Men's Osteoporosis Support Group
T'ai Chi and health; glucocorticoids and bone health
Br J Sports Med. 2011 May 16. [Epub ahead of print]. Systematic reviews of t'ai chi: an overview. Lee MS, Ernst E. PMID: 21586406. This Is a report of a systematic review of the English, Chinese and Korean electronic databases with articles relating to t'ai chi and health improvement. There have been reports that t'ai chi improves: “. . . cancer, older people, Parkinson's disease, musculoskeletal pain, osteoarthritis, rheumatoid arthritis (RA), muscle strength and flexibility, improving aerobic capacity, cardiovascular disease and risk factors, lowering resting blood pressure, osteoporosis or bone mineral density, type 2 diabetes, psychological health, fall prevention and improving balance, and any chronic conditions.” The authors, however, found evidence for only two areas of improvement: fall prevention and psychological health.
Editor's comments. So, although t'ai chi has been promoted to improve many areas of health, including increasing bone mineral density (BMD), there appears to be no evidence that it actually increases BMD. But, since fractures are the main problem related to osteoporosis, and most fractures are the result of falling, t'ai chi could be a very important aid in fracture prevention. And it has proven psychological benefits, thus this gentle form of exercise might be something to discuss with your care provider if you have osteoporosis. For added benefit regarding increasing BMD, some form of weigh-bearing exercise could also be included in your routine. See this recent Update for more on that topic.
PM R. 2011 May;3(5):466-71. Adverse effects of corticosteroids on bone metabolism: a review. Mitra R. PMID: 21570035. This abstract provides a very succinct and informative review of problems of glucocorticoids on bone which can lead to osteoporosis. I won't repeat what the abstract says since it is so well done. I will explain a few terms that might not be generally well known: apoptosis is cell death, osteoblasts form bone and osteoclasts remove bone.
The three-month waiting period between exposures to glucocorticoids is new to me but sounds like a rational way to decrease or prevent the damage to bone mineral density that occurs with glucocorticoids. So, if you are taking one of these medications, I highly recommend printing out the Mitra abstract and taking it to your care provider to discuss it's information and suggestions. You don't want to add a bone fracture along with whatever other condition you have that requires glucocorticoids.