Download PDF
B&G Bewegungstherapie und Gesundheitssport 2020; 36(01): 3-11
DOI: 10.1055/a-0976-4032
Wissenschaft

Erst Rheuma, dann Osteoporose – aktuelle Empfehlungen aus sport- und bewegungstherapeutischer Sicht

Where science meets practice: An introduction to applied research in exercise therapy and health sports
Matthias Dreher
1   Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin Mainz
,
Robert Liebscher
2   Universitätsklinikum Freiburg, Akademie für Medizinische Berufe, Schule für Physiotherapie
,
Andreas Schwarting
1   Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin Mainz
3   ACURA Rheumazentrum Rheinland-Pfalz, Bad Kreuznach
› Author Affiliations
› Further Information
    Permissions and Reprints

Zusammenfassung

Die gesundheitlich positiven Wirkungsweisen von körperlicher Aktivität und körperlichem Training sind für viele Erkrankungsbilder wissenschaftlich weitestgehend belegt. Auch bei entzündlich-rheumatischen Erkrankungen und der Osteoporose wird von positiven Effekten auf das Krankheitsbild und deren potenziellen Komorbiditäten durch die Sport- und Bewegungstherapie ausgegangen. Ihre Wirkungsweisen werden in dieser Übersichtsarbeit näher betrachtet.

Auf Basis einer Literaturrecherche wurden randomisierte kontrollierte Studien (RCT), nicht-RCT-Studien, systematische Übersichtsarbeiten und Empfehlungen von Fachgesellschaften einbezogen.

Die Ausbildung einer Osteoporose ist eine häufig auftretende Komorbidität der medikamentösen Therapie bei entzündlich-rheumatischen Erkrankungsbildern. Dies wird durch das Manifestationsalter der entzündlich-rheumatischen Erkrankungen und den Bewegungsmangel bei bereits Erkrankten unterstützt. Körperliche Aktivität und Training zeigen eine positive Wirkung, sowohl auf entzündlich-rheumatische Erkrankungsbilder als auch auf das Erkrankungsbild der Osteoporose und darüber hinaus auf deren Komorbiditäten. Zudem existieren auf Basis der Bewegungs- und Trainingsempfehlungen des American College of Sports Medicine (ACSM) und der American Heart Association (AHA) Ansatzpunkte, die durch die European League Against Rheumatism (EULAR) adaptiert wurden, um Intensität, Dauer und Umfänge in der Prävention und Rehabilitation zu steuern.

Die Steigerung der körperlichen Aktivität und das regelmäßige körperliche Training sollten grundlegende additive Bestandteile der Therapie bei entzündlich-rheumatischen Erkrankungen und der Osteoporose sein. In einzelnen Subaspekten ist die Studienlage sehr heterogen, vor allem bei entzündlich-rheumatischen Erkrankungen. Hierzu bedarf es weiterer Forschung.

Summary

The positive health effects of physical activity and physical training have been scientifically proven for many diseases. This review focuses on the examination of inflammatory rheumatic diseases and the potential comorbidities like osteoporosis and the positive effects assumed from this adjuvant treatment opportunity. Based on the available literature, the review comprised randomized controlled trials (RCTs), non-RCT studies, reviews and recommendations from professional bodies. Physical activity and training show positive effects on inflammatory rheumatic diseases and osteoporosis itself and also on potential comorbidities with existing safety. In addition, the exercise and training recommendations of the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) provide recommendations, which were adapted by the European League Against Rheumatism (EULAR) to control intensity, duration and training extent.

The increase of physical activity and regular physical training should be a basic additive component of the therapy of inflammatory rheumatic diseases as well as osteoporosis. In individual sub-aspects, the study situation is very heterogeneous, especially in the field of rheumatology and requires further research.

Stichworte

Sport - Training - entzündlich-rheumatische Erkrankungen - Glukokortikoide - Osteoporose.

