骨质疏松症治疗中的运动疗法

背景：骨质疏松症是以骨量减少、骨组织显微结构退化为特征，以致骨的脆性增高而骨折危险性增加的一种全身骨病，通常治疗的首要手段为药物治疗。而单纯药物治疗无法提高肌肉力量，改善平衡功能，进而预防跌倒的发生，因此已不能满足骨质疏松症的综合管理。运动作为一种重要的非药物治疗手段，在骨质疏松症的预防中公认应作为首选，在骨质疏松症的治疗中的重要性逐渐被认识。目的：结合最新的一些研究文献，探讨运动在骨质疏松症治疗中的作用。方法：以“骨质疏松症，骨密度，骨强度，治疗，运动，应力，太极，肌肉，骨组织构建”为中文检索词，以“osteoporosis，bonemineraldensity，bonestrength，treatment，exercise，stress，taichi，muscle，bonearchitecture”为英文检索词，检索中国知网（CNKI）期刊全文数据库和Medline2001年1月至2013年2月有关不同运动类型对人骨强度的影响特别是对骨质疏松症患者的治疗作用的临床报道及机制研究。排除重复性研究和不典型报道。结果与结论：治疗性运动包括有氧运动、抗阻运动、冲击性运动、振动运动等类型，可以安全的提高骨强度，提高肌肉力量，改善平衡功能，预防跌倒和骨折。对于脊柱畸形者适当选用矫形器可提高安全性、促进运动治疗。与药物治疗一样，运动治疗也遵循个体化原则，在良好的依从性和安全性条件下进行运动方案的选择，各种运动的效果均较小，包含高应变速率的运动似乎更有效，但均需要长期坚持运动以维持疗效。

Exercise in the treatment of osteoporosis

BACKGROUND： Osteoporosis is a condition resulting in an increased risk of skeletal fractures due to a reduction in bone mass and degradation in bone microstructure. Treatment of osteoporosis usually involves the application of pharmacological agents as the first choice. Pharmacotherapy alone is not sufficient for the comprehensive management of osteoporosis, as pharmacotherapy has no effect on increasing muscle strength, improving balance ability, and preventing fells. Exercise, considered as an important non-pharmacologic therapy, plays a considerable role in the prevention of osteoporosis. The importance of therapeutic exercises in the treatment of osteoporosis has been recognized gradually. OBJECTIVE： To discuss the effect of exercise in the treatment of osteoporosis combined with some of the latest research literatures. METHODS： Clinical reports and mechanism researches about effects of different types of exercise on bone strength especially the treatment of osteoporosis were retrieved from CNKI database and Medline database with the key words of osteoporosis, bone mineral density, bone strength, treatment, rexercise, stress, tai chi, muscle, bone architecture in both Chinese and English from January 2001 to February 2013. The repetitive researches and atypical reports were eliminated. RESULTS AND CONCLUSLON： Therapeutic exercises including aerobic exercise, resistance, impact movement, and vibration, which can safely increase bone strength and muscle strength, improve equilibrium function, and prevent falls and fractures. For spinal deformity patients, appropriate orthotics can improve the security and promote exercise therapy As with drug therapy, therapeutic exercises are also individualized. Exercise program should be selected under the insurance of good compliance and security. Exercises that involve high strain rates seem to be more effective than others. However, all these benefits are comparatively small, and should be maintained by continuous exercises.