Kajita (Toyama Med. Pharmaceu. Univ., Toyama, Japan), Yukie Saito (Fukui Inst. of Technol. for Med., Fukui, Japan), Yukinori Kusaka, Imura Shinichi, Yasushi Ishii (Fukui Med. School, Matsuoka, Japan)
To establish an effective exercise prescription for prevention of postmenopausal bone loss, we examined the effects of muscle strength of the trunk and extremities on the change in bone mineral density (BMD) of the lumbar spine.
We measured isokinetic concentric torque of the knee flexors and extensors, isokinetic concentric and eccentric torque of the trunk flexors (CTF and ETF, respectively) and extensors (CTE and ETE), and some other muscle strength indices of the upper extremities, and at the same time measured BMD by dual-energy X-ray absorptiometry in 149 healthy Japanese postmenopausal women. Among the subjects, 120 were followed up for four years and their changes in BMD (△BMD) were determined.
Significant partial positive correlations between △BMD and ETF (r=-0.207) and between △BMD and ETE (r=0.296) were observed after allowing for the effects of age at menopause, years since menopause, weight and BMD at baseline. In multiple regression analyses of △BMD, all the muscle torque indices of the trunk but none of those of the extremities showed significant effects in increasing BMD and ETE had the greatest effect among them (R2=43.3%).
These results suggest that an exercise program for gaining the strength of the trunk muscles, among others the trunk extensors, decreases the postmenopausal bone loss and is beneficial in the prevention of osteoporosis.
TITLE: REHABILITATION OF OSTEOPOROSIS
AUTHORS: Angela McNamara MB, FRCPI; Francis J Bonner., MD.
National Rehabilitation Board and Hospital, Dublin IRELAND, and Graduate Hospital Philadelphia PA USA.
Rehabilitation Medicine has a definite role to play in the management of osteoporosis in relieving symptoms and restoring function. Treatment must be based upon the degree of frailty or fitness, functional limitations, skeletal involvement and comorbidity.
Purpose: This presentation introduces a treatment guide for physicians which has been developed for the rehabilitation of the patient with osteoporosis.
Method: Basic principles of rehabilitation medicine and information from the clinical assessment and bone mineral density (BMD) are all used for the treatment plan.
Result: Three treatment programmes for the patient are suggested. The first is for those at risk of osteoporosis who have a normal BMD, and the other two for those with a low BMD depending on severity.
Conclusion: This serves as a useful guide for physicians involved in the comprehensive treatment of patients at risk of osteoporosis and those with established disease.