After a Stroke, Your Bones Need Care

After a Stroke, Your Bones Need Care

THURSDAY, April 25, 2019 (HealthDay News) — Stroke survivors often face limited mobility, which quadruples their odds of osteoporosis, broken bones and falls. But most are never screened for these problems, new research reveals.

“Our study adds to previous research that found despite an increased risk, only a small number of people who have recently had a stroke are tested and treated for osteoporosis,” said lead author Dr. Moira Kapral. She is director of general internal medicine at the University of Toronto.

Impaired mobility can result in bone mineral density decline, which is associated with osteoporosis. The condition weakens bones and increases risk of fractures.

In this study, researchers looked at more than 16,500 Canadian stroke survivors, aged 65 and older, from Ontario. Of these patients, only 5% had undergone bone mineral density testing; 15.5% had been prescribed medications for osteoporosis within the year after their stroke, and only a small percentage were prescribed medications for osteoporosis for the first time.

Patients most likely to have bone mineral density testing tended to be younger, female and to have had low-trauma fractures in the year after their stroke.

Patients were more likely to be prescribed medications for osteoporosis after their stroke if they were female, already had the bone-thinning disease, had previously broken bones, had previous bone mineral density testing, or had fallen or broke bones after their stroke.

The study was published April 25 in the journal Stroke.

“This study offers more evidence that there is a missed opportunity to identify people with stroke at increased risk of fractures, and to initiate treatment to prevent bone loss and fractures,” Kapral said in a journal news release.

Less than one-third of older U.S. women are screened for osteoporosis. The maximum treatment rate for some high-risk patients is about 30%, the researchers pointed out.

More information

The U.S. Office on Women’s Health has more about osteoporosis.

SOURCE: Stroke, news release, April 25, 2019

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Step-by-Step Exercises for a Stronger Back

Step-by-Step Exercises for a Stronger Back

THURSDAY, April 11, 2019 (HealthDay News) — Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.

The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.

Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.

Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.

Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.

Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.

You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.

More information

The American Council on Exercise has more on exercises targeting the back muscles.

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One Short, Brisk Walk a Day May Keep Arthritis at Bay

One Short, Brisk Walk a Day May Keep Arthritis at Bay

MONDAY, April 1, 2019 (HealthDay News) — Less than 10 minutes a day of brisk walking can help prevent disability in people with arthritis pain in their knee, hip, ankle or foot, researchers report.

Just one hour a week of brisk physical activity “is less than 10 minutes a day for people to maintain their independence. It’s very doable,” said lead study author Dorothy Dunlop. She’s a professor of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

“This minimum threshold may motivate inactive older adults to begin their path toward a physically active lifestyle with the wide range of health benefits promoted by physical activity,” Dunlop added in a university news release.

She and her team analyzed four years of data from more than 1,500 older adults in Baltimore, Pittsburgh, Columbus, Ohio, and Pawtucket, R.I., who had pain, aching or stiffness in their lower joints from osteoarthritis but were initially free of disability.

The participants’ levels of physical activity were monitored using a wearable device.

An hour a week of moderate-to-vigorous physical activity reduced their risk of disability, the study found. Specifically, the activity reduced the risk of walking too slowly to safely cross a street by 85 percent, and their risk of not being able to do daily living activities — for example, morning routine tasks such as walking across a room, bathing and dressing — by nearly 45 percent.

By the end of the four years, 24 percent of participants who did not get a weekly hour of brisk physical activity were walking too slowly to safely cross the street, and 23 percent had difficulty performing their morning routines, according to the study.

About 14 million older Americans have symptomatic knee osteoarthritis, the most common type of osteoarthritis. About 2 in 5 people with osteoarthritis — most of whom have it in their lower joints — develop disability.

Federal guidelines recommend low-impact physical activity for older adults with arthritis, and recommend that older adults do at least 2.5 hours a week of moderate-intensity activity.

But that amount of activity can be too much for inactive older adults with lower extremity pain, according to Dunlop.

“We hope this new public health finding will motivate an intermediate physical activity goal,” she said. “One hour a week is a stepping stone for people who are currently inactive. People can start to work toward that.”

The study was published April 1 in the American Journal of Preventive Medicine.

More information

The Arthritis Foundation offers exercise tips.

SOURCE: Northwestern University, news release, April 1, 2019

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Stretches to Strengthen Your Core

Stretches to Strengthen Your Core

THURSDAY, March 21, 2019 (HealthDay News) — Ever had a bad spasm from bending down to pick up your child or tie your shoes?

Keeping your core muscles — the workhorses that stabilize your spine — flexible with a stretching routine can help prevent this common occurrence and protect your back in general.

The Pelvic Tilt targets your lower back and your abdominals. Lie on your back with knees bent and feet about hip-width apart. Flatten and then press your lower back into the floor. You’ll feel your hips tilt forward. Hold for 10 to 20 seconds and repeat five times.

The Side Stretch helps your back and sides become more limber. In a standing position, extend your right arm above your head. Put your left hand on your hip. Slowly bend to the left without twisting or jerking. Hold for 10 to 20 seconds and repeat five times. Then repeat the sequence on the other side.

The Back Arch stretches hips and shoulders as well as your back. Stand up straight, legs shoulder width apart. Support your lower back with both hands and bend backwards. Hold for 10 to 20 seconds and repeat five times.

