Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener Medizinische Wochenschrift 1-2/2016

01.02.2016 | main topic

Prevention and rehabilitation of osteoporosis

verfasst von: MD Assoc. Prof. Katharina Kerschan-Schindl

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 1-2/2016

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Osteoporosis is a frequent disease in postmenopausal women. Despite the fact that fragility fractures cause many problems, osteoporosis is still underdiagnosed and undertreated. This manuscript outlines the topics diagnosis of osteoporosis, fracture risk prevention, and therapy after fracture. Regular physical activities, a sufficient intake of calcium, and a normal vitamin D level are important for bone health. Depending on the personal fracture risk, the patient may also be prescribed bone-specific medication to prevent fragility fractures. In case of a prevalent osteoporotic fracture, the initiation or adaptation of bone-specific therapy is indispensable. Since most osteoporotic fractures occur during a fall, fall risk reduction is an important measure to inhibit a new fracture. Rehabilitation of patients with fragility fractures varies with different localizations of the fracture and should be performed by a multidisciplinary team.
Literatur
1.
Zurück zum Zitat Consensus development conference. prophylaxis and treatment of osteoporosis. Am J Med. 1991;90:107–10. Consensus development conference. prophylaxis and treatment of osteoporosis. Am J Med. 1991;90:107–10.
2.
Zurück zum Zitat Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(Suppl 2):S3–7. CrossRefPubMed Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(Suppl 2):S3–7. CrossRefPubMed
3.
Zurück zum Zitat Kerschan-Schindl K, Patsch J, Kudlacek S, Gleiss A, Pietschmann P. Measuring quality of life with the German Osteoporosis Quality of Life Questionnaire in women with osteoporosis. Wien Klin Wochenschr. 2012;124:532–7. CrossRefPubMed Kerschan-Schindl K, Patsch J, Kudlacek S, Gleiss A, Pietschmann P. Measuring quality of life with the German Osteoporosis Quality of Life Questionnaire in women with osteoporosis. Wien Klin Wochenschr. 2012;124:532–7. CrossRefPubMed
4.
Zurück zum Zitat Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C, IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probably of fracture worldwide. Osteoporos Int. 2012;23:2239–56. PubMedCentralCrossRefPubMed Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C, IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probably of fracture worldwide. Osteoporos Int. 2012;23:2239–56. PubMedCentralCrossRefPubMed
5.
Zurück zum Zitat Borgström F, Lekander I, Ivergard M, Ström O, Svedborn A, Alekna V, Bianchi ML, Clark P, Curiel MD, Dimai HP, Jürisson M, Kallikorm R, Lesnyak O, McCloskey E, Nassonov E, Sanders KM, Silverman S, Tamulaitiene M, Thomas T, Tosteson AN, Jönsson B, Kanis JA. The international costs and utilities related to osteoporotic fractures study (ICUROS)-quality of life during the first 4 months after fracture. Osteoporos Int. 2013;24:811–23. CrossRefPubMed Borgström F, Lekander I, Ivergard M, Ström O, Svedborn A, Alekna V, Bianchi ML, Clark P, Curiel MD, Dimai HP, Jürisson M, Kallikorm R, Lesnyak O, McCloskey E, Nassonov E, Sanders KM, Silverman S, Tamulaitiene M, Thomas T, Tosteson AN, Jönsson B, Kanis JA. The international costs and utilities related to osteoporotic fractures study (ICUROS)-quality of life during the first 4 months after fracture. Osteoporos Int. 2013;24:811–23. CrossRefPubMed
6.
Zurück zum Zitat Díez-Pérez A, Hooven FH, Adachi JD, Adami S, Anderson FA, Boonen S, et al. Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone. 2011;49:493–8. CrossRefPubMed Díez-Pérez A, Hooven FH, Adachi JD, Adami S, Anderson FA, Boonen S, et al. Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone. 2011;49:493–8. CrossRefPubMed
7.
Zurück zum Zitat Kanis JA, Melton J III, Christiansen C, et al. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9:1137–41. (Perspective) CrossRefPubMed Kanis JA, Melton J III, Christiansen C, et al. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9:1137–41. (Perspective) CrossRefPubMed
8.
