Osteoporosis refers to a disorder characterised by loss of bone mass density and gradual deterioration of the skeletal structure; the heightened fragility of the bones leads to an increased incidence of osteoporotic fractures, especially hip fractures that can cause permanent disability.
Clinically, a bone mineral density (BMD) which is either equal to or greater than -2.5 standard deviations is diagnosed as osteoporosis. The resultant effect on the musculoskeletal system involves a host of physical and physiological alterations such as limited mobility and joint deformities.
Dr. Lawrence G. Raisz, of the UConn Musculoskeletal Institute, clearly outlines the pathogenesis of osteoporosis as a failure to produce a skeleton of optimal mass and strength during growth; excessive bone resorption resulting in decreased bone mass and microarchitectural deterioration of the skeleton; and an inadequate formation response to increased resorption during bone remodelling.
Oestrogen deficiency represents the highest risk for the development of osteoporosis with bone remodelling accelerated at menopause, causing an increase in bone resorption and facilitating bone loss.
Secondary hyperparathyroidism results from a culmination of decreased calcium intake, impaired intestinal absorption of calcium and a deficiency in Vitamin D; this accelerates bone loss and fragility in addition to contributing to neuromuscular impairment that perpetuates risk of falls.
Pfeifer et al. state in their review on musculoskeletal rehabilitation for osteoporosis that the strong correlation between osteoporosis and falls makes it necessary for preventative strategies to focus on bone-related factors and on risk factors for falls.
The authors recommend proprioceptive dynamic posture training after a vertebral fracture in the form of back strengthening exercises to reduce thoracic hyperkyphosis, vertebral fracture and the kyphotic posture associated with osteoporosis and ageing.
The efficacy of including MASS4D® customised orthotics in active rehabilitation programmes stems from increased functionality in the lower limbs, improvement in gait patterns and enhanced mobility.
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