Exercise and osteoporosis

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Shao Jinkang Zhou TiThe relationship between exercise and endocrine hormonesExercise increased the concentration of estrogen in postmenopaus


Shao Jinkang Zhou Ti

The relationship between exercise and endocrine hormones

Exercise increased the concentration of estrogen in postmenopausal women, and increased the content of bone calcium [1]. Testosterone and estradiol can promote protein synthesis of bone, bone matrix increased, the mineral deposition retention, bone thickening, epiphyseal fusion, so as to promote the growth and development of bone [2]. Interleukin 1 and interleukin &ndash, can stimulate bone resorption, regular exercise training can reduce the level of these cytokines, delay the osteoclast activity, reduce bone loss. Endogenous prostaglandin E2 (PGE2) and prostaglandin I2 (PGI2) have been shown to promote bone formation and increase PGE2 and PGI2 secretion under the action of mechanical stress. Exercise training can improve the level of testosterone and estrogen, promote bone growth, increase bone density and bone density [3]. Kawata et al on rat skull cells treated with tension stimulation after 24 hours, you can see the formation of [4] IGF-1 and osteocalcin. There must be some coupling mechanism between the mechanical stimulation and the up regulation of gene and cytokine expression. There is a mechanical signal receptor in bone tissue, which can convert mechanical signals into biochemical signals and the expression of this receptor can be up-regulated by sex hormones [5]. Zhang Peizhen et al. Found that the appropriate load of swimming could slow down the decrease of sex hormone levels with age increasing, especially in the heavy load swimming [6]. Shao Zhijie et al observed the effects of long-term swimming exercise on E2 in postmenopausal women, and found that the swimming group was significantly higher (33.030± 1.35pg/ml to 26.065± 1.52pg/ml) [7].

However, it is necessary to recognize the dual effects of exercise on sex hormones. Intense exercise training can interfere with the menstrual cycle of female athletes, leading to the lack of estrogen, which can lead to the loss of inorganic salts and increase the risk of fracture. Study on the content of inorganic salts in the lumbar and forearm bones of 28 female athletes by Drikewaten. It was found that the amount of weekly training (running) had a significant effect on menstruation. Week 24.9 Miles Group, the normal menstrual weeks; 41.8 miles, have amenorrhea. There was no significant difference between the two groups in forearm bone mineral density, but there was significant difference in the density of inorganic salts of L1-4. Normal menstruation group 1.30± 0.03g/cm2 group was 1.12± 0.04g/cm2, amenorrhea. The bone density of Nelson et al 11 amenorrhea for more than 1 years of subjects, and 17 normal menstruation of female runners (the average age was 25.2 years and 29.2 years; the height, weight and body surface area were similar) were compared. Found that the radius of inorganic salt density amenorrhea group of subjects for 1.099± 0.027g/cm2, 1.196± group was significantly lower than that of normal menstruation; 0.025g/cm2. The research also demonstrated that estradiol concentration in the blood decreased amenorrhea in female athletes. In order to reduce the level of estrogen, Wancus et al. Studied the bone metabolism of 17 elite long-distance runners. The subjects were highly trained and could run 10 thousand meters in 3 hours. Among them, 11 people with secondary amenorrhea (1-7), 6 normal menstruation. Through measuring and analyzing their strength training, body composition and endocrine level, found amenorrhea athletes age is small, light weight, low levels of estrogen, bone density is low, low calcium intake. Measurement of lumbar mineral density by CT, normal menstruation group 182± group 4.9mg/ml, only 151± 8mg/ml amenorrhea; (20%). Their non athletes control group of women for 166± 4mg/ml, 10% higher than female athletes were amenorrhea. It is worth noting that the amenorrhea group was increased in 6 athletes fracture, multiple metatarsal fatigue fracture of tibia and history.

