scholarly journals Modern Rehabilitation in Osteoporosis, Falls, and Fractures

2014 ◽  
Vol 7 ◽  
pp. CMAMD.S14077 ◽  
Author(s):  
Yannis Dionyssiotis ◽  
Grigorios Skarantavos ◽  
Panayiotis Papagelopoulos
Keyword(s):  
Bone Strength ◽  
Calcium Supplementation ◽  
Weight Bearing ◽  
Osteoporotic Fractures ◽  
Falls Prevention ◽  
Pharmacologic Therapy ◽  
Educational Approach ◽  
Risk Factors For Falls ◽  
Spinal Orthosis

In prevention and management of osteoporosis, modern rehabilitation should focus on how to increase muscular and bone strength. Resistance exercises are beneficial for muscle and bone strength, and weight-bearing exercises help maintain fitness and bone mass. In subjects at higher risk for osteoporotic fractures, particular attention should be paid to improving balance – the most important element in falls prevention. Given the close interaction between osteoporosis and falls, prevention of fractures should be based on factors related to bone strength and risk factors for falls. Fractures are the most serious complication of osteoporosis and may be prevented. The use of modern spinal orthosis helps to reduce pain and improve posture. Vibration platforms are used in rehabilitation of osteoporosis, based on the concept that noninvasive, short-duration, mechanical stimulation could have an impact on osteoporosis risk. Pharmacologic therapy should be added for those at high risk of fracture, and vitamin D/calcium supplementation is essential in all prevention strategies. Success of rehabilitation in osteoporotic and fractured subjects through an individualized educational approach optimizes function to the highest level of independence while improving the overall quality of life.

Osteoporosis

2019 ◽  
pp. 5-10
Author(s):  
Peter J. Haar
Keyword(s):  
Lifestyle Modification ◽  
Osteoporotic Fractures ◽  
Pharmacologic Therapy ◽  
Skeletal Disease ◽  
Metabolic Bone Disorder ◽  
Metabolic Bone ◽  
Reduce Life Expectancy ◽  
Osteopenic Bone ◽  
Fracture Risk Prediction

Chapter 71 discusses osteoporosis, which is a systemic skeletal disease characterized by generalized loss of bone mass. Osteoporosis is the most common metabolic bone disorder. Symptoms in osteoporosis arise from complications, particularly fractures. Early diagnosis is important because osteoporotic fractures can markedly decrease quality of life and reduce life expectancy. Radiography alone is inadequate for detecting early bone loss. MRI has a higher sensitivity for detecting nondisplaced fractures in osteopenic bone than does radiography. Dual-energy x-ray absorptiometry (DXA) is the gold standard for diagnosis and fracture risk prediction. Detection of fragility and insufficiency fractures is highly important in patient care, often initiating lifestyle modification and pharmacologic therapy.

Osteoporosis in the oldest old

2017 ◽  
pp. 521-532
Author(s):  
René Rizzoli
Keyword(s):  
High Risk ◽  
Oldest Old ◽  
Weight Bearing ◽  
Osteoporotic Fractures ◽  
Fracture Prevention ◽  
Pharmacological Interventions ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Subgroup Analyses

Osteoporosis and frailty greatly increase the risk of fracture. Hip fractures are the most serious osteoporotic fractures, with increased risk of mortality. In most countries, the majority are over 80 years old. Large rises on hip and other fragility fracture rates are predicted for much of South America and Asia in the coming decades. The survivors have a high risk of sustaining another major fracture and face deterioration in their quality of life and high risk of dependency. Optimal protein and calcium intakes, and vitamin D supplies, together with regular weight-bearing and balance-improving physical exercise are the cornerstones of fracture prevention. Evidence for antifracture efficacy of pharmacological interventions relies on randomized controlled trials in postmenopausal women between the ages of 50 and 80 years and the evidence of antiosteoporotic efficacy in the oldest old has come primarily from subgroup analyses.

Osteoporosis in the oldest old

2017 ◽  
pp. 521-532
Author(s):  
René Rizzoli
Keyword(s):  
High Risk ◽  
Oldest Old ◽  
Weight Bearing ◽  
Osteoporotic Fractures ◽  
Fracture Prevention ◽  
Pharmacological Interventions ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Subgroup Analyses

Osteoporosis and frailty greatly increase the risk of fracture. Hip fractures are the most serious osteoporotic fractures, with increased risk of mortality. In most countries, the majority are over 80 years old. Large rises on hip and other fragility fracture rates are predicted for much of South America and Asia in the coming decades. The survivors have a high risk of sustaining another major fracture and face deterioration in their quality of life and high risk of dependency. Optimal protein and calcium intakes, and vitamin D supplies, together with regular weight-bearing physical exercise are the cornerstones of fracture prevention. Evidence for antifracture efficacy of pharmacological interventions relies on randomized controlled trials in postmenopausal women between the ages of 50 and 80 years and the evidence of antiosteoporotic efficacy in the oldest old has come primarily from subgroup analyses.