Zurück zum Zitat Bieglmayer C, Dimai HP, Gasser RW, et al. Biomarkers of bone turnover in diagnosis and therapy of osteoporosis: a consensus advice from an Austrian working group. Wien Med Wochenschr. 2012;162:464–77. CrossRefPubMed Bieglmayer C, Dimai HP, Gasser RW, et al. Biomarkers of bone turnover in diagnosis and therapy of osteoporosis: a consensus advice from an Austrian working group. Wien Med Wochenschr. 2012;162:464–77. CrossRefPubMed
9.
Zurück zum Zitat Kanis JA, Oden A, Johnell O, et al. The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int. 2007;18:1033–46. CrossRefPubMed Kanis JA, Oden A, Johnell O, et al. The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int. 2007;18:1033–46. CrossRefPubMed
10.
11.
Zurück zum Zitat Nordström P, Sievänen H, Gustafson Y, Pedersen NL, Nordström A. High physical fitness in young adulthood reduces the risk of fractures later in life in men: a nationwide cohort study. J Bone Miner Res. 2013;28:1061–7. CrossRefPubMed Nordström P, Sievänen H, Gustafson Y, Pedersen NL, Nordström A. High physical fitness in young adulthood reduces the risk of fractures later in life in men: a nationwide cohort study. J Bone Miner Res. 2013;28:1061–7. CrossRefPubMed
12.
Zurück zum Zitat Bonjour JP, Chevalley T, Rizzoli R, Ferrari S. Gene-environment interactions in the skeletal response to nutrition and exercise during growth. Med Sport Sci. 2007;51:64–80. CrossRefPubMed Bonjour JP, Chevalley T, Rizzoli R, Ferrari S. Gene-environment interactions in the skeletal response to nutrition and exercise during growth. Med Sport Sci. 2007;51:64–80. CrossRefPubMed
13.
Zurück zum Zitat Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011; CD000333. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011; CD000333.
14.
Zurück zum Zitat Tucker LA, Strong JE, LeCheminant JD, et al. Effect of two jumping programs on hip bone mineral density in premenopausal women: a randomized controlled trial. Am J Health Promot. 2015;29:158–64. CrossRefPubMed Tucker LA, Strong JE, LeCheminant JD, et al. Effect of two jumping programs on hip bone mineral density in premenopausal women: a randomized controlled trial. Am J Health Promot. 2015;29:158–64. CrossRefPubMed
15.
Zurück zum Zitat Ma D, Wu L, He Z. Effects of walking on the preservation of bone mienral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause. 2013;20:1216–26. CrossRefPubMed Ma D, Wu L, He Z. Effects of walking on the preservation of bone mienral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause. 2013;20:1216–26. CrossRefPubMed
16.
Zurück zum Zitat Gianoudis J, Bailey CA, Ebeling PR, et al. Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. J Bone Miner Res. 2014;29:182–91. CrossRefPubMed Gianoudis J, Bailey CA, Ebeling PR, et al. Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. J Bone Miner Res. 2014;29:182–91. CrossRefPubMed
17.
Zurück zum Zitat Wilks DC, Winwood K, Gilliver SF, Kwiet A, Chatfield M, Michaelis I, Sun LW, Ferretti JL, Sargeant AJ, Felsenberg D, Rittweger J. Bone mass and geometry of the tibia and the radius of master sprinters, middle and long distance runners, race-walkers and sedentary control participants: A pQCT study. Bone. 2009, 91–97. Wilks DC, Winwood K, Gilliver SF, Kwiet A, Chatfield M, Michaelis I, Sun LW, Ferretti JL, Sargeant AJ, Felsenberg D, Rittweger J. Bone mass and geometry of the tibia and the radius of master sprinters, middle and long distance runners, race-walkers and sedentary control participants: A pQCT study. Bone. 2009, 91–97.
18.
Zurück zum Zitat Rizzoli R, Stevenson JC, Bauer JM, et al. The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and economic aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas. 2014;79:122–32. CrossRefPubMed Rizzoli R, Stevenson JC, Bauer JM, et al. The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and economic aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas. 2014;79:122–32. CrossRefPubMed
19.
Zurück zum Zitat Kannus P, Palvanen M, Jarvinen T, Pakkari J. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366:1885–93. CrossRefPubMed Kannus P, Palvanen M, Jarvinen T, Pakkari J. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366:1885–93. CrossRefPubMed
20.