Two, the movement of the time machine reasonable choice

As an important means of prevention of osteoporotic fractures, with its mechanical characteristics, the first is site specific, i.e. skeletal bone density should be part of the force increased, followed by increased bone mass may be lost to the termination of the movement. It is very important to design appropriate exercise prescription for different age groups, such as the purpose of exercise, to increase the peak bone mass as much as possible in order to achieve the best bone salt reserve. The old stage is mainly to slow the loss of bone salt.

1 the purpose of exercise for the prevention and treatment of osteoporosis: (1) the movement of the

Stress and mechanical stress act on the bone to promote bone formation and prevent bone loss. (2) exercise training can enhance the strength of the back muscles, help to support the spine and prevent the wedging of the vertebral body or kyphosis. (3) exercise can improve the body's flexibility and balance ability, and prevent fractures caused by falls. (4) proper exercise can relieve the symptoms of back pain.

2 the movement of osteoporosis:

The aerobic endurance exercise aerobic exercise such as jogging, walking, treadmill and stage order, can directly stimulate bone formation and inhibit bone resorption in the [8]. The training of muscle strength training can prevent the decrease of muscle strength caused by age, and is helpful to prevent and treat osteoporosis. Muscle movement with barbells and dumbbells as the representative of the isotonic exercise and forced against the resistance and don't move the isometric exercise, and requires special equipment such as motion. The above exercise can increase the local muscle endurance, local muscle will have a corresponding increase, but also improve the body's coordination function. Patients with osteoporosis are recommended to carry out a comprehensive exercise program based on lighter weight, which can enhance the muscle mass of the attached skeleton. With posture change activities, can be imposed on the bone surface curvature of the load, it is concerned with the reconstruction of bone, so exercise can increase the surface area, stimulate the activity of osteoblasts, and enhance the ability of bone under stress. Of course, these activities should be based on the individual potential ability to start and gradually increase the minimum load, so that patients have enough time to adapt to [9, 10]. Progressive resistance exercise can improve the bone health and improve the function, but it is only suitable for osteoporosis patients without fractures. The effect of progressive resistance exercise on muscle strength and bone mineral density is greater than that of endurance exercise. The hip joint's resistance exercise can increase the bone density of the greater trochanter, but it has little effect on the femoral neck. Balance and flexibility training is an important way to prevent falls, such as gymnastics, dance, Tai Chi, etc.. Tai Chi exercise can reduce the incidence of falls, especially the incidence of hip fracture. In patients with low bone density and multiple fractures, there is a need for musculoskeletal protection, and exercise should be performed to enhance muscle strength, balance, and flexibility, but to avoid spinal flexion. For patients with reduced bone mineral density, and muscle weakness and balance disorders, exercise training can enhance the ability to coordinate and balance, increase bone density and muscle strength, prevent falls. Flexibility training can maintain the proper range of motion of the joint, and can maintain the normal function of skeletal muscle. Stretching can be divided into two types: dynamic and static. Dynamic stretching is the use of inertia flexion and extension joints, should be done before the static stretching exercise. Moderate intensity of static stretching exercise, can reduce the tension of the muscle nerve, joint flexion and extension to a certain position to maintain 10-30 seconds, the extent of expansion to not cause pain as the limit. Static stretching exercise less trauma, suitable for middle and old people's joint stretching exercise, can be carried out 3 times a week.