scholarly journals Insight into falls prevention programmes for people with visual impairments and intellectual disabilities: A scoping review

2019 ◽  
Vol 37 (2) ◽  
pp. 94-107
Author(s):  
Lotte Enkelaar ◽  
Mathilde Overbeek ◽  
Evelien van Wingerden ◽  
Ellen Smulders ◽  
Paula Sterkenburg
Keyword(s):  
Intellectual Disability ◽  
Visual Impairment ◽  
Scoping Review ◽  
Research Direction ◽  
Falls Prevention ◽  
Prevention Programmes ◽  
Training Programmes ◽  
New Research ◽  
Risk Factors For Falls

The aim of this study was to review the current literature on falls prevention in people with visual impairment and to estimate the applicability of methods of fall prevention for people with visual impairment and intellectual disability. A scoping review was performed according to the Arksey and O’Malley framework. Relevant studies were collected from PubMed, Web of Science, and the Cochrane Register of Controlled Trials (CENTRAL). All records covering the time span from January 1980 until November 2017 were collected. Studies were included if the participants had a visual impairment according to objective ophthalmic assessments, the article described interventions to reduce falls or risk factors for falls, and the study was written in English and published in a peer-reviewed journal. The methodological quality of the studies were determined by consensus of the authors on the PEDro scale. Fifteen articles were included in this scoping review. Three articles focused on screening and intervention programmes, five articles addressed the effectiveness of environmental adjustments, and seven articles involved training programmes for physical improvement. Environmental adjustments emerged as having the best evidence for falls prevention for people with a visual impairment. Physical training programmes improved balance in those with a visual impairment but could not reduce the number of falls. Environmental adjustments also may be effective for persons with a visual impairment and intellectual disability. In addition, multifactorial screening and intervention programmes are recommended as an important new research direction with important clinical implications.

Exercise Capacity in Chronic Heart Failure

2012 ◽  
Vol 9 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Gina G Mentzer ◽  
Alex J Auseon
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Exercise Capacity ◽  
Positive Impact ◽  
Pharmacologic Therapy ◽  
The Past ◽  
Diagnosis And Prognosis ◽  
Future Therapy

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF ELEG FEM CAPSULES (ASTHISHRINKHALAADI YOGA) IN THE MANAGEMENT OF OSTEOPOROSIS

2021 ◽  
pp. 62-63
Author(s):  
Neha Thakur ◽  
B.L. Mehra ◽  
Sunil Thakur ◽  
Anil Bhardwaj
Keyword(s):  
Quality Of Life ◽  
Clinical Study ◽  
Osteoporotic Fractures ◽  
Bone Fragility ◽  
Drop Out ◽  
Mineral Density ◽  
Life Index ◽  
T Score ◽  
Quality Of Life Index

Osteoporosis is an alarming issue in the society today. It is continuously increasing its signicance with increasing elderly population and is affecting both the sexes at different degrees. It is characterized by low bone mass with microarchitectural deterioration of bone leading to enhanced bone fragility, thus increasing the susceptibility to fracture. Taking into account the references available in various Ayurvedic classics it can be correlated to Asthikshaya. Asthikshaya occurs due to decrease in strength of Asthi Dhatu chiey due to Kala, Swabhava and Vata Prakopa. International Osteoporosis Foundation estimated that the annual direct cost of treating osteoporotic fractures has increased grossly. In India the general population is not much aware about the hazardous complications of osteoporosis. The modern pharmacological treatment is long and beyond the nancial reach of common people. Therefore the best way to deal with it is to prevent this as early as possible. To achieve this aim a clinical study was conducted to evaluate the effect of an Ayurvedic Formulation known as Eleg Fem capsules (Asthishrinkhalaadi Yoga) in osteoporotic patients. In the clinical trial 30 patients above the age of 40 years with low BMD T-Score were registered from OPD and IPD of Kayachikitsa department of Rajiv Gandhi Govt. Post Graduate Ayurvedic College and Hospital Paprola, Kangra. Out of 30 patients, 27 completed the trial and 3 patients were drop out. Criteria of assessment of patients was change in bone mineral density (BMD T- Score) and change in the score of Quality of Life Index Questionnaire for Osteoporosis (QUALEFFO-41). All the registered patients were given the formulation for 6 weeks. Improvement was observed with statistically signicant results on mean BMD TScore and moderately signicant result on Quality of Life Index scoring. The study revealed that the Eleg Fem capsules (Asthishrinkhalaadi Yoga) is a safe and effective therapy in the Osteoporotic patients.

