TheraPilates Blog

Professional Cyclists Have Lower Bone Density

sherribetz — Sat, 01 May 2010 13:55:27 +0000

Read an abstract comparing professional cyclists to controls…..http://www.ncbi.nlm.nih.gov/pubmed/20432201

Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women

sherribetz — Sat, 03 Apr 2010 16:48:45 +0000

Although there is ample evidence supporting the effectiveness of physical activity in the prevention and treatment of osteoporosis, there are no previous studies to examine the effect of office-based brief high-impact exercise (HIE) on bone mineral density (BMD) in healthy premenopausal women. This study evaluated the effects of office-based HIE on BMD in healthy premenopausal Japanese women. Ninety-one healthy premenopausal women were randomized to receive stretching exercise (SE) or HIE (stretching, along with up to 5 x 10 vertical and versatile jumps) for 12 months.

There was a significant difference in the change in the femoral neck BMD between the groups in favor of the HIE group [0.6% (95% CI: -0.4, 1.7) vs. -1.0% (95% CI: -2.2, 0.2)].

These finding suggested that office-based brief HIE can be recommended for premenopausal women for preventing bone mineral loss.

Read the full abstract…

Wendy Katzman’s Stand Tall Evidence-Based Exercise Program Reduces Kyphosis

sherribetz — Thu, 01 Apr 2010 23:30:38 +0000

Dr. Wendy Katzman, PT, DPTSc, OCS and her colleagues at the University of California San Francisco created a 12-week group activity program for women with an average age of 72 who had kyphosis or a stooped posture. The 2009 study was funded by a grant from the National Institutes of Health. The aim was to determine if women could experience improvements in posture, body strength, range of motion, and physical performance through a 12-week group activity program. In all of the women who participated, their kyphosis improved, meaning they stood taller with less of a stooped posture, they improved their strength and range of motion or joint flexibility, along with all of the other variables studied.

Short Step Lunges vs. Long Step Lunges?

sherribetz — Thu, 01 Apr 2010 19:34:18 +0000

Patellofemoral joint force and
stress magnitudes were greater during
the forward lunge short compared to the
forward lunge long at higher knee angles
and were greater with a stride compared
to without a stride at lower knee angles.

Read the article published in the Journal of Orthopedic and Sports Physical Therapy…

Thoracic Spine Compression Fracture in a Patient with Low Back Pain – Case Report

sherribetz — Thu, 01 Apr 2010 18:55:37 +0000

Interesting case report about a 55 year old man who experienced the onset of back pain while jogging. He discovered that he had osteoporosis and underwent a vertebroplasty to repair the fracture. He was painfree within one week post surgery.

Read the abstract…

Atypical Subtrochanteric Fractures with Long-Term use of Bisphosphonates (Fosamax, Actonel, Boniva, Reclast)

sherribetz — Fri, 12 Mar 2010 15:22:03 +0000

Last week, Good Morning America hosted a segment on spontaneous fractures with long-term use of bisphosphonates commonly used to treat osteoporosis. They implicated that these drugs taken for 7-8 years actually make bones more brittle. Here is a link to the story. But please read the following article about the FDA Task force as well. Good Morning America Story…

The FDA and the American Society of Bone and Mineral Research Subtrochanteric Femoral Fracture Task Force (read about the task force here) are convening to investigate this topic. At present these types of fractures are extremely rare and all fractures of this type are under investigation by medical specialists in this field.

When considering drug therapies for bone health, one must consider the risks and benefits. When we know that the risk for someone breaking a bone due to osteoporosis past the age of 50 is 1 out of every 2, sometimes the risks of these rare types of fracture is worth it. I am not advocating the use of drugs, I am just stating that this should be a conversation and a mutual decision by patient and physician.

On a side note, it is currently recommended that patients take a “drug holiday” occasionally when on a bisphosphonate type of drug.

We will keep looking at the research as it comes forward to make informed decisions. So, for now, let’s keep exercising, practicing balance, working on leg strength and spinal extensor strength to aid in fracture prevention and overall health and function!

Discs don’t “hurt”

sherribetz — Thu, 25 Feb 2010 16:23:24 +0000

Just heard an amazing lecture by Dr. Lorimer Moseley at the APTA Combined Sections Meeting in San Diego. “Explain Pain” is a book written by Dr. Moseley and Dr. David Butler (Mobilization of the Nervous System) for chronic pain patients that explains the concept of pain as a perception in our brains. They also call spinal discs “living active force transducers” to help people get away from the concept of a “slipped disc” that doesn’t happen! Very interesting work!

Read more at: http://noinotes.blogspot.com/ or listen to David Butler’s podcast “explain pain” here… Scroll down to the bottom of the page to get the mp3 file for free!

Diaphragmatic Rupture during Pilates

sherribetz — Wed, 24 Feb 2010 18:24:53 +0000

Read this 2010 case report of a Pilates student who experienced a spontaneous diaphragmatic rupture while doing Pilates. Published in the American Journal of Emergency Medicine by Yang, et al.

