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0Senior friends pay special attention to the issue of the "three highs", but do you know? The "three highs" are also closely related to another common disease in the elderly - osteoporosis . In the program "Healthy Life", we invited Professor Han Rui from the Department of Endocrinology, , , the First Affiliated Hospital of Kunming Medical University, to tell the elderly about how patients with osteoporosis exercise.
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Han Rui, third-level professor , doctor of medicine, doctoral supervisor.
has been engaged in the endocrine major for 27 years, has rich clinical experience, and is good at the diagnosis and treatment of diabetes , osteoporosis, and dyslipidemia .
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In addition to paying attention to diet or supplementing calcium agent , what other issues should we pay attention to in daily life?
is recommended to perform appropriate exercise. Lack of exercise can easily cause muscle atrophy and loss of bone mass. On the contrary, regular exercise stimulation can maintain normal bone density and and bone strength. Especially when active in outdoor sunlight, sun exposure can also promote the skin to synthesize vitamin D, which helps calcium absorption. Movement includes three parts, which we will call for the "movement trilogy".
The first part is pre-exercise assessment: mainly includes the assessment of five physical functions: pain assessment, joint range of motion, muscle strength, balance function and psychological state. These recommendations are systematically evaluated by professionals. At the same time, the specific values of bone metabolic markers and bone density are clarified before exercise to evaluate the degree of osteoporosis. We must fully consider and evaluate a series of chronic diseases that cannot fully tolerate long-term strenuous exercise, such as chronic respiratory diseases, heart diseases, rheumatism and immune system diseases, and comprehensively evaluate the patient's condition, so as to formulate an individualized exercise prescription . This is recommended that patients go to the hospital for evaluation.
The second part is the choice of exercise mode: The most common form of exercise for elderly friends is walking, which is also very popular among the elderly because it is harmless, can be self-managed, and is easy to implement. Walking has no obvious impact on the lumbar spine or femoral neck. In addition, aerobic exercises such as jogging, swimming, cycling (fixed), Tai Chi , etc. can limit the reduction of bone density, and it is also recommended that elderly patients persist for a long time. Of course, elderly and frail patients with osteoporosis must determine their exercise style and intensity based on their own conditions and venue conditions.
The third part is post-exercise evaluation: In clinical practice, we first prescribe individualized exercise prescriptions for the patients' muscle strength, range of motion, balance, gait, cardiopulmonary function, comorbidities, bone density, past history of fractures, and risk of falls. After exercising for a period of time, go to the hospital for evaluation to see if the exercise prescription performed by the patient is suitable.
Can patients with osteoporosis undergo strength training?
People with osteoporosis should also practice strength and resistance. This exercise can indirectly produce mechanical stimulation to the bone. Strength exercise determines the joint response and muscle enhancement, and has important clinical benefits for bone density, lumbar spine and femoral neck.
In addition, the combination of different exercises (aerobic exercise, enhancement, progressive resistance, balance and dance) has a significant impact on the bone density in the three parts of the lumbar spine, femoral neck and large trochanter, and the most benefit is the spine.
How to grasp the duration and intensity of exercise?
Exercise time and frequency: recommends that elderly patients should perform at least 150 minutes to 300 minutes of moderate-intensity exercise per week, or perform high-intensity physical activities per week for about 75 minutes to 150 minutes. You can also combine moderate-intensity and high-intensity activities to complete equal amounts of physical activities. On the premise of ensuring the above exercise volume, you can complete it in multiple times within 1 week based on your personal time and physical condition. Exercise at least 3 days a week not only benefits the body, but also prevents physical injuries.
In terms of grasping exercise intensity: For example, the intensity of aerobic exercise is expressed in two ways: absolute intensity and relative intensity. Absolute intensity refers to the amount of energy and absolute physical load consumed during activities without considering the physiological tolerance of a person such as cardiopulmonary function. Relative intensity is the degree of effort required to do an activity, which belongs to the category of physiological intensity, and considers more about the response and tolerance of individual physiological conditions during physical activity. Most elderly people use relative intensity to measure. relative intensity is measured using self-perceived motion intensity, measured at levels 0 to 10. When using relative intensity, you need to pay attention to the impact of physical activity on heart rate and breathing, and judge the intensity of physical activity based on the degree of individual subjective force and fatigue. Level 0: rest state; Level 1 to 2: feel weak or very weak; Level 3 to 4: feel gentle; Level 5 to 6: medium; Level 7 to 8: fatigue; Level 9 to 10: very tired. In the range of 0 to 10, moderate-intensity activities are level 5 or 6. Of course, we recommend elderly patients to perform relatively moderate-intensity exercise. Generally speaking, moderate-intensity exercise is judged by being able to speak but not singing.
How do older patients with osteoporosis choose exercise?
Currently in special groups, such as elderly patients, they advocate daily activities combined with low-intensity aerobic exercise; for patients with chronic low back pain, they are recommended to exercise that does not increase spinal load and forward flexion load.
Of course, for friends who are not very old, it is best to ensure about half an hour of aerobic exercise and weight-bearing training for if you find osteoporosis when you find osteoporosis, under the guidance of a professional rehabilitation teacher, such as walking, fitness running , practicing Tai Chi, etc. Pay attention to avoid skipping ropes, sit-ups, etc. that can cause vertebral body compression.
When exercising, you need to choose the exercise method, amount and frequency of exercise based on your physical health and physical tolerance. In addition, even friends who are bedridden should often let their family push themselves outdoors and bask in the sun, and allow their limbs to undergo passive activities and exercise with the help of their family.
For healthy people, if you want to stay away from osteoporosis, it is recommended to do moderate-intensity exercise at least 5 days a week, running, equipment and fitness, playing ball, cycling, etc., with a total time of more than 150 minutes.
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Source: Anchor Ziyun
Editor: Li Qingyun
Editor: Fu Xiao Zhang Lei
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