3 the general principles of exercise intensity and duration of osteoporosis: exercise quantification is the key to the formulation of exercise prescription for osteoporosis. Exercise therapy programs were developed based on differences in exercise capacity, bone mineral density, and fracture. With exercise intensity endurance exercise available the following indicators (1) heart rate: as the training intensity index, called the target heart rate or target heart rate. The target heart rate is calculated according to the maximum heart rate of the individual, such as the maximum heart rate multiplied by the percentage of moving target heart rate can be obtained. (2) RPE level of perceived exercise intensity: RPE can be used independently or in combination with heart rate to assess the exercise intensity of aerobic endurance training. RPE rating scale, 12-13 60% of the maximum heart rate, equivalent to 16 of the maximum heart rate of 90%. Patients with osteoporosis should be trained in the range of 12-13. The intensity of exercise was different for different individuals and osteoporosis. The intensity of exercise increases gradually to make the bones strong. The load should be within the range of mechanical stress that the bone can bear. Low level exercise has a role in maintaining bone mineral density, and high levels of exercise can enhance bone mass in order to adapt to the new environment. The least suitable type of exercise, the role of stimulating osteoblasts. Duration of exercise: each exercise training should be prepared and finishing activities (10-15 points), the exercise duration of 20-30 minutes. The patients with osteoporosis should not carry out the exercise with high intensity and short time. At the beginning of the first week of exercise, low and moderate intensity exercise 20-30 minutes, 2-4 weeks after the exercise of normal exercise response and no complications, exercise time can be gradually increased from the 20 points. Patients with severe osteoporosis may also be intermittent exercise. Exercise frequency is usually 3 times a week.

4 different age groups exercise choice: (1) youth movement methods of adolescence, bone is not yet completely ossified, between the epiphyseal bone and bone backbone exist cartilage and epiphyseal cartilage, childhood and adolescence, epiphyseal growth is very fast, especially in the limbs is more obvious, and during this period bearing, small bone deformation, therefore, the physical training content should speed and explosive power projects, less weight, each exercise time is short, intermittent time, exercise intensity and exercise should be moderate. He Yuxiang observed effect of exercise on bone mineral density in adolescents, the age of 8-9 46 ordinary students divided into 3 groups, first groups of 13 people, adhere to the 1 hours of track and field training every day, for a large amount of exercise group, the second group of 17 people, 20 minutes of track and field training every day, for the small amount of exercise group and non exercise group 16 people. The exercise group in 4 months before and after training was L2-4, left femoral neck, greater trochanter, Ward’ bone mineral density, s triangle and non dominant arm of the radial measurement results, 4 months of track and field training, small changes than the exercise group and non exercise group values of bone mineral density in exercise group the difference of no small amount of exercise group and control group. Therefore, through the physical exercise to increase bone density, improve the peak bone mass, prevent osteoporosis, must reach a certain amount of exercise intensity and exercise time, in order to achieve good results.

(2) youth movement method and the choice of young people aged 25 to stop the ossification process, their bone stress ability is greatly enhanced, the general athletic ability is also very strong, training should be used more explosive force and a certain amount of absolute power and the amount of endurance exercise during this period of bone stimulation exercise more direct, to produce a more obvious effect, such as multiple 50-100 meters sprint, push ups and weight-bearing squat exercise training can prevent the bone of proximal and distal limb and spine osteoporosis.

(3) the physiological characteristics and the exercise ability of the middle-aged and elderly people in the choice of exercise methods determine the choice of exercise methods should be different from those of other age groups. Gu Liyan and so on were studied and compared between the old and the elderly. The results show that with the increase of age, senile osteoporosis is an inevitable trend, a change can not be reversed, but aerobic exercise group decreased less than normal group, the aerobic exercise to maintain bone mineral content and delaying senile osteoporosis have more positive role. This result confirms that gravity has a good effect on the formation of bone, because long distance training increases the body's bone stimulation. Yang Baozhu will be the basic body Jiankang retirees in 145 cases, male 90 cases, female 55 cases, aged 50-70 years old in sports including croquet, billiards, table tennis, Taijiquan (sword), walking, dancing, elderly fitness, according to the monthly time in total time is divided into a small amount of activity in the group, activity group, activity group. The small activity group 0.5-1 hours / day, the activity group 2 hours / day, the cumulative time was 1 years, the large activity group 3-4 hours / day, the cumulative time of 2 years. Results the incidence of osteoporosis was 37.5% (33/88) and 75% (21/28) in the small and medium activity groups, but no osteoporosis occurred in the active group. This result proved that aerobic exercise can effectively prevent and treat osteoporosis in middle aged and elderly people, on the other hand, the elderly in the aerobic process, should increase the amount of exercise within its capacity, in order to achieve a better control effect.


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