Fitness Exercise for Osteoporosis Patients

Fitness Exercise for Osteoporosis Patients

Osteoporosis can be classified into three main types based on its underlying causes: primary osteoporosis, secondary osteoporosis, and idiopathic osteoporosis. Primary osteoporosis is the most common type, accounting for 90% of all cases. It is primarily caused by age-related changes, hormonal fluctuations, and decreased organ physiological function. Primary osteoporosis can be further divided into Type I and Type II. Type I osteoporosis, also known as postmenopausal osteoporosis, occurs in women due to decreased ovarian function and a reduction in estrogen levels after menopause. Type II osteoporosis, on the other hand, is senile osteoporosis, which is more prevalent in individuals over the age of 70. It results from age-related decreases in calcium intake and absorption, leading to lower blood calcium levels, accelerated bone loss, and the development of osteoporosis. Secondary osteoporosis is caused by other factors such as certain diseases or medications that affect bone metabolism. This includes endocrine-related osteoporosis, drug-induced osteoporosis, and disuse osteoporosis. Idiopathic osteoporosis is a type of osteoporosis with an unknown cause, often occurring during specific periods such as childhood, adolescence, pregnancy, or lactation. Fitness exercise for osteoporosis patients primarily targets those with primary osteoporosis, but it can also have certain benefits for those with secondary and idiopathic osteoporosis.

(1) Objectives of Fitness Exercise for Osteoporosis Patients

The primary goals of fitness exercise for osteoporosis patients are to increase blood flow to the bones, deliver more nutrients to bone cells, enhance osteoblast activity, promote bone formation, increase the demand for calcium, and facilitate its absorption. Engaging in outdoor fitness exercises to receive adequate sunlight can also help boost vitamin D levels, which further aids calcium absorption. Strength exercises that involve overcoming gravity or added resistance can increase mechanical stress on the bones, promoting bone remodeling and reshaping, thus increasing bone mass and density. Fitness exercises can also elevate estrogen and testosterone levels, stimulate bone protein synthesis, increase total bone matrix, and promote bone mineralization, thickening, and epiphyseal fusion.

(2) Key Points to Consider in Fitness Exercise for Osteoporosis Patients

First, before starting any exercise regimen, individuals must consult professionals for health and fitness assessments, taking into account their specific diseases and physical conditions to develop suitable fitness plans. Osteoporosis patients with comorbidities such as obesity, hypertension, or other cardiovascular conditions should consider special exercise requirements.

Second, high-impact exercises like basketball, soccer, and tennis can prevent osteoporosis, but middle-aged and elderly patients should reduce high-impact or collision sports.

Third, during exercise, attention should be paid to dietary adjustments. A diet that is high in calcium, low in salt, and contains moderate protein is essential. Relying solely on health supplements should be avoided. Bone health requires long-term attention, so establishing good dietary habits and regular exercise routines are the most effective and ideal methods for preventing and treating osteoporosis.

Fourth, balance ability is essential for fall prevention. In addition to strength exercises, middle-aged and elderly osteoporosis patients should also engage in balance and flexibility exercises.

Fifth, in general, fitness exercise should be consistently performed for at least four months to achieve the purpose of treating osteoporosis and promoting bone health. Patients need to gradually progress and maintain consistency in their exercise routine.

(3) Selection of Fitness Exercise for Osteoporosis Patients

Different exercise types have varying impacts on bone density. While all forms of exercise promote blood circulation and nutrient delivery to bones, the gravitational load and mechanical stress on bones differ between different activities. For example, football and running athletes tend to have higher bone density in their legs, while boxers, weightlifters, and climbers have higher bone density in their upper limbs. Rugby players tend to have higher lumbar spine bone density. Activities like swimming, water polo, rowing, and cycling, which do not require overcoming body weight, have a less potent effect on bone density compared to running, jumping exercises, climbing stairs, or ball games. Therefore, high-impact exercises like running and jumping are the most effective means to increase bone mass. Generally, short-duration, high-speed, and high-intensity exercises have better effects on bone promotion compared to low-load, long-duration repetitive exercises. To prevent osteoporosis, exercises like brisk walking, running, dancing, skipping, stair climbing, basketball, soccer, tennis, badminton, climbing, and aerobics are recommended.

Preventing osteoporosis through fitness exercise is age-specific:

(1) children and adolescents have not fully ossified bones, and their epiphyseal cartilage growth is rapid, resulting in lower bone load-bearing capacity and increased vulnerability to deformation. Therefore, they should avoid high-load weight exercises and focus on speed and explosive exercises, ideally in the form of games, such as gymnastics, skipping, hopscotch, shuttlecock kicking, soccer, and chasing games. Resistance exercises can be combined with activities like push-ups and pull-ups during physical education classes to stimulate bones and accumulate peak bone mass, leading to higher peak bone mass in adulthood.

(2) Adults aged 25 to 50 have relatively balanced bone growth, with bone density at its peak. During this period, the focus is on maintaining peak bone mass and avoiding excessive bone loss. Engaging in overall body movements, such as running, climbing stairs, skipping, ballroom dancing, basketball, soccer, tennis, badminton, aerobics, and step aerobics, is recommended. Avoid focusing on a single exercise type. Intermittent exercise can be combined with low-intensity strength training, such as push-ups, pull-ups, squats, half-squats, half-jumps, weightlifting rotations, calf raises, bench presses, leg raises, and solid ball throwing, to stimulate hormone secretion and maintain peak bone mass for a longer period.

(3) Individuals aged 50 to 70 experience declining bone mass and physical capacity. During this period, the emphasis should be on preventing bone loss, delaying the onset of osteoporosis, and preventing fractures caused by falls. Apart from regular aerobic exercise and lower-intensity strength exercises, they should also include exercises that improve balance and flexibility, such as tai chi. For individuals with normal bone density, they can refer to exercise types for adults aged 25 to 50 and add appropriate martial arts fitness exercises, such as tai chi, Mulan Boxing, Mulan fan, and Wuqinxi, to enhance balance.

(4) Individuals over 70 are at significantly increased risk of osteoporosis, combined with muscle atrophy and slower reaction times, making them more prone to falling and experiencing fractures. Therefore, for individuals aged 70 and above with normal bone density, fast walking, croquet, and senior fitness exercises are suitable, while incorporating some strength exercises that maintain muscle strength, such as lifting dumbbells or heavy objects, performing push-ups with support at the table height, and engaging in weight-bearing activities, is essential to maintain a certain level of physical activity daily.

Osteoporosis patients can engage in aerobic and strength exercises. Aerobic exercises include brisk walking, jogging, skipping rope, square dancing, aerobics, ballroom dancing, basketball, soccer, volleyball, tennis, climbing, stair climbing, croquet, tai chi, Mulan boxing, and fitness qigong. Strength exercises include push-ups, pull-ups, sit-ups, dumbbell lifting, squats, half-squats, half-jumps, weighted rotations, calf raises, bench presses, leg lifts, medicine ball throwing, etc. Individuals over 50 should reduce high-impact or collision exercises and focus on fitness exercises that enhance balance and flexibility, such as tai chi.