Zurück zum Zitat Zambito A, Bianchini D, Gatti D, Rossini M, Adami S, Viapiana O. Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study. Osteoporos Int. 2007;18:1541–5. CrossRefPubMed Zambito A, Bianchini D, Gatti D, Rossini M, Adami S, Viapiana O. Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study. Osteoporos Int. 2007;18:1541–5. CrossRefPubMed
21.
Zurück zum Zitat Sinaki M, Breay RH, Hughes CA, Larson DR, Kaufman KR. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int. 2005;16:1004–10. CrossRefPubMed Sinaki M, Breay RH, Hughes CA, Larson DR, Kaufman KR. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int. 2005;16:1004–10. CrossRefPubMed
22.
Zurück zum Zitat Itoi E, Sinaki M. Effect of back-stengthening exercise on posture in healthy women 49 to 65 years of age. Mayo Clin Proc. 1994;69:1054–9. CrossRefPubMed Itoi E, Sinaki M. Effect of back-stengthening exercise on posture in healthy women 49 to 65 years of age. Mayo Clin Proc. 1994;69:1054–9. CrossRefPubMed
23.
Zurück zum Zitat Lynn SG, Sinaki M, Westerlind KC. Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil. 1997;78:273–7. CrossRefPubMed Lynn SG, Sinaki M, Westerlind KC. Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil. 1997;78:273–7. CrossRefPubMed
24.
Zurück zum Zitat Sinaki M, Itoi E, Ahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone. 2002;30:836–41. CrossRefPubMed Sinaki M, Itoi E, Ahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone. 2002;30:836–41. CrossRefPubMed
25.
Zurück zum Zitat Giangregorio LM, McGill S, Wark JD, Laprade J, Heinonen A, Ashe MC, MacIntyre NJ, Cheung AM, Shipp K, Keller H, Jain R, Papaioannou A. Too fit to fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures. Osteoporos Int. 2015;26:891–910. CrossRefPubMed Giangregorio LM, McGill S, Wark JD, Laprade J, Heinonen A, Ashe MC, MacIntyre NJ, Cheung AM, Shipp K, Keller H, Jain R, Papaioannou A. Too fit to fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures. Osteoporos Int. 2015;26:891–910. CrossRefPubMed
26.
Zurück zum Zitat Pfeifer M, Begerow B, Minne HW. Effects of a new spinal orthesis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2004;83:177–86. CrossRefPubMed Pfeifer M, Begerow B, Minne HW. Effects of a new spinal orthesis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2004;83:177–86. CrossRefPubMed
27.
Zurück zum Zitat Guo JB, Chen BL, Xie B, Zhang WY, Yang YJ, Wang XQ. Surgical versus non-surgical treatment for vertebral compression fracture with osteopenia: a systematic review and meta-analysis. PLoS One. 2015;10:e0127145. PubMedCentralCrossRefPubMed Guo JB, Chen BL, Xie B, Zhang WY, Yang YJ, Wang XQ. Surgical versus non-surgical treatment for vertebral compression fracture with osteopenia: a systematic review and meta-analysis. PLoS One. 2015;10:e0127145. PubMedCentralCrossRefPubMed
28.
Zurück zum Zitat Black DM, Thompson DE, Bauer DC, Ensrud K, Musliner T, Hochberg MC, Nevitt MC, Suryawanshi S, Cummings SR, Fracture Intervention Trial. Fracture risk reduction with alendronate in women with osteoporosis: the fracture intervention trial. J Clin Endocrinol Metab. 2000;85:4118–24. CrossRefPubMed Black DM, Thompson DE, Bauer DC, Ensrud K, Musliner T, Hochberg MC, Nevitt MC, Suryawanshi S, Cummings SR, Fracture Intervention Trial. Fracture risk reduction with alendronate in women with osteoporosis: the fracture intervention trial. J Clin Endocrinol Metab. 2000;85:4118–24. CrossRefPubMed
29.
Zurück zum Zitat Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR; HORIZON Pivotal Fracture Trial. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356:1809–22. CrossRefPubMed Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR; HORIZON Pivotal Fracture Trial. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356:1809–22. CrossRefPubMed
30.
Zurück zum Zitat Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282:637–45. CrossRefPubMed Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282:637–45. CrossRefPubMed
31.
Zurück zum Zitat Cummings SR, Martin JS, Mc Clung MR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756–65. CrossRefPubMed Cummings SR, Martin JS, Mc Clung MR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756–65. CrossRefPubMed
32.