Medical Management of Erectile Dysfunction

2018 ◽  
Author(s):  
Matthew G Cowper ◽  
Andrew T Gabrielson ◽  
Laith M Alzweri ◽  
Wayne J Hellstrom
Keyword(s):  
Erectile Dysfunction ◽  
Medical Management ◽  
Treatment Modalities ◽  
Pharmacologic Therapy ◽  
Intracavernosal Injection ◽  
Future Directions ◽  
Emerging Therapies ◽  
Phosphodiesterase 5 ◽  
Vacuum Erection Device

The management of erectile dysfunction has made tremendous strides over the past four decades, owing to concomitant advances in our understanding of the complex neurovascular, hormonal, and psychologic processes involved in penile erectile. The field has transitioned from predominantly psychotherapy-based management to focused treatment modalities that have been rigorously tested for both safety and efficacy in the clinical setting. The etiology of the erectile dysfunction must first be ascertained through careful history-taking, physical examination, laboratory testing, and in select cases, imaging. Once the etiology is known, the urologist has numerous options in their armamentarium to improve symptomatology and quality of life. The use of psychotherapy, pharmacologic therapy, injectable therapy, intraurethral suppositories, topical agents, and vacuum-assist erection devices can be used as monotherapy or in combination to tailor treatment to patient needs. Future directions in erectile dysfunction management are focusing on therapies that alter the course of the disease and permanently restore erectile function, rather than simply treating the symptomatology. The continued advancements taking place in the preclinical setting demonstrate considerable promise for the treatment and ultimate cure for this disease. This review contains 6 figures, 1 table, and 50 references. Key Words: alprostadil, emerging therapies, erectile dysfunction, intracavernosal injection therapy, intraurethral suppository, medical management, papaverine, phentolamine, phosphodiesterase-5 inhibitors, vacuum erection device, vasoactive intestinal peptide

scholarly journals Effectiveness of interventions to prevent falls for people with multiple sclerosis, Parkinson’s disease and stroke: an umbrella review

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicola O’Malley ◽  
Amanda M. Clifford ◽  
Mairéad Conneely ◽  
Bláthín Casey ◽  
Susan Coote
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Falls Prevention ◽  
Umbrella Review ◽  
Falls Risk ◽  
Prevention Interventions ◽  
Evidence Table

Abstract Background The implementation of condition-specific falls prevention interventions is proving challenging due to lack of critical mass and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for groups comprising of people with these three neurological conditions may provide a pragmatic solution to these challenges. The aims of this umbrella review were to investigate the effectiveness of falls prevention interventions in MS, PD and stroke, and to identify the commonalities and differences between effective interventions for each condition to inform the development of an intervention for mixed neurological groups. Methods A systematic literature search was conducted using 15 electronic databases, grey literature searches and hand-screening of reference lists. Systematic reviews of studies investigating the effects of falls prevention interventions in MS, PD and stroke were included. Methodological quality of reviews was assessed using the A MeaSurement Tool to Assess Systematic Reviews 2. A matrix of evidence table was used to assess the degree of overlap. The Grading of Recommendations Assessments, Development and Evaluation framework was used to rate the quality of evidence. Findings were presented through narrative synthesis and a summary of evidence table. Results Eighteen reviews were included; three investigating effectiveness of falls prevention interventions in MS, 11 in PD, three in stroke, and one in both PD and stroke. Exercise-based interventions were the most commonly investigated for all three conditions, but differences were identified in the content and delivery of these interventions. Low to moderate quality evidence was found for the effectiveness of exercise-based interventions at reducing falls in PD. Best available evidence suggests that exercise is effective at reducing falls in stroke but no evidence of effect was identified in MS. Conclusions The findings suggest that exercise-based interventions are effective at reducing falls in PD, however, the evidence for MS and stroke is less conclusive. A strong theoretical rationale remains for the use of exercise-based interventions to address modifiable physiological falls risk factors for people with MS, PD and stroke, supporting the feasibility of a mixed-diagnosis intervention. Given the high overlap and low methodological quality of primary studies, the focus should be on the development of high-quality trials investigating the effectiveness of falls prevention interventions, rather than the publication of further systematic reviews.

scholarly journals SciaticNeuralgia an Agonising Encumbrance and its Modern Approach

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Avinash Shankar
Keyword(s):  
Quality Of Life ◽  
Clinical Response ◽  
Medical Diagnosis ◽  
Calcium Supplementation ◽  
Modern Approach ◽  
Excellent Quality ◽  
Post Therapy

Sciatica not a medical diagnosis but is a symptom of an underlying vertebral condition i.e.,-lumbar herniation. dislocated disc, Spondylolisthesis and spinal stenosiswhere usually practiced medicine.Physicaltherapy, surgery and even alternative therapyfails to ensure cure but present regimea composite ofintravenous Calcium supplementation, cholecalciferoland bio neurogen composite achieved grade I clinical response in 93% cases without anywithdrawal. Drug adversity, hepatorenal alteration and recurrence in 5yrs of post therapy follow up with excellent quality of life

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