[Practices and strategies for the prevention of falls in the osteoporotic elderly].

Among seniors with osteoporosis, falls can cause devastating injuries such as hip fractures even with only weak impacts. We have begun a combined medical examination and educational program for exercise to prevent injurious falls. To make fall prevention practices more widespread, we hold one-day simplified fall prevention program and instruction courses for practitioners.

[Osteoporosis in the disabled].

Osteoporosis is a well-known complication of paralytic diseases. We investigated 11 patients with chronic spinal cord injury who have been paralyzed for 20 years or more. History of fracture was searched in these 11 patients. Mineral density in the lower limbs was measured, and the bone metabolism was examined. Of the total of 8 fractures, 87.5% occurred in the relatively low muscle tonus group. Patients showed decreased bone mineral density of the femoral neck, and this was negatively correlated with period of paralysis. One female patient showed an abnormal rise in bone absorption markers. In this case, bisphosphonates can be effective to increase the bone mineral density. To prevent fracture in patients with paralysis, particular care should be taken in wheelchair operation and handling of the lower limbs.

[The basic idea and exercise program of "fall and fracture prevention school" for elderly people].

With the arrival of an aging society in Japan, accidents among elderly people involving falls and bone fractures are on the increase. Efforts to prevent such accidents are strongly required, so the concept of a "fall and fracture prevention school" is spreading. The aims of these classes are to make elderly people aware of the condition of their bodies and to improve deteriorating physical ability through exