Ziebart Christina, Pt Caitlin McArthur, Pt Judi Laprade
Health and Rehabilitation Sciences, Western University, 1201 Western Rd., London, ON N6A 3K7, Canada.
School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.
Gerontol Geriatr Med. 2021 Nov 19;7:23337214211052398. doi: 10.1177/23337214211052398. eCollection 2021 Jan-Dec.
The risks of end-range movements for people with osteoporosis, specifically at the hips and shoulder, are not well understood. To synthesize literature on the safety of stretching for people with osteoporosis by searching: 1) biomechanical literature to determine how much force results from an end-range maneuverer and is required to fracture joint components (focusing on the hip joint) and 2) clinical literature to describe techniques used, populations studied, effects, and reported adverse events. We conducted two separate search strategies in PubMed, EMBASE, and Scopus (1955-2020). 16 articles described either biomechanical or clinical effects of passive and active end ranges of the hip joint. The largest load in the hip, described in the literature was in a crescent lunge during yoga. The moment produced in a crescent lunge is much smaller than that of the tensile strength of osteoporotic bone, suggesting the crescent lunge movement could be considered safe. Clinically, no adverse events were reported in exercise, stretching or yoga interventions. This review found no evidence that end range movements of the hip are unsafe, but there is little evidence. No studies were identified that explored the risk of humeral fracture during end range stretches.
骨质疏松症患者进行终末范围运动的风险，尤其是在髋部和肩部，目前尚未得到充分了解。通过检索以下内容来综合关于骨质疏松症患者拉伸安全性的文献：1）生物力学文献，以确定终末范围动作会产生多大的力以及导致关节部件骨折所需的力（重点关注髋关节）；2）临床文献，以描述所使用的技术、研究的人群、效果以及报告的不良事件。我们在PubMed、EMBASE和Scopus数据库（1955 - 2020年）中进行了两种独立的检索策略。16篇文章描述了髋关节被动和主动终末范围的生物力学或临床效果。文献中描述的髋部最大负荷出现在瑜伽中的新月式弓步动作中。新月式弓步产生的力矩远小于骨质疏松性骨的拉伸强度，这表明新月式弓步动作可被认为是安全的。临床上，在运动、拉伸或瑜伽干预中均未报告不良事件。本综述未发现证据表明髋关节的终末范围运动不安全，但证据也很少。未找到探索终末范围拉伸期间肱骨骨折风险的研究。