As a reminder, never bounce when stretching. This can cause muscles to tighten and lead to injury. Ease into every stretch with a slow, steady movement. Stop if any stretch feels uncomfortable. You should feel slight tension, but not pain. And do stretches that you hold only when your body is warm — after a workout is perfect.

More information

Love yoga? The American Council on Exercise details how you can use yoga to work core muscles.

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What’s the Right Age to Test for Osteoporosis?

What’s the Right Age to Test for Osteoporosis?

Osteoporosis is a threat to many women, especially after menopause. But the lead up to weak, brittle bones can start much earlier in life.

When bone density drops but isn’t yet at the level of osteoporosis, it’s called osteopenia. Osteopenia affects more than 33 million Americans over age 50, men and women, while 10 million have osteoporosis.

Yet the DEXA scan, the painless X-ray-based test that measures bone density, isn’t recommended for women until age 65, when they may need bone-building drugs to avoid fractures. For men, the prevalence of osteoporosis doesn’t increase with age until 80, but even then, there are no screening guidelines. So, what’s the answer?

Cost versus benefit is one reason insurers don’t universally cover the scan for women under 65. But you may be a candidate for earlier testing if you broke a bone after age 45, are losing height, are developing a slumped or hunched posture, or have sudden, unexplained back pain.

If you’re healthy but have concerns about bone health or risk factors for osteoporosis, you can talk to your doctor about earlier testing.

Factors that can increase your fracture risk include your height and weight — very thin women are at greater risk. Not getting enough exercise, smoking, drinking alcohol, a family history of osteoporosis or having a parent who broke a hip are others. Having a disease or taking medications associated with an increased risk of osteoporosis also increases your risk of fractures.

For better bone health, make sure your diet includes good sources of calcium-rich foods, that you get enough vitamin D through sunlight or a supplement, and that you get regular, weight-bearing exercise. That includes activities done while standing, like walking, which helps develop bone. Limit alcohol to one drink a day and don’t smoke.

More information

Harvard Health has more on osteopenia and osteoporosis.

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One-Third of U.S. Kids Have Back Pain, Study Says

One-Third of U.S. Kids Have Back Pain, Study Says

TUESDAY, March 12, 2019 (HealthDay News) — As American kids pack on the pounds, the number of those with back pain is on the rise.

One in three between the ages of 10 and 18 said they had backaches in the past year, according to a survey of about 3,700 youngsters. The incidence rose along with kids’ age and weight and was higher among those who play competitive sports.

Though many people probably associate back pain with older people, the orthopedic surgeon who led the study was not surprised by his findings.

“We see a lot of kids who have pain from overuse injuries or joint pain from playing sports,” said Dr. Peter Fabricant, who treats pediatric patients at the Hospital for Special Surgery in New York City. “Of these kids who had back pain, very few actually required any sort of medical intervention. Most didn’t need treatment at all.”

About 80 percent of adults suffer from lower back pain at some time, according to the U.S. National Institutes of Health.

But this is the first time the extent of back pain among children has been estimated on nationwide scale, the authors said. The youngsters surveyed were equally split by age and gender.

On average, those who reported back pain weighed more and had higher body mass indexes, or BMIs. (BMI is a measure of body fat based on height and weight.)

Back pain was more common among girls than boys (38 percent to 29 percent). And the percentage reporting back pain rose about 4 percent with each year of increasing age, according to the authors. Most often, pain affected the lower back.

Nearly half said they hurt in the evenings and more than 15 percent said back pain interrupted their sleep. Only 41 percent sought treatment, and most who did had physical therapy.

Participation in competitive sports was strongly linked to back pain, with junior varsity and varsity athletes experiencing it more often than younger or recreational players. Most survey participants were active, with basketball the most commonly played sport, followed by dance, baseball, football and soccer.

Another contributor to kids’ back pain is the backpacks they use to tote their stuff, researchers said. Those who used one strap to carry their packs reported significantly more back pain than did those who used both straps.

Those who used rolling backpacks reported back pain the most often. Fabricant said it wasn’t clear whether pain prompted their use of the rolling packs or whether the rolling packs contributed to their pain.

While long-term pain prospects are unclear, Fabricant said “it would certainly stand to reason” that kids who experience backaches would be more likely to do so as adults.

Dr. Henock Wolde-Semait is a pediatric orthopedist at NYU Winthrop Hospital in Mineola, N.Y., who reviewed the findings. He said the results mirror what he sees in his own practice.

“Lots of kids have back pain for various reasons. It seems like it’s on the rise,” he said.

“The majority of them do well [without surgical treatment], which is why in the past this may have been overlooked or taken for granted,” Wolde-Semait added.

Fabricant suggested parents urge their kids to avoid any sport or activity related to their back pain. Physical therapy may help by stretching and strengthening key muscles, he said, and it’s wise to avoid carrying backpacks on only one shoulder.

Wolde-Semait said excessive screen time may also play a role in kids’ back pain. He said youngsters should seek “moderation in every aspect.”

The study is to be presented March 12 at the American Academy of Orthopaedic Surgeons’ annual meeting, in Las Vegas. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

Harvard Health offers tips for a pain-free back.

SOURCES: Peter Fabricant, M.D., M.P.H., pediatric orthopedic surgeon, Hospital for Special Surgery, New York, N.Y.; Henock Wolde-Semait, M.D., pediatric orthopedist, NYU Winthrop Hospital, Mineola, N.Y.; presentation, American Academy of Orthopaedic Surgeons annual meeting, Las Vegas, March 12, 2019

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