Key words

Sports - training - inflammatory rheumatic diseases - glucocorticoids - osteoporosis.


Publication History

Received: 16 November 2019

Accepted: 26 November 2019

Article published online:
17 February 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 Zink A, Albrecht K. Wie häufig sind muskuloskeletale Erkrankungen in Deutschland? Zeitschrift für Rheumatologie 2016; 75: 346-353. DOI: DOI 10.1007/s00393-016-0094-2.
    CrossrefPubMed
  • 2 Alamanos Y, Voulgari PV, Drosos AA. Incidence and prevalence of psoriatic arthritis: a systematic review. J Rheumatol 2008; 35: 1354-1358
    PubMedGoogle Scholar
  • 3 Mease PJ, Gladman DD, Papp KA. et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European / North American dermatology clinics. J Am Acad Dermatol 2013; 69: 729-735. DOI: 10.1016/j.jaad.2013.07.023.
    CrossrefPubMedGoogle Scholar
  • 4 Bakland G, Nossent HC. Epidemiology of spondyloarthritis: a review. Curr Rheumatol Rep 2013; 15: 351 . DOI: 10.1007/s11926-013-0351-1.
    CrossrefPubMedGoogle Scholar
  • 5 Smolen JS, Landewe R, Bijlsma J. et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 2017; 76: 960-977. DOI: 10.1136/annrheumdis-2016-210715.
    CrossrefPubMedGoogle Scholar
  • 6 van der Linden MP, le Cessie S, Raza K. et al. Long-term impact of delay in assessment of patients with early arthritis. Arthritis Rheum 2010; 62: 3537-3546. DOI: 10.1002/art.27692.
    CrossrefPubMedGoogle Scholar
  • 7 Kirwan JR, Bijlsma JW, Boers M. et al. Effects of glucocorticoids on radiological progression in rheumatoid arthritis. Cochrane Database Syst Rev 2007. doi:10.1002/14651858.CD006356: CD006356. doi:10.1002/14651858.CD006356
    PubMedGoogle Scholar
  • 8 Schwarting A, Dreher M, Assmann G. et al. Erfahrungen und Ergebnisse aus Rheuma-VOR. Zeitschrift für Rheumatologie, Under Review. 2019
    PubMedGoogle Scholar
  • 9 Schwarting A. From ADAPTHERA to Rheuma-VOR: Concept of Coordinated Cooperation to Improve the Quality of Rheumatology Care. Aktuelle Rheumatologie 2018; 43: 406-409 . doi:10.1055/a-0658-1031
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Proschek D, Rehart S. Sport and rheumatoid arthritis. Z Rheumatol 2014; 73: 434-438. doi:10.1007/s00393-013-1341-4
    CrossrefPubMedGoogle Scholar
  • 11 Foundation IO. Broken Bones, Broken Lives: A roadmap to solve the fragility fracture crisis in Europe;
    PubMed
  • 12 Thomasius F, Baum E, Bernecker P. et al. DVO Leitlinie 2017 zur Prophylaxe, Diagnostik und Therapie der Osteoporose bei postmenopausalen Frauen und Männern. Osteologie 2018; 27: 154-160. DOI: 10.1055/s-0038-1673537.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Werle J. ICF Core Set Osteoporose – didaktisch-methodische Überlegungen zur Bewegungstherapie. B & G 2014; 30: 260-267. doi:10.1055/s-0034-1384453
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Adachi JD, Adami S, Gehlbach S. et al. Impact of prevalent fractures on quality of life: baseline results from the global longitudinal study of osteoporosis in women. Mayo Clin Proc 2010; 85: 806-813. DOI: doi:10.4065/mcp.2010.0082.
    CrossrefPubMedGoogle Scholar
  • 15 Sinigaglia L, Varenna M, Girasole G. et al. Epidemiology of osteoporosis in rheumatic diseases. Rheum Dis Clin North Am 2006; 32: 631-658. DOI: 10.1016/j.rdc.2006.07.002.
    CrossrefPubMedGoogle Scholar
  • 16 Maruotti N, Corrado A, Cantatore FP. Osteoporosis and rheumatic diseases. Reumatismo 2014; 66: 125-135 . doi:10.4081/reumatismo.2014.785
    CrossrefPubMedGoogle Scholar
  • 17 Haugeberg G, Uhlig T, Falch JA. et al. Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County Rheumatoid Arthritis register. Arthritis Rheum 2000; 43: 522-530 . doi:10.1002/1529-0131(200003)43:3<522::AID-ANR7>3.0.CO;2-Y
    CrossrefPubMedGoogle Scholar
  • 18 Forsblad D’Elia H, Larsen A, Waltbrand E. et al. Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalised osteoporosis. Ann Rheum Dis 2003; 62: 617-623 . doi:10.1136/ard.62.7.617
    CrossrefPubMedGoogle Scholar
  • 19 Lodder MC, de Jong Z, Kostense PJ. et al. Bone mineral density in patients with rheumatoid arthritis: relation between disease severity and low bone mineral density. Ann Rheum Dis 2004; 63: 1576-1580. doi:10.1136/ard.2003.016253
    CrossrefPubMedGoogle Scholar
  • 20 El Maghraoui A, Borderie D, Cherruau B. et al. Osteoporosis, body composition, and bone turnover in ankylosing spondylitis. J Rheumatol 1999; 26: 2205-2209
    PubMedGoogle Scholar
  • 21 Hinze AM, Louie GH. Osteoporosis Management in Ankylosing Spondylitis. Curr Treatm Opt Rheumatol 2016; 2: 271-282. doi:10.1007/s40674-016-0055-6
    CrossrefPubMedGoogle Scholar
  • 22 Bessant R, Keat A. How should clinicians manage osteoporosis in ankylosing spondylitis? J Rheumatol 2002; 29: 1511-1519
    PubMed
  • 23 Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2015; 25 Suppl 3: 1-72. DOI: doi:10.1111/sms.12581.
    CrossrefPubMedGoogle Scholar
  • 24 Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol 2017; 32: 541-556. DOI: doi:10.1097/HCO.0000000000000437.
    CrossrefPubMedGoogle Scholar
  • 25 Reiner M, Niermann C, Jekauc D. et al. Long-term health benefits of physical activity – a systematic review of longitudinal studies. BMC Public Health 2013; 13: 813 . doi:10.1186/1471-2458-13-813
    CrossrefPubMedGoogle Scholar
  • 26 Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ 2006; 174: 801-809. DOI: 10.1503/cmaj.051351.
    CrossrefPubMedGoogle Scholar
  • 27 Fiuza-Luces C, Garatachea N, Berger NA. et al. Exercise is the real polypill. Physiology (Bethesda) 2013; 28: 330-358. DOI: 10.1152/physiol.00019.2013.
    CrossrefPubMedGoogle Scholar
  • 28 Heyward VH, Gibson AL. Advanced fitness assessment and exercise prescription. Seventh edition. Aufl. Champaign, IL: Human Kinetics; 2014
    Google Scholar
  • 29 Ekelund U, Steene-Johannessen J, Brown WJ. et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality?: A harmonised meta-analysis of data from more than 1 million men and women. The Lancet 2016; 388: 1302 - 1310 . doi:10.1016/S0140-6736(16)30370-1
    CrossrefPubMedGoogle Scholar
  • 30 Pfeifer K, Banzer W, Ferrari N. et al. Nationale Empfehlungen für Bewegung und Bewegungsförderung. Köln; 2017 DOI: 10.1055/s-0042-123346
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Hernandez-Hernandez V, Ferraz-Amaro I, Diaz-Gonzalez F. Influence of disease activity on the physical activity of rheumatoid arthritis patients. Rheumatology (Oxford) 2014; 53: 722-731. DOI: 10.1093/rheumatology/ket422.
    CrossrefPubMedGoogle Scholar
  • 32 Swinnen TW, Scheers T, Lefevre J. et al. Physical activity assessment in patients with axial spondyloarthritis compared to healthy controls: a technology-based approach. PLoS One 2014; 9: e85309. DOI: 10.1371/journal.pone.0085309.
    CrossrefPubMedGoogle Scholar
  • 33 Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases-myokine regulation. Nat Rev Rheumatol 2015; 11: 86-97. DOI: 10.1038/nrrheum.2014.193.
    CrossrefPubMedGoogle Scholar
  • 34 Metsios GS, Kitas GD. Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation. Best Pract Res Clin Rheumatol 2019; 32: 669-682. DOI: 10.1016/j.berh.2019.03.013.
    CrossrefPubMedGoogle Scholar
  • 35 O’Dwyer T, Durcan L, Wilson F. Exercise and physical activity in systemic lupus erythematosus: A systematic review with meta-analyses. Semin Arthritis Rheum 2017; 47: 204-215. DOI: 10.1016/j.semarthrit.2017.04.003.
    CrossrefPubMedGoogle Scholar
  • 36 Pecourneau V, Degboe Y, Barnetche T. et al. Effectiveness of Exercise Programs in Ankylosing Spondylitis: A Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2018; 99: 383-389 e381. DOI: 10.1016/j.apmr.2017.07.015.
    CrossrefPubMedGoogle Scholar
  • 37 Rausch Osthoff AK, Juhl CB, Knittle K. et al. Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip / knee osteoarthritis. RMD Open 2018; 4: e000713. DOI: 10.1136/rmdopen-2018-000713.
    CrossrefPubMedGoogle Scholar
  • 38 Sveaas SH, Smedslund G, Hagen KB. et al. Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis. Br J Sports Med 2017; 51: 1065-1072. DOI: 10.1136/bjsports-2016-097149.
    CrossrefPubMedGoogle Scholar
  • 39 Dagfinrud H, Halvorsen S, Vollestad NK. et al. Exercise programs in trials for patients with ankylosing spondylitis: do they really have the potential for effectiveness?. Arthritis Care Res (Hoboken) 2011; 63: 597-603. DOI: 10.1002/acr.20415.
    CrossrefPubMedGoogle Scholar
  • 40 Burghardt RD, Kazim MA, Ruther W. et al. The impact of physical activity on serum levels of inflammatory markers in rheumatoid arthritis: a systematic literature review. Rheumatol Int 2019; 39: 793-804. DOI: 10.1007/s00296-019-04284-x.
    CrossrefPubMedGoogle Scholar
  • 41 Fedewa MV, Hathaway ED, Ward-Ritacco CL. Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials. Br J Sports Med 2017; 51: 670-676. DOI: 10.1136/bjsports-2016-095999.
    CrossrefPubMedGoogle Scholar
  • 42 Agca R, Heslinga SC, Rollefstad S. et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015 / 2016 update. Ann Rheum Dis 2017; 76: 17-28. DOI: 10.1136/annrheumdis-2016-209775.
    CrossrefPubMedGoogle Scholar
  • 43 Metsios GS, Stavropoulos-Kalinoglou A, Veldhuijzen van Zanten JJ. et al. Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review. Rheumatology (Oxford) 2008; 47: 239-248. DOI: 10.1093/rheumatology/kem260.
    CrossrefPubMedGoogle Scholar
  • 44 Musumeci G. Effects of exercise on physical limitations and fatigue in rheumatic diseases. World J Orthop 2015; 6: 762-769. DOI: 10.5312/wjo.v6.i10.762.
    CrossrefPubMedGoogle Scholar
  • 45 Kelley GA, Kelley KS, Hootman JM. Effects of exercise on depression in adults with arthritis: a systematic review with meta-analysis of randomized controlled trials. Arthritis Res Ther 2015; 17: 21 . DOI: 10.1186/s13075-015-0533-5.
