Recent osteoporosis studies
Resistance training to prevent osteoporosis in lung transplant patients. A recent study has reported very significant improvement in bone mineral density (BMD) in lung transplant recipients (LTR) who were taking high-dose corticosteroids. Normally, it would be expected that one of the approved medications for treating and preventing osteoporosis, such as Fosamax or Actonel, would be required to prevent the loss of BMD in individuals on corticosteroid therapy. See Transplantation. 2003 Aug 15;76(3):557-62 for more details on this study by Mitchell MJ and others, PMID: 12923444. The lumbar BMD in the exercise group increased by 9.2% in only six months, which is an incredible improvement. The authors concluded, "Mechanical loading associated with progressive resistance exercise, using a specific exercise that isolated the lumbar spine, was efficacious in preventing steroid-induced osteoporosis in LTR." Unfortunately, I don't have a copy of this study so I can't tell you exactly what the exercises are that the LTRs did, but I hope to follow up later with an explanation. The authors describe the exercise as being done in a "lumber extensor machine," which would most likely be a machine that strengthens the lumbar extensor muscles. It might be possible that others with osteoporosis might benefit from these exercises, although it will probably be quite some time before others studies are done and the results reported. Here is a Website describing the MedX® Lumbar Extensor Machine for low back pain. I'm not certain this is the exact machine used in the Mitchell study, but it may be similar. Here is another Website with diagrams of a patient using a lumber extensor machine. Click on the Medical Rehabilitative Equipment Learn More.
Pins and plaster aren't enough. I have reported often in the newsletters and updates on this Website about the problems that patients have after fracture. They often fail to get adequate diagnosis and treatment for the osteoporosis that is the cause of their fracture in the first place. A recent article by Siris ES and others in J Clin Endocrinol Metab. 2003 Aug;88(8):3482-6 once again points out the importance of proper follow up by the physicians that treat and diagnose fractures to assure that osteoporosis is detected and properly treated. See PMID: 12915621. The authors conclude, "A call to action is necessary to reduce the human and economic costs associated with this serious and treatable disease." I suggest that, unless you know for certain that a friend or acquaintance has been properly diagnosed and treated for osteoporosis after a low-impact fracture, you talk to them about getting a referral for a dual-energy X-ray absorptiometry (DXA) exam and other diagnostic tests that might be required to rule out osteoporosis. Unfortunately, proper diagnosis and treatment are of the exception rather than the rule after low-impact fracture. Until those practitioners that treat fractures get this message, it behooves all of us to educate those we know who have had a fracture that osteoporosis might be the reason.