04/18/23

قالوا سبحانك ال قالوا سبحانك ال ““علم لنا اال ما علمتنا علم لنا اال ما علمتنا

انك انت العليم انك انت العليم

””الحكيمالحكيم3232سورة البقرة - اآلية سورة البقرة - اآلية

قالوا سبحانك ال قالوا سبحانك ال ““علم لنا اال ما علمتنا علم لنا اال ما علمتنا

انك انت العليم انك انت العليم

””الحكيمالحكيم3232سورة البقرة - اآلية سورة البقرة - اآلية

04/18/23

Osteoporosis Osteoporosis

BY

Dr. Ali Abd El Monsif Thabet Assistant professor of Physical Therapy

Department of Physical therapyFaculty of Applied Medical Science

Umm ALQura University

04/18/23Menopausal phase Post menopausal phase

Climacteric: means period of waning ovarian function which signals the end of the reproductive life span.

It is divided into three phases:

Pre menopausal phase

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Natural or physiological menopause.

Pathological menopause (premature, artificial,

delayed).

Menopause is defined as the cessation of menstrual cycles and results from follicular

depletion which

May be either:

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Menopausal changes

• Breast changes.

• Female genital organs.

• Cardiovascular changes.

• Endocrinal changes

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Postmenopausal symptoms

Amenorrhea.

vasomotor

Psychological changes.

Gastrointestinal

Obesity.

Fatigue

Sexual

Osteoporosis

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Osteoporosis, which means “ porous bone”, is quantitative reduction of bone mass, a disease characterized by progressive bone thinning. The deterioration of bone tissue can lead to bone fragility and fracture, especially of the hip, spine, and wrist.

OsteoporosisOsteoporosis

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The development of osteoporosis associated with a variety of risk factors.

Etiology of osteoporosis

Age and sexRaceGenetic factorSmoking Nutritional factorsPhysical activity and weigh bearing stress

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Alcohol abuse

Endocrinal factor

Body built

Breast feeding

Nuliparity

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(1) Hormonal theory

Pathogenesis of osteoporosis

(2) Nutritional theory

(3) Local biomechanical theory

The development of osteoporosis can be explained by three theories:-

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Pathogenesis of osteoporosis

Alteration in cellular activity whether decreased osteoblastic activity, increase resorption activity or a synchrony of theses

phases that result in loss of bone

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Osteoporotic patients usually complains from:

Clinical features of osteoporosis

(I) Bone pain

(II) fracture

(III) Loss of height

(IV) Deformities of the vertebral column

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Diagnosis of osteoporosis

(A) Radiological methods

(B) Laboratory methods

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Treatment of bone loss (Osteoporosis)

[I] Exercise

[II] Electrical modalities

[III] Advices

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Suggested exercise program for individual suffering from bone loss

A basic exercise program should have the A basic exercise program should have the following four components:following four components:

• Frequency• Duration• Intensity• Variety

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The exercise program should be performed in three stages:

• Warm-up stage

• Active exercise stage

And finally

• Cool-down gradually

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(II) Specific training (Spine and extremities)

Forms of exercise which can performed by patient suffering from bone loss

(I) Aerobic training (Generalized)

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A) Non weight bearing exercise

B) Weight bearing exercise

(I) Aerobic training (Generalized)

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Exercises were performed from various positions as

• Crock lying position.• Half crock lying position.• Prone lying position.• Prone kneeling.• Sitting position.

(II) Specific training program

(a) Spine

(b) For upper limbs

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Crock lying positionCrock lying position

Shoulder press exerciseShoulder press exercise

Head press exerciseHead press exercise

Decompression exercise for the spineDecompression exercise for the spine

Exercise to decrease Exercise to decrease lumbar lordosis. lumbar lordosis.

Back extension exercise.Back extension exercise.

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Half crock lying positionHalf crock lying position

Leg press exerciseLeg press exercise

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Prone lying positionProne lying position

Back extension exerciseBack extension exercise

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Prone kneeling positionProne kneeling position

Exercise to flatten Exercise to flatten lumbar spinelumbar spine

Back extension Back extension exerciseexercise

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Sitting positionSitting position

Back extension exerciseBack extension exercise

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Upper limbsUpper limbs

Forms of exercise for upper limbsForms of exercise for upper limbs

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*Piezo electric potential.

[II] Electrical modalities for bone loss

* Increase calcium flux of osteoblastic

cells.

* Induce osteogenesis and reduce resorption on the

bone surface.

(A) Electromagnetic fields (EMFs) It reduces bone loss through:

• Parameters • Frequency:- 50 – 150 Hz

• Duration:- 1 Hour daily

• Intensity:- 10 microvolt

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(B) Pulsed ultrasound therapy

Using frequency of 1.5MHz and intensity from 0.5-2W/cm for 10 minutes over paravertebral muscles

*It makes an electromechanical kinetic effect on the cell membrane interface the treated bone.

*Also relieves the pain via gate control theory, increase blood supply to the treated area that carry

waste metabolites.

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(C ) Ultraviolet therapy

*It converted 7 dehydrocholesterol into vit.D3 which converted in the liver into 25hydrocholecalciferol, then

in the kidney into active vit.D which increases the formation of calcium binding protein that aids calcium absorption from the GIT and helps to control calcium

deposition in the bone.

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(D) Laser

It reduced pain and enhance calcium deposition.

It increases mechanical load over the bone and blood supply to the treated area .electrical stimulation increases endogenous calcitonin levels

(E) Electrical stimulation

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For patient with osteoporosis, some movements should be avoided :

(1) Reaching above your shoulders is not recommended for someone with severe kyphosis.

[III] Advices

(2) Be cautious about bending forward to pick something from the floor .

(3) A twisting movement in the spine is dangerous for someone with spinal fractures.

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* Getting into and out of the bed.* Getting in and out of the chair.

*Driving.

Move safely to avoid Move safely to avoid injuryinjury

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