Osteoporosis – How can physiotherapy help?

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Osteoporotic fractures are more common among people aged 50 and older, particularly in women (1 in 3 women) compared to men (1 in 5 men).

Osteoporosis is diagnosed by using bone mineral density (BMD) tests. These results are compared to what is considered normal for young adults. If your BMD is lower than the average by 2.5 standard deviations (SD) or more, it indicates osteoporosis. If your BMD is between -1 and -2.5 SD, it’s called osteopenia, which is a lower level of bone density.

Exercise plays a significant role in maintaining bone health by preserving bone strength and mass. One of the main benefits of exercise is that it helps prevent fractures by reducing the risk of falls. Recent research from the Cochrane review showed that exercise can decrease the rate of falls in older adults by 23% and reduce the number of people experiencing fractures by 27%.

An illustrative instance of this concept is the Training Muscle and Osteoporosis Rehabilitation (LIFTMOR) program. It spans 8 months and involves supervised high-intensity progressive resistance and impact training (HiRIT). The focus of LIFTMOR has been on enhancing bone mass density (BMD) in the femoral neck and lumbar spine, along with bolstering muscle strength and overall physical function.

Here’s a breakdown of the intervention:

  • Duration: 8 months
  • Frequency: 2 sessions per week
  • Time: Each session lasts for 30 minutes

The intensity is set to be high, as indicated by the Rating of Perceived Exertion (RPE) scale, with the target of maintaining an RPE level of ≥ 16 on the 6-20 point Borg Scale. The regimen involves both machine-based isometric axial compression (IAC) exercises and HiRIT exercises.

For machine-based isometric axial compression (IAC) exercises:

  • The BioDensity equipment is utilized for exercises

For HiRIT exercises:

  • Free weight training
  • Impact loading exercises. The intensity of impact is gradually escalated by working towards achieving a controlled stiff-legged landing, based on individual tolerance.

The sets and repetitions comprise 5 sets of each exercise, with participants lifting the maximum weight they can handle for five repetitions, while maintaining proper form.

In terms of results: Improvements were observed in both HiRIT and IAC exercises. However, when compared to IAC exercises or the control group, HiRIT exercises exhibited more substantial enhancements in BMD and physical function. Additionally, HiRIT exercises demonstrated a greater reduction in the risk of fracture.

At the physio crew we have tailored OP program for individuals. If you have OP and want a proven solution through exercise and guidance, please contact our friendly reception staff.

Amar Sran (TPC)

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