Zurück zum Zitat Neer R, Arnaud CD, Zanchettta JR, et al. Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344:1434–41. CrossRefPubMed Neer R, Arnaud CD, Zanchettta JR, et al. Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344:1434–41. CrossRefPubMed
33.
Zurück zum Zitat Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350:459–68. CrossRefPubMed Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350:459–68. CrossRefPubMed
34.
Zurück zum Zitat Kerschan-Schindl HJ, Obermayer-Pietsch B, Gasser RW, Dimai HP, Fahrleitner-Pammer A, Dobnig H, Roschger P, Preisinger E, Klaushofer K, Resch H, Pietschmann P. How long should women with postmenopausal osteoporosis be treated with a bisphosphonate? Horm Metab Res. 2013;45:621–8. CrossRefPubMed Kerschan-Schindl HJ, Obermayer-Pietsch B, Gasser RW, Dimai HP, Fahrleitner-Pammer A, Dobnig H, Roschger P, Preisinger E, Klaushofer K, Resch H, Pietschmann P. How long should women with postmenopausal osteoporosis be treated with a bisphosphonate? Horm Metab Res. 2013;45:621–8. CrossRefPubMed
35.
Zurück zum Zitat Pfeifer M, Minne H. Musculoskeletal rehabilitation after hip fracture: a review. Arch Osteoporos. 2010;5:49–59. CrossRef Pfeifer M, Minne H. Musculoskeletal rehabilitation after hip fracture: a review. Arch Osteoporos. 2010;5:49–59. CrossRef
36.
Zurück zum Zitat Handoll HH, Sherrington C, Mak JC. Interventions for improving mobility after hip fracture surgery in adults. Cochrane Database Syst Rev. 2011;16(3):CD001704. Handoll HH, Sherrington C, Mak JC. Interventions for improving mobility after hip fracture surgery in adults. Cochrane Database Syst Rev. 2011;16(3):CD001704.
37.
Zurück zum Zitat Kronborg L, Bandholm T, Palm H, Kehlet H, Kristensen MT. Feasibility of progressive strength training implemented in the acute ward after hip fracture surgery. PLoS One. 2014;9:e93332. PubMedCentralCrossRefPubMed Kronborg L, Bandholm T, Palm H, Kehlet H, Kristensen MT. Feasibility of progressive strength training implemented in the acute ward after hip fracture surgery. PLoS One. 2014;9:e93332. PubMedCentralCrossRefPubMed
38.
Zurück zum Zitat Overgaard J, Kristen MT. Feasibility of progressive strength training shortly after hip fracture surgery. World J Orthop. 2013;18:248–58. CrossRef Overgaard J, Kristen MT. Feasibility of progressive strength training shortly after hip fracture surgery. World J Orthop. 2013;18:248–58. CrossRef
39.
Zurück zum Zitat Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;12:CD007146. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;12:CD007146.
40.
Zurück zum Zitat El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f6234. PubMedCentralPubMed El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f6234. PubMedCentralPubMed
41.
Zurück zum Zitat Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG, Kerse N. Interventions in preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2012;12:CD005465. PubMed Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG, Kerse N. Interventions in preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2012;12:CD005465. PubMed
42.
Zurück zum Zitat Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev. 2010;6(10):CD001255. Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev. 2010;6(10):CD001255.
43.
Zurück zum Zitat Kerschan-Schindl K, Mikosch P, Obermayer-Pietsch B, Gasser RW, Dimai HP, Fahrleitner-Pammer A, Dobnig H, Roschger P, Preisinger E, Klaushofer K, Resch H, Pietschmann P. Current controversies in clinical management of postmenopausal osteoporosis. Exp Clin Endocrinol Diabetes. 2014;122:437–44. CrossRefPubMed Kerschan-Schindl K, Mikosch P, Obermayer-Pietsch B, Gasser RW, Dimai HP, Fahrleitner-Pammer A, Dobnig H, Roschger P, Preisinger E, Klaushofer K, Resch H, Pietschmann P. Current controversies in clinical management of postmenopausal osteoporosis. Exp Clin Endocrinol Diabetes. 2014;122:437–44. CrossRefPubMed
Metadaten
Titel
Prevention and rehabilitation of osteoporosis
verfasst von
MD Assoc. Prof. Katharina Kerschan-Schindl
Publikationsdatum
01.02.2016
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 1-2/2016
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-015-0417-y