    CrossrefPubMedGoogle Scholar
  • 46 Rausch Osthoff AK, Niedermann K, Braun J. et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018; 77: 1251-1260. DOI: 10.1136/annrheumdis-2018-213585.
    CrossrefPubMedGoogle Scholar
  • 47 van der Heijde D, Ramiro S, Landewe R. et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 2017; 76: 978-991 DOI: 10.1136/annrheumdis-2016-210770.
    CrossrefPubMedGoogle Scholar
  • 48 Combe B, Landewe R, Daien CI. et al. 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis 2017; 76: 948-959. DOI: 10.1136/annrheumdis-2016-210602.
    CrossrefPubMedGoogle Scholar
  • 49 Fanouriakis A, Kostopoulou M, Alunno A. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019; 78: 736-745. DOI: 10.1136/annrheumdis-2019-215089.
    CrossrefPubMedGoogle Scholar
  • 50 Medicine ACoS. Guidelines for exercise testing and prescription. 10.. Aufl: Lippincott Williams&Wilkins; 2017
    Google Scholar
  • 51 Medicine ACoS, Chodzko-Zajko WJ, Proctor DN. et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009; 41: 1510-1530. DOI: 10.1249/MSS.0b013e3181a0c95c.
    CrossrefPubMedGoogle Scholar
  • 52 Medicine ACoS. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 2009; 41: 687-708. DOI: 10.1249/MSS.0b013e3181915670.
    CrossrefPubMedGoogle Scholar
  • 53 Garber CE, Blissmer B, Deschenes MR. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359. doi:10.1249/MSS.0b013e318213fefb
    CrossrefPubMedGoogle Scholar
  • 54 Piercy KL, Troiano RP, Ballard RM. et al. The Physical Activity Guidelines for Americans. JAMA 2018; 320: 2020-2028. DOI: 10.1001/jama.2018.14854.
    CrossrefPubMedGoogle Scholar
  • 55 Murray JM, Brennan SF, French DP. et al. Effectiveness of physical activity interventions in achieving behaviour change maintenance in young and middle aged adults: A systematic review and meta-analysis. Soc Sci Med 2017; 192: 125-133. DOI: 10.1016/j.socscimed.2017.09.021.
    CrossrefPubMedGoogle Scholar
  • 56 Organization WH. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010
    Google Scholar
  • 57 Lofgren B, Dencker M, Nilsson JA. et al. A 4-year exercise program in children increases bone mass without increasing fracture risk. Pediatrics 2012; 129: e1468-1476. DOI: 10.1542/peds.2011-2274.
    CrossrefPubMedGoogle Scholar
  • 58 Nelson ME, Rejeski WJ, Blair SN. et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation 2007; 116: 1094-1105. DOI: 10.1161/CIRCULATIONAHA.107.185650.
    CrossrefPubMedGoogle Scholar
  • 59 Andreoli A, Celi M, Volpe SL. et al. Long-term effect of exercise on bone mineral density and body composition in post-menopausal ex-elite athletes: a retrospective study. Eur J Clin Nutr 2012; 66: 69-74. DOI: 10.1038/ejcn.2011.104.
    CrossrefPubMedGoogle Scholar
  • 60 Benedetti MG, Furlini G, Zati A. et al. The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients. Biomed Res Int 2018; 2018: 4840531 . DOI: 10.1155/2018/4840531.
    CrossrefPubMedGoogle Scholar
  • 61 Guadalupe-Grau A, Fuentes T, Guerra B. et al. Exercise and bone mass in adults. Sports Med 2009; 39: 439-468. DOI: 10.2165/00007256-200939060-00002.
    CrossrefPubMedGoogle Scholar
