Häuselmann H J, Kramer E, Michel B A
Rheumaklinik und Institut für Physikalische Medizin, Universitätsspital Zürich.
Ther Umsch. 1998 Nov;55(11):724-30.
Osteoporotic fractures, and in particular, hip fractures result in significant morbidity and mortality. Low bone mass is the main risk factor of enhanced bone fragility, resulting in an increased risk for hip fracture. Bone density of osteoporotic women with and without hip fractures show a considerable overlap. Therefore, other bone-independent factors also play an important role for the development of hip- and other osteoporotic fractures. One other important factor is falling. In 90% of hip fractures falling was involved [10-15], but only 5% or less of these falls resulted in a subsequent fracture. The view that adequate exercise is beneficial for skeletal health of children and for prevention and treatment of osteoporosis in adults is supported primarily by two lines of evidence: longitudinal and cross-sectional trials in children and young adult athletes showing a significant increase of muscle- and bone mass after strenuous (children) or chronic exercise (athletes) as compared to normally active (children) or sedentary control subjects. What are the potential benefits and limits of specific exercise programs with respect to bone mass, prevention of falls and fractures? In this review these questions are discussed and a specific exercise program in osteoporotic patients with fractures is delineated.
骨质疏松性骨折，尤其是髋部骨折，会导致显著的发病率和死亡率。低骨量是骨脆性增加的主要危险因素，会导致髋部骨折风险升高。有髋部骨折和无髋部骨折的骨质疏松女性的骨密度存在相当大的重叠。因此，其他与骨无关的因素在髋部骨折和其他骨质疏松性骨折的发生发展中也起着重要作用。另一个重要因素是跌倒。90%的髋部骨折与跌倒有关[10 - 15]，但这些跌倒中只有5%或更少会导致随后的骨折。充足的运动对儿童骨骼健康以及对成年人骨质疏松症的预防和治疗有益这一观点主要有两方面的证据支持：对儿童和年轻成年运动员进行的纵向和横断面试验表明，与正常活动的儿童或久坐不动的对照受试者相比，剧烈运动（儿童）或长期运动（运动员）后肌肉和骨量显著增加。就骨量、预防跌倒和骨折而言，特定运动计划的潜在益处和局限性有哪些？在本综述中，将对这些问题进行讨论，并描述针对有骨折的骨质疏松患者的特定运动计划。
