It can be applied at any age in order to maintain strong bones and reduce the risk of fracture. Adapted physical activity represents physical activity individually tailored according to the psychosomatic capabilities of a person and the goal to be achieved. It is important to note that the quality of bone achieved by training at younger age cannot be maintained permanently if it is not supported by physical activity later in life. This suggests that training in early childhood may be an important factor in the prevention of osteoporosis in later life. THE QUALITY AND QUANTITY OF BONE TISSUE: Developing bones are much more responsive to mechanical loading and physical activity than mature bones. There are many reasons for that: the world's population is growing older, diet is getting poorer in vitamins and minerals and physical activity is decreasing. It is assumed that the number of patients with osteoporosis will increase by 30% in every 10 years in the 21st century. Osteoporosis, a disease characterized by the progressive loss of bone tissue, is one of the most common complications of aging.Īccording to some calculations, there were 25% of women and 4% of men older than 50 years with osteoporosis in the world in 2010. An algorithm for diagnosis and management of osteoporosis in MS is proposed. The known effect of different MS disease-modifying therapies on bone health is limited. The role of the inflammatory processes related to the underlying disease is considered in the context of the complex bone metabolism. Additional possible factors leading to reduced bone mass are low vitamin D levels, and use of medications such as glucocorticoids and anticonvulsants. Physical inactivity and reduced mechanical load on the bones (offsetting gravity) is likely the major contributing factor for osteoporosis in MS. This review summarizes the common risk factors and physiologic pathways that play a role in development of osteoporosis in MS patients. The development of osteoporosis in MS patients can be related to the cumulative effects of various factors. There has been mounting evidence showing that MS is associated with increased risk of osteoporosis and fractures. Multiple sclerosis (MS) is a chronic inflammatory-demyelinating disease of the nervous system.
So we outline some consequences: 1) health will be attained even in the presence of a disease, if the desire of the patient is not the disappearance of the disease-he/she is aware of the ineluctability of the disease- but is orientated to obtain other gratifications 2) even nonverbal patients can express desires, so health can be in their range 3) considering health not as the realization of desires but of wishes may contrast with the principles of justice and non-maleficence, as will be highlighted in the text. Desires differ according to age and possible underlying pathologies even the possibility of expressing them can be different. It might be helpful to consider health as the realisation of our desires, that is, the possibility of restoring previous skills or to perform skills the average person can perform. It is difficult for caregivers to have clear awareness of their aim, health, because the present WHO definition of health has widely been criticised as utopian and misleading.