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Osteologie 2023; 32(03): 202-209
DOI: 10.1055/a-2076-7579
Review

Zusammengefasste Empfehlungen für ein körperliches Training zur Frakturprophylaxe postmenopausaler Frauen und Männer 45 Jahre und älter

Summarized Recommendations on Exercise and Fracture Prevention for Postmenopausal Women and Men 45 Years and Older
Simon von Stengel
1   Institut für Radiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
,
Daniel Schöne
2   Institut für Medizinische Physik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
,
Matthias Kohl
3   Department of Medical and Life Sciences, Hochschule Furtwangen – Campus Villingen-Schwenningen, Villingen-Schwenningen, Deutschland
,
Clemens Becker
4   Abteilung Digitale Medizin, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
,
Markus Gosch
5   Gerontologie und Geriatrie, Paracelsus Medizinische Privatuniversität – Nürnberg, Nürnberg, Deutschland
,
Franz Jakob
6   Bernhard-Heine-Centrum für Bewegungsforschung, Julius-Maximilians-Universität Würzburg, Würzburg, Deutschland
,
Katharina Kerschan-Schindl
7   Physikalische Medizin und Rehabilitation, Universität Wien, Wien, Österreich
,
Bernd Kladny
8   Fachbereich Orthopädie, m&i-Fachklinik Herzogenaurach, Herzogenaurach, Deutschland
,
Uwe Lange
9   Physikalische Medizin und Osteologie, Kerckhoff-Klinik GmbH, Bad Nauheim, Deutschland
,
Stefan Peters
10   Deutscher Verband für Gesundheitssport und Sporttherapie e.V., Hürth, Deutschland
,
Cornel Sieber
11   Institut für Biomedizin des Alters, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
,
Friederike Thomasius
12   Frankfurter Hormon- und Osteoporosezentrum, Frankfurt, Deutschland
,
Michael Uder
1   Institut für Radiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
,
Mahdieh Shojaa
13   Institute of Health Science, Universitätsklinikum Tübingen, Tübingen, Deutschland
,
Wolfgang Kemmler 
1   Institut für Radiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
2   Institut für Medizinische Physik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
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Zusammenfassung

Trainingsprotokolle zur Frakturprophylaxe müssen eine Vielzahl von trainingswissenschaftlichen, logistischen und finanziellen Rahmenbedingungen berücksichtigen, um die erwünschte Effektivität und Anwendbarkeit im Einzel- oder Gruppentraining zu gewährleisten. Basierend auf dem individuellen Risikoprofil ist eine Zuordnung von dedizierten Trainingszielen als Ausgangspunkt der Trainingsplanung zielführend. Die konkrete Adressierung individueller Trainingsziele ermöglicht die Auswahl geeigneter Trainingsinhalte, -mittel und -methoden, die ebenfalls den gesundheitlichen Status und Neigungen des Betroffenen berücksichtigen sollten. Durch die idealerweise überdauernde Trainingsdurchführung kommt der Beachtung nachhaltiger Trainingsprinzipen (progressive Belastungserhöhung, Periodisierung) besondere Relevanz im Trainingsprozess zu. Grundsätzlich ist ein individualisiertes körperliches Training zur Frakturprophlaxe aufgrund der großen Anzahl von Therapieoptionen und Ansatzpunkten in jedem Alter und angepasst an funktionellen Status, gesundheitlichen Beschwerden und potentiellen Kontraindikationen sinnvoll und möglich. Mit Ausnahme von Angebotsstrukturen für ambulante Sturzpräventions-Maßnahmen als Einzelangebote existieren im Gesundheitswesen grundsätzlich belastbare Strukturen, die eine eng supervidierte, qualifizierte und co-finanzierte Trainingsdurchführung unterstützen. Die breite Anwendbarkeit und dichte Struktur von Gesundheitsangeboten zur Frakturprophylaxe für nahezu alle Risiko- und Neigungsgruppen kollidiert allerdings mit dem häufig zu geringen Informationsstand bezüglich Effektivität, Durchführung und Angebotsstruktur von Betroffenen aber auch Entscheidern des Gesundheitswesens.

Abstract

The design and implementation of promising training protocols for fracture prevention is a multi-step approach that has to consider a wide range of diverging aspects. Apart from the effectiveness as such, a large number of individual, logistical and financial aspects have to be taken into account to generate ideally persistantly applicable exercise training programs. Applying a sport scientific approach, the definition of dedicated training aims, based on the individual fracture risk profile, is the first step of the training process. The appropriate selection of training content and types along with training tools and methods that best possibly address the defined training aim(s) should also consider the (fracture) risk profile, health status and predispositions of the individual. Since training programs should be maintained as long as possible, ideally for life, particular attention should be paid to training principles (e. g. progressive overload, periodization), something often overlooked in scientific studies of limited duration. Summing up the applicability of exercise programms for fracture prevention, in view of the large variaty of training options and technologies, exercise is a feasible and promizing therapy for most if not all cohorts at risk for fractures – individually adjustable relating to functional status, health issues and potential contraindications. With the exception of structures for fall prevention programs as an individual home-based approach, health care systems already provide closely supervised, qualified and co-financed training programs that could be increasingly used as vehicles for fracture prevention. Unfortunately, the broad applicability of training programs on fracture prevention for almost all risk and propensity groups is often stymied by the frequently insufficient level of information of stakeholders and decision-makers regarding effectiveness, feasibility and applicability of exercise.

Schlüsselworte

Frakturprophylaxe - körperliches Training - Empfehlungen - Kontraindikationen - Angebotsstrukturen

Key words

fracture prevention - exercise training - recommendations - contraindications - setting


Publication History

Received: 24 March 2023

Accepted: 18 April 2023

Article published online:
26 May 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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