Physical Activity and Osteoporosis

Osteoporoza je sistemska koštana bolest karakterizirana smanjenom koštanom masom i poremećenom mikroarhitekturom, što za posljedicu ima krhkost kostiju i povišen rizik od razvoja prijeloma. Za razvoj osteoporoze u starijoj dobi kritična je vršna koštana masa dosegnuta u mladosti. Tjelesna aktivnost, poglavito vježbe s opterećenjem i one jakog intenziteta, s vjerojatnim mehanizmom mehaničkog stresa i indukcije osteoblasta, imaju važnu ulogu u postizanju vršne koštane mase te prevenciji osteoporoze i osteoporotskih prijeloma. Osobama različitih dobnih skupina, ovisno o komorbiditetu, čimbenicima rizika od padova i prijeloma, ali i afinitetu prema određenim sportovima, preporučuju se različite tjelesne aktivnosti radi zaštite zdravlja kosti. Djeci i mladima radi postizanja maksimalne vršne koštane mase preporučuje se bavljenje sportovima kao što su košarka, odbojka, gimnastika odnosno aktivnostima s otporom, ponajprije onim antigravitacijskima. U žena, a napose nakon menopauze tjelesna aktivnost trebala bi uključivati vježbe snaženja mišića, aerobik, trening jakog intenziteta i/ili antigravitacijske vježbe radi smanjenja gubitka mineralne koštane mase. Program vježbanja za osobe s osteoporozom trebao bi sadržavati i vježbe posture, koordinacije i ravnoteže, hoda, snaženja mišića zdjeličnog obruča te mišića stabilizatora trupa. Osobe s verificiranim prijelomom kralješka u kroničnoj fazi trebale bi provoditi vježbe koordinacije i ravnoteže te vježbe snaženja mišića ekstenzora kralježnice. Rehabilitacijski program nakon osteoporotske frakture kuka uključuje uglavnom vježbe opsega pokreta, snaženja mišića, vježbe hoda i ravnoteže te funkcionalni trening. Pri osmišljavanju programa treninga za prevenciju ili liječenje osteoporoze nužno je individualno planiranje. Vježbe bi trebale biti specifične i postupno progresivne pri postizanju jačine intenziteta ili opterećenja kosti te se provoditi kontinuirano.Osteoporosis is a systematic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone leading to greater bone fragility and consequentially increased risk of fractures. Peak bone mass in youth is critical for the development of osteoporosis at an older age. Physical activity, especially resistance and high intensity exercises, with a probable mechanism of mechanical stress and osteoblastic induction, play a significant role in achieving peak bone mass and preventing osteoporosis and osteoporotic fractures. Various types of physical activity aimed at protecting bone health are recommended to individuals of different age groups, depending on comorbidity, risk factors for falls and fractures, as well as affinity for certain sports. To achieve maximum peak bone mass, children and young people are advised to engage in sports such as basketball, volleyball, gymnastics or resistance training, especially weight-bearing exercises. In the case of women, especially postmenopausal women, physical activity should include muscle strength training, aerobics, high intensity training and/or weight-bearing exercises to reduce the loss of bone mineral. Exercise programme for osteoporosis patients should include exercises for improving posture, coordination and balance, walking exercises, pelvic muscle strengthening exercises and core stability exercises. People with verified vertebral fracture in chronic phase should do exercises for improving coordination and balance, as well as back extensor strengthening exercises. The rehabilitation programme after osteoporotic hip fracture involves mainly the range of motion and muscle strength exercises, exercises for improving walking and balance, and functional training. When designing a training programme for the prevention or treatment of osteoporosis, individual planning is crucial. Exercises should be specific and gradually progressive in achieving intensity and bone load, and they should be performed regularly