Read the case report…

My friend and colleague Peter Abaci, MD, just released a new book called “Take Charge of your Chronic Pain”

sherribetz — Sat, 13 Feb 2010 17:15:22 +0000

Dr. Abaci is a compassionate and caring anesthesiologist who runs the Bay Area Pain Management Clinic in Los Gatos, CA and has other sites across California. He has just written a book about his philosophies, techniques and the science of chronic pain. Dr. Abaci has a wonderful holistic approach to dealing with pain and highly stresses exercise like Pilates, Yoga and Tai Chi in his treatment programs. He is an avid student of Pilates as well! He also has a great blog that I love reading!

Upright and Steady:

Part of being happy during later years is being able to remain engaged and maintain a sense of independence. A decline in balance can interrupt a person’s ability to meet with friends, buy groceries, or play with grandchildren. Falls in the elderly is a major source of painful orthopedic injuries like broken hips and compression fractures in the vertebrae of the spinal column. Once these injuries take place, it becomes even harder to re-engage in upright activities like cooking meals and walking.

Read more on Dr. Abaci’s blog…. http://takechargeofyourchronicpain.com/2010/02/upright-and-steady

I’ve seen a few articles about the effect of strontium supplements on osteoporosis. What do you think?

sherribetz — Thu, 28 Jan 2010 19:06:55 +0000

Response from Gayle Nicholas Scott, PharmD, BCPS, ELS
Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia; Clinical Pharmacist, Chesapeake Regional Medical Center, Chesapeake, Virginia

Strontium is located on the periodic table in the alkali earth metal group, the same group that includes calcium. Strontium is used for a variety of indications ranging from an ingredient in toothpaste for sensitive teeth (Sensodyne®, GlaxoSmithKline, Research Triangle Park, North Carolina) to strontium-89 (Metastron™, GE Healthcare, Waukesha, Wisconsin) for metastatic bone pain. Strontium is widely promoted for treatment of osteoporosis. In Europe, strontium ranelate is available as a prescription drug. In the United States, strontium is a dietary supplement available as the carbonate, chloride, citrate, gluconate, and sulfate salts. The US Food and Drug Administration (FDA) granted strontium malonate investigational new drug (IND) status.

Most drugs for osteoporosis inhibit bone resorption. Available antiresorptive agents include bisphosphonates (alendronate, risedronate, ibandronate, and zoledronic acid), estrogen, selective estrogen modulators (raloxifene), and calcitonin. Parathyroid hormone (teriparatide) and fluoride stimulate bone formation. Strontium ranelate is unique in that it appears to act by both of these mechanisms.^[1]

Strontium ranelate is comprised of 2 atoms of strontium and the organic acid ranelic acid. Product information about strontium ranelate on the Website of the European Medicines Agency, the European Union equivalent of the FDA, explains the choice of the ranelate salt with “the organic part permit[s] the best compromise in terms of molecular weight, pharmacokinetics and acceptability of the medicinal product.”^[1] The bioavailability of strontium ranelate ranges from 19% to 27%; food and calcium products reduce its already low bioavailability by 60%-70%.^[1]

The safety and efficacy of strontium ranelate for osteoporosis have been investigated in 4 randomized, double-blind, placebo-controlled trials. Three trials evaluated strontium ranelate 0.5-2 g/day for osteoporosis treatment,^[2-4] and 1 study evaluated 125 mg-1 g/day for osteoporosis prevention.^[5] For treatment, strontium ranelate 2 g/day for 3 years reduced vertebral fractures by 37% (relative risk [RR] 0.63; 95% confidence interval [CI] 0.56, 0.71) and nonvertebral fractures by 14% (RR 0.86; 95% CI 0.75, 0.98). Lower doses were superior to placebo, but reduction in vertebral fractures and increase in bone mineral density were greater with 2 g/day.^[6] A recent study of women with osteoporosis taking strontium ranelate 2 g daily for 8 years showed sustained increases in bone mineral density.^[7] In all studies, patients took supplemental calcium and vitamin D.

Diarrhea is the most common adverse effect associated with strontium ranelate, usually occurring with higher doses. Data suggest that patients receiving strontium 2 g/day for 3-4 years have a higher risk for vascular side effects (eg, blood clots) and nervous system side effects (eg, seizures).^[6]

All research published in peer-reviewed journals is on strontium ranelate. A phase 2 study on strontium malonate has been published as a meeting abstract.^[8] No credible research is available on other strontium salts, and the bioavailability and effectiveness of these products are unknown.

For patients concerned about osteoporosis prevention, emphasize the importance of weight-bearing exercises and adequate calcium and vitamin D intake. For patients with diagnosed osteoporosis, FDA-approved treatments are indicated. Tell patients that dietary supplements containing strontium are unproven and should be avoided.

http://www.medscape.com/viewarticle/714870?src=mp&spon=17&uac=75614MR