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Is knee to chest exercise safe with osteoporosis
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Is knee to chest exercise safe with osteoporosis - August 19, 2008 2:41:37 PM
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Kaden
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Is this type of exercise safe with someone with osteoporosis. I have heard conflicting opinions. Thought I would pull the board and see what others thought.
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RE: Is knee to chest exercise safe with osteoporosis - August 20, 2008 9:16:56 AM
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PTupdate.com
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From: Pittsburgh, PA USA
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I can't see how it would cause any harm......anybody with such a condition where a fracture occurs during KTC was ready to break anyway......
Seated flexion, the next step in that flexion routine, does suffer more of a bad rep, but in all my years of practice, acute compression fractures occur with bending/lifting/twisting....I've never seen one just from flexing without some physical component (pulling bed covers, lifting, pulling, etc). I ran a quick online check, and could not find a source that was definitive with regards to the actual rate. The slower form of compression collapse, without pain and leading to the Dowager's hump, may be accelerated with flexion for long periods of time....such as an elderly care giver, flexing to avoid stenotic pain, etc
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John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Is knee to chest exercise safe with osteoporosis - August 20, 2008 9:49:21 AM
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torques
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From: Marion, IN
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Hi Kaden,
It depends on what region is involved. I see a few osteoporotic older clients with thoracic compression fracture (likely the anterior vertebral compartment/anterior wedging) hence I would lean towards using trunk extension exercises to minimize compression of the site. I find sitting exercises more tolerable for patient (such as overhead reaches). I would also do hip flexor stretches as well since this could induce stooped/flexed posture.
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Julius Quezon PT DPT MTC CPed
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RE: Is knee to chest exercise safe with osteoporosis - August 20, 2008 2:57:00 PM
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Shill
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From: Madison WI USA
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its unloaded, and really there isnt a great deal of spine flexion with this, beyond the lower to mid lumbar spine, and up to L1/T12 jct. The T spine usually sits fairly flat on the table, through gravity and bodyweight. So, with gentle force, I cant imagine it is too bad. I would want to know the intent of the knees to chest exercise with that particular patient. What is the purpose? Pain relief, ROM improvement, entertainment? Truly limited spine flexion ROM is not something I see a lot of, and therefore I dont often give this with the intent to improve ROM.
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RE: Is knee to chest exercise safe with osteoporosis - August 21, 2008 11:35:35 AM
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Kaden
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Thanks for the replies.
Shill. The intent is to give some relief from stenotic symptoms, just a simple way for relief when she gets symptoms.
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RE: Is knee to chest exercise safe with osteoporosis - August 22, 2008 8:39:54 AM
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Shill
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From: Madison WI USA
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Ah, I see. Not that you needed my vote of confidence but thats good rationale/intent. I often include extension as well, if it doesnt worsen them. As this population doesnt really fit the directional preference idea completely, I often have them extend as a means of preventing deformity, keeping the hip flexors lengthened in a relative sense, etc.
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RE: Is knee to chest exercise safe with osteoporosis - August 24, 2008 10:04:05 PM
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Kaden
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Would your opinion change if the paitent allready had a history of compression fracture?
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RE: Is knee to chest exercise safe with osteoporosis - August 25, 2008 8:33:20 AM
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Shill
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From: Madison WI USA
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It depends where the compression fx is/was. Up high in the T spine, my opinion would not change. Low L spine, probably. Really though, if it was the only thing to relieve symptoms, and it actually did this as a result of the movement, AND the patient had the education and other movements needed to prevent further flexion deformity, then I would probably still do it, of course explaining to them the whole idea of why it is often not done......
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RE: Is knee to chest exercise safe with osteoporosis - August 26, 2008 1:25:42 PM
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Kaden
Posts: 329
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Okay, so apparently it is compression fracture week at my clinic. Would one's opinion change if there was a history of compression fracture but no osteoporosis. These were more traumatic in nature and some maybe degenerative from MVA.
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