  • 62 Langsetmo L, Hitchcock CL, Kingwell EJ. et al. Physical activity, body mass index and bone mineral density-associations in a prospective population-based cohort of women and men: the Canadian Multicentre Osteoporosis Study (CaMos). Bone 2012; 50: 401-408. DOI: 10.1016/j.bone.2011.11.009.
    CrossrefPubMedGoogle Scholar
  • 63 Carter ND, Kannus P, Khan KM. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports Med 2001; 31: 427-438. DOI: 10.2165/00007256-200131060-00003.
    CrossrefPubMedGoogle Scholar
  • 64 Engelke K, Kemmler W, Lauber D. et al. Exercise maintains bone density at spine and hip EFOPS: a 3-year longitudinal study in early postmenopausal women. Osteoporos Int 2006; 17: 133-142. DOI: 10.1007/s00198-005-1938-9.
    CrossrefPubMedGoogle Scholar
  • 65 Hartard M, Haber P, Ilieva D. et al. Systematic strength training as a model of therapeutic intervention. A controlled trial in postmenopausal women with osteopenia. Am J Phys Med Rehabil 1996; 75: 21-28. DOI: 10.1097/00002060-199601000-00006.
    CrossrefPubMedGoogle Scholar
  • 66 Howe TE, Shea B, Dawson LJ. et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 2011. DOI: 10.1002/14651858.CD000333.pub2: CD000333. doi:10.1002/14651858.CD000333.pub2
    CrossrefPubMedGoogle Scholar
  • 67 Karinkanta S, Heinonen A, Sievanen H. et al. A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial. Osteoporos Int 2007; 18: 453-462. DOI: 10.1007/s00198-006-0256-1.
    CrossrefPubMedGoogle Scholar
  • 68 Kemmler W, Lauber D, Weineck J. et al. Benefits of 2 years of intense exercise on bone density, physical fitness, and blood lipids in early postmenopausal osteopenic women: results of the Erlangen Fitness Osteoporosis Prevention Study (EFOPS). Arch Intern Med 2004; 164: 1084-1091. DOI: 10.1001/archinte.164.10.1084.
    CrossrefPubMedGoogle Scholar
  • 69 Preisinger E, Alacamlioglu Y, Pils K. et al. Therapeutic exercise in the prevention of bone loss. A controlled trial with women after menopause. Am J Phys Med Rehabil 1995; 74: 120-123
    PubMedGoogle Scholar
  • 70 Vincent KR, Braith RW. Resistance exercise and bone turnover in elderly men and women. Med Sci Sports Exerc 2002; 34: 17-23. doi:10.1097/00005768-200201000-00004
    PubMedGoogle Scholar
  • 71 Itoi E, Sinaki M. Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age. Mayo Clin Proc 1994; 69: 1054-1059. doi:10.1016/s0025-6196(12)61372-x
    CrossrefPubMedGoogle Scholar
  • 72 Sinaki M, Itoi E, Wahner HW. et al. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone 2002; 30: 836-841. DOI: 10.1016/s8756-3282(02)00739-1.
    CrossrefPubMedGoogle Scholar
  • 73 Feskanich D, Willett W, Colditz G. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 2002; 288: 2300-2306. doi:10.1001/jama.288.18.2300
    CrossrefPubMedGoogle Scholar
  • 74 Gregg EW, Cauley JA, Seeley DG. et al. Physical activity and osteoporotic fracture risk in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med 1998; 129: 81-88. DOI: 10.7326/0003-4819-129-2-199807150-00002.
    CrossrefPubMedGoogle Scholar
  • 75 Gregg EW, Pereira MA, Caspersen CJ. Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence. J Am Geriatr Soc 2000; 48: 883-893. doi:10.1111/j.1532-5415.2000.tb06884.x
    CrossrefPubMedGoogle Scholar
  • 76 Kujala UM, Kaprio J, Kannus P. et al. Physical activity and osteoporotic hip fracture risk in men. Arch Intern Med 2000; 160: 705-708. DOI: 10.1001/archinte.160.5.705.
