Exercise in the Prevention of Age-Related Fragility Fractures (Narrative Review).

IF 3.1 3区 医学 Q3 GERIATRICS & GERONTOLOGY
Gerontology Pub Date : 2025-01-01 Epub Date: 2025-01-17 DOI:10.1159/000543377
Katharina Kerschan-Schindl, Timothy Hasenoehrl
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引用次数: 0

Abstract

Background: Loss of bone integrity and the age-associated decrease of the neuromuscular function make elderly subjects prone to fragility fractures.

Summary: Exercise is a strategy to counteract these age-associated changes and impairments. Because of the tight relationship between muscle and bone - anatomically, functionally, and biochemically - physical activities and targeted exercises, which induce muscle contraction and sufficient mechanical stress, influence bone metabolism. Exercise proved to have a positive effect on bone mineral density. The young skeleton is especially susceptible to impact and strenuous stimuli. This also applies to the neuromuscular system in the case of balance training. Therefore, the best time to start preventing fragility fractures is at young age. Despite the lower responsiveness in older age, targeted training is also very important at an advanced age. Lowering the modeling threshold, osteoanabolic treatment seems to increase the responsiveness to mechanical loading. In case of antiresorptive treatment, a more intensive training may be necessary.

Key message: A multiple component exercise intervention reduces the risk of age-associated fragility fractures. Depending on the mode of exercise, it mainly affects bone integrity or the neuromuscular system. The effect of exercising also depends on age and bone-specific medications influencing the sensitivity of these structures. However, despite a lower sensitivity to exercise at higher age, targeted training is especially important when getting older to decrease the risk of fragility fractures. In case of prevalent fragility fractures, patients should exercise as well; the training stimulus simply needs to be adapted.

Background: Loss of bone integrity and the age-associated decrease of the neuromuscular function make elderly subjects prone to fragility fractures.

Summary: Exercise is a strategy to counteract these age-associated changes and impairments. Because of the tight relationship between muscle and bone - anatomically, functionally, and biochemically - physical activities and targeted exercises, which induce muscle contraction and sufficient mechanical stress, influence bone metabolism. Exercise proved to have a positive effect on bone mineral density. The young skeleton is especially susceptible to impact and strenuous stimuli. This also applies to the neuromuscular system in the case of balance training. Therefore, the best time to start preventing fragility fractures is at young age. Despite the lower responsiveness in older age, targeted training is also very important at an advanced age. Lowering the modeling threshold, osteoanabolic treatment seems to increase the responsiveness to mechanical loading. In case of antiresorptive treatment, a more intensive training may be necessary.

Key message: A multiple component exercise intervention reduces the risk of age-associated fragility fractures. Depending on the mode of exercise, it mainly affects bone integrity or the neuromuscular system. The effect of exercising also depends on age and bone-specific medications influencing the sensitivity of these structures. However, despite a lower sensitivity to exercise at higher age, targeted training is especially important when getting older to decrease the risk of fragility fractures. In case of prevalent fragility fractures, patients should exercise as well; the training stimulus simply needs to be adapted.

运动预防与年龄相关的脆性骨折(叙述性评论)。
背景:骨完整性丧失和与年龄相关的神经肌肉功能下降使老年人容易发生脆性骨折。总结:锻炼是一种对抗这些与年龄相关的变化和损伤的策略。由于肌肉和骨骼在解剖学、功能和生化上的紧密关系,体育活动和有针对性的锻炼会引起肌肉收缩和足够的机械应力,从而影响骨代谢。运动被证明对骨密度有积极的影响。年轻的骨骼特别容易受到冲击和剧烈的刺激。这也适用于平衡训练中的神经肌肉系统。因此,开始预防脆性骨折的最佳时间是在年轻的时候。尽管老年人的反应能力较低,但有针对性的训练在老年人中也非常重要。降低建模阈值,骨合成代谢治疗似乎增加了对机械负荷的反应性。在抗吸收治疗的情况下,可能需要更密集的训练。关键信息:多组分运动干预可降低与年龄相关的脆性骨折的风险。根据运动方式的不同,它主要影响骨骼完整性或神经肌肉系统。锻炼的效果还取决于年龄和影响这些结构敏感性的骨特异性药物。然而,尽管老年人对运动的敏感度较低,但随着年龄的增长,有针对性的训练对于降低脆性骨折的风险尤为重要。如果脆性骨折普遍存在,患者也应该锻炼;训练刺激只是需要适应而已。背景:骨完整性丧失和与年龄相关的神经肌肉功能下降使老年人容易发生脆性骨折。总结:锻炼是一种对抗这些与年龄相关的变化和损伤的策略。由于肌肉和骨骼在解剖学、功能和生化上的紧密关系,体育活动和有针对性的锻炼会引起肌肉收缩和足够的机械应力,从而影响骨代谢。运动被证明对骨密度有积极的影响。年轻的骨骼特别容易受到冲击和剧烈的刺激。这也适用于平衡训练中的神经肌肉系统。因此,开始预防脆性骨折的最佳时间是在年轻的时候。尽管老年人的反应能力较低,但有针对性的训练在老年人中也非常重要。降低建模阈值,骨合成代谢治疗似乎增加了对机械负荷的反应性。在抗吸收治疗的情况下,可能需要更密集的训练。关键信息:多组分运动干预可降低与年龄相关的脆性骨折的风险。根据运动方式的不同,它主要影响骨骼完整性或神经肌肉系统。锻炼的效果还取决于年龄和影响这些结构敏感性的骨特异性药物。然而,尽管老年人对运动的敏感度较低,但随着年龄的增长,有针对性的训练对于降低脆性骨折的风险尤为重要。如果脆性骨折普遍存在,患者也应该锻炼;训练刺激只是需要适应而已。
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来源期刊
Gerontology
Gerontology 医学-老年医学
CiteScore
6.00
自引率
0.00%
发文量
94
审稿时长
6-12 weeks
期刊介绍: In view of the ever-increasing fraction of elderly people, understanding the mechanisms of aging and age-related diseases has become a matter of urgent necessity. ''Gerontology'', the oldest journal in the field, responds to this need by drawing topical contributions from multiple disciplines to support the fundamental goals of extending active life and enhancing its quality. The range of papers is classified into four sections. In the Clinical Section, the aetiology, pathogenesis, prevention and treatment of agerelated diseases are discussed from a gerontological rather than a geriatric viewpoint. The Experimental Section contains up-to-date contributions from basic gerontological research. Papers dealing with behavioural development and related topics are placed in the Behavioural Science Section. Basic aspects of regeneration in different experimental biological systems as well as in the context of medical applications are dealt with in a special section that also contains information on technological advances for the elderly. Providing a primary source of high-quality papers covering all aspects of aging in humans and animals, ''Gerontology'' serves as an ideal information tool for all readers interested in the topic of aging from a broad perspective.
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