[Show abstract][Hide abstract] ABSTRACT: Bone is a remarkable, very strong and flexible structure. Running and jumping, together with muscle work, and lever arms generate ground reaction forces helping to model developing bone. Peak bone mass, strongly determined by genetic factors and exercise, is one of the most important factors in bone health. The amount of bone accrued, especially before the end of the third decade of life, is a major determinant of the risk of fractures in later life. Bones are a living tissue and constantly changing throughout one's lifetime, thus manifold osteopathies are known. The bone itself does not need to be the primary cause of diseases, but rather be affected in combination with other diseases. Besides osteopathies, such as fractures, achondroplasy, Morbus Paget, etc., osteoporosis which is defined as a systematic skeletal disease characterised by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture, according to the World Health Organization (WHO), is ranked among the ten prime widespread diseases. Bone mineral density (BMD) is used in diagnosing osteoporosis. Anamnesis and clinical findings, bone densitometry, medical imaging and the basic laboratory are basic diagnostics for osteoporosis. Physical inactivity, medication, sex, age, low body mass index, need to be regarded as risk factors for osteoporosis. Acute and chronic pain caused by osteoporosis restricts activities of daily living and diminishes quality of life. FRAX (a diagnostic tool), disregarding all advantages and disadvantages of the computer based algorithm, calculates the country-specific 10-year-probability of a major hip fracture. Several different bone disorders, especially osteoporosis, are among other reasons linked to a sedentary lifestyle and poor nutrition habits. Preventing osteoporosis is a lifelong task, involving aspects such as nutrition and body weight, physical activity, as well as the abuse of dependence-causing substances. Thus lifestyle modification, calcium, vitamin D3, physical activity, exercise and prevention of falls establish the basic therapy for osteoporosis. Building on this, secondary and tertiary prevention addresses the risk of fracture and repeated fracture prevention via medication. Physical medicine represents not merely an alternative, but rather a complementary and inevitable therapy option in treating bone disorders, especially osteoporosis. Consequently, physical exercise plays a key role in reducing fractures and repeated fractures. The study situation concerning physical activity and osteoporosis is so far not easy to evaluate, because interventions disagree on duration, intensity, specificity, and subject groups. Although there is a vast amount of literature on physical activity (described as one of the best medications against diseases of lifestyle), there is a lack of consensus according to the best dose-response correlation for bone health. In the context of bone health, particular attention is paid to whole body vibration. Whole body vibration may improve muscle strength and power and consequently bones and balance as well. However, the mechanism is not well understood and the exact role is still debated and cannot be uniformly prescribed. As society grows older and lifestyle becomes more and more sedentary, the occurrence of osteoporosis should be held as low as possible and therefore the diagnostic methods need to take action to recognise indications of osteoporosis as soon as possible and be able to determine the most effective treatment options.
No preview · Article · Jan 2014 · INTERNATIONAL SPORTMED JOURNAL
[Show abstract][Hide abstract] ABSTRACT: Lumbal spinal stenosis causes back pain spreading as far as the legs and thereby constrains the activities of daily living. By walking in a flexed position patients try to extend the foramina intervertebralia. Claudicatio intermittens/ spinalis forces them to stop walking and sit down, because of pain, parasthesias or paresis.(1) Loss of physical activity may lead to a decline of physical condition and slowly restrict independence.(2) The differential air pressure technology of AlterG treadmills reduces body weight in lower extremity up to 80% and facilitates normal postural control.(5) METHODS: After completing physiotherapy, a 70-year-old left sided lower leg amputed man started extensive endurance training. 250 m of walking were challenging. Therefore antigravity treadmill training was initiated in April.
Early therapy, visual analog scale (VAS) was set at 5.5. At the beginning of AlterG training, body weight was decreased by 40% up to 5% in November (VAS 0). As walking time increased (13-35min.) walking distance increased equally from 870 m to 2.4 k m.
One aim of functional rehabilitation is to decrease the pain,(3) keep the patient independent and thereby obtain his physical condition in order to prevent further (cardiorespiratory) diseases. One of the goals of using AlterG in rehabilitation of orthopedic patients is to restore normal walking mechanics.(4) The combination of physiotherapy and AlterG training leads to absence of lower back pain, walking distance increases significantly, the patient feels safer while walking and his independence is ensured.
The use of innovative AlterG can improve postural control, increase safety while walking as well as economy of movements and thereby affect the lower back pain.
No preview · Article · Jul 2013 · British Journal of Sports Medicine