    CrossrefPubMedGoogle Scholar
  • 77 Robertson MC, Campbell AJ, Gardner MM. et al. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc 2002; 50: 905-911. DOI: 10.1046/j.1532-5415.2002.50218.x.
    CrossrefPubMedGoogle Scholar
  • 78 Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med 2003; 348: 42-49. doi:10.1056/NEJMcp020719
    CrossrefPubMedGoogle Scholar
  • 79 Karinkanta S, Kannus P, Uusi-Rasi K. et al. Combined resistance and balance-jumping exercise reduces older women’s injurious falls and fractures: 5-year follow-up study. Age Ageing 2015; 44: 784-789. DOI: 10.1093/ageing/afv064.
    CrossrefPubMedGoogle Scholar
  • 80 Silva RB, Eslick GD, Duque G. Exercise for falls and fracture prevention in long term care facilities: a systematic review and meta-analysis. J Am Med Dir Assoc 2013; 14: 685-689 e682. doi:10.1016/j.jamda.2013.05.015
    CrossrefPubMedGoogle Scholar
  • 81 Uusi-Rasi K, Patil R, Karinkanta S. et al. Exercise and vitamin D in fall prevention among older women: a randomized clinical trial. JAMA Intern Med 2015; 175: 703-711. DOI: 10.1001/jamainternmed.2015.0225.
    CrossrefPubMedGoogle Scholar
  • 82 de Kam D, Smulders E, Weerdesteyn V. et al. Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials. Osteoporos Int 2009; 20: 2111-2125. DOI: 10.1007/s00198-009-0938-6.
    CrossrefPubMedGoogle Scholar
  • 83 Martyn-St James M, Carroll S. A meta-analysis of impact exercise on postmenopausal bone loss: the case for mixed loading exercise programmes. Br J Sports Med 2009; 43: 898-908. doi:10.1136/bjsm.2008.052704
    CrossrefPubMedGoogle Scholar
  • 84 Vieira S, Silva Jr JA. Different land-based exercise training programs to improve bone health in postmenopausal women. 2013
    PubMedGoogle Scholar
  • 85 Varahra A, Rodrigues IB, MacDermid JC. et al. Exercise to improve functional outcomes in persons with osteoporosis: a systematic review and meta-analysis. Osteoporos Int 2018; 29: 265-286. DOI: 10.1007/s00198-017-4339-y.
    CrossrefPubMedGoogle Scholar
  • 86 Hars M, Herrmann FR, Fielding RA. et al. Long-term exercise in older adults: 4-year outcomes of music-based multitask training. Calcif Tissue Int 2014; 95: 393-404. DOI: 10.1007/s00223-014-9907-y.
    CrossrefPubMedGoogle Scholar
  • 87 Gillespie LD, Robertson MC, Gillespie WJ. et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; DOI: 10.1002/14651858.CD007146.pub. 3: CD007146. doi:10.1002/14651858.CD007146.pub3
    CrossrefPubMedGoogle Scholar
  • 88 Pfeifer M, Minne HW. Bone loading exercise recommendations for prevention and treatment of osteoporosis. IOF International Osteoporosis Foundation: Committee of Scientific Advisors 2005
    PubMed
  • 89 Clasen M, Schwarting A. Leben mit Rheuma: Rehabilitation und adjuvante Therapien. Akt Rheumatol 2018; 43: 289-296. doi:10.1055/a-0649-4933
    Article in Thieme ConnectPubMedGoogle Scholar
  • 90 Lauter A, Triantafyllias K, Leiss R. et al. ADAPTHERA-Statewide cross-sectoral care network for patients with early rheumatoid arthritis shows sustained remission in standard care. Z Rheumatol 2019 DOI: doi:10.1007/s00393-019-0653-4. doi:10.1007/s00393-019-0653-4
    CrossrefPubMedGoogle Scholar