康复医学（仁济临床医学院）骨质疏松症的康复预防与治疗.pptVIP

* * * * Regular exercise is one of the best things we can do to prevent Osteoporosis. Bones, like muscles need exercise to stay strong. Moderate exercise 3-4 times per week is recommended. Weight bearing exercises like walking, jogging, tennis and low impact exercise classes are best for building and maintaining strong bones. * 骨质疏松症的康复预防与治疗 安丙辰 上海交通大学医学院 附属仁济医院 骨质疏松症概念 正常骨 骨质疏松骨 * Bone Densitometry 骨质疏松的 药物治疗 促进骨形成、抑制骨吸收 骨质疏松症的药物治疗抑制骨吸收 性激素替代疗法（HRT） 选择性雌激素受体调节剂(SERM) 二磷酸盐类 降钙素 甲状旁腺激素（PTH） 氟化物 维生素D制剂 钙制剂 中草药 骨质疏松症的药物治疗 促进骨形成 康复治疗前补充矿物质及维生素 For adults over fifty, the recommended levels of vitamins and minerals required for healthy bones are as follows 1,200-1,500 mg of calcium 1,000 IU of vitamin D Late Fall and Winter: 5,000 IU Early Fall and Spring: 2,000 IU Summer: 15-20 minutes of sunshine mid-day 120 mcg vitamin K 320 mg of magnesium (420 mg for men) strontium can improve bone density 8%-14% when taken with sufficient calcium and vitamin D 骨质疏松的 康复治疗 促进骨形成、预防骨折 最基本康复方法 运动疗法 促进骨形成、预防跌倒及骨折 负重运动是最基本的训练方法 规律锻炼是预防骨质疏松的最好办法 负重可以促进骨形成 治疗性运动可以改善骨质量 重力和肌肉拉力是维持骨质量自然刺激 卧床一周，骨量丢失~1%（ Krolner Toft 1983, LeBlanc et al 1990) 目前其确切机制还不清楚 Frost“最小有效力”原则 只有超过“最小有效力”的刺激才能使骨产生重建，增加骨质量 阈值水平由激素水平、负重史、遗传和年龄决定. 力异常分布、高应力、高应力率和 周期性负载可以促进成骨 (Lanyon, 1996) 运动治疗的目标 首要任务: 增进骨健康 降低跌倒几率 预防骨折 改善姿势、降低畸形 减轻或控制疼痛 优化功能 通过健康教育和视觉训练提高患者的自理能力 * * Bone densitometry is a safe, painless x-ray technique that compares bone density to the peak bone density that someone of your same sex and ethnicity should have reached at about age 20-25 when it is at its highest. Bone densitometry allows your doctor to: Detect a potential problem before fracture occurs, Predict chances of future fractures and Determine your rate of bone loss. All of these factors can then be weighed to determine a course of treatment. * * * * Bone densitometry is a safe, painless x-ray technique that compares bone density to the peak bone density that someone of your same sex and et