Immobility
What is immobility?
Any disease or disability that
requires complete bed rest or extremely limits your activity is
considered immobility. Patients who have had a stroke resulting in
partial or complete hemiparesis/paralysis, spinal cord injury resulting
in paraplegia or quadriplegia, fracture, or prolonged bed rest after
surgery are considered immobilized. Any condition causing
immobility for 6 months or longer increases the risk for bone
boss that may lead to osteoporosis.
Why does immobility increase the risk for osteoporosis?
Individuals
who are immobile are limited or unable to participate in weight-bearing
activities. Weight-bearing activity is any physical activity in
which your body works against gravity. It simply means that your feet
and legs are supporting or carrying your weight. This type of exercise
builds bone mass in youth and maintains it in adulthood. However, the
inability to perform weight-bearing activity due to immobility can lead
to bone loss. An extreme example of what happens to bones without
weight-bearing activity is observed in space travelers. When there is
no gravity putting pressure on the bone, astronauts will lose bone mass
even though they exercise in space
When someone is immobile,
the cells that make bone (osteoblasts) are not able to work as
well. In addition, there is more activity of the cells that
breakdown bone (osteoclasts). Studies in people on bed rest have shown
drastic bone loss, as great as 10% in the spine and hip in 1 year.
During bed rest there is an increased loss of calcium and phosphorus in
the urine and often, higher blood calcium levels. If the person
regains mobility, many of these blood and urine tests will return to
normal and bone loss will stop.
How do I know if I am at increased risk for osteoporosis for other reasons?
Immobility
for more than 6 months for any reason is a risk factor for
osteoporsis. In addition to immobility, there are other risk
factors for osteoporosis that might affect you. It is important for you
to assess all of your personal risk factors for osteoporosis. Choose
the appropriate NYSOPEP Osteoporosis Risk Assessment, " Osteoporosis Risk Assessment for Premenopausal Women", for "Postmenopausal Women", or "for Men" to help you better understand your risk factors for bone loss or osteoporosis.
How can I reduce the risk for bone loss and fracture if I have been or I am currently immobilized?
You
may benefit from physical therapy and rehabilitation. Always check with
your physician to determine if a certain exercise program is safe for
your specific medical condition. Exercise is important not only for
your bones but also to maintain your muscles and strength during
immobility.
The prevention and treatment of osteoporosis
should always include a eating a well-balanced diet, getting an
adequate intake of calcium and vitamin D, taking safety precautions for
fall prevention, avoiding tobacco products and limiting the consumption
of alcohol.
You may want to discuss the need for a bone mineral density (BMD) test with your medical professional. If osteoporosis is diagnosed, it is important to make bone healthy lifestyle choices. However, lifestyle modifications alone are often not enough. Your medical professional may tell you that you need an osteoporosis medication to help stop further bone loss and to reduce your risk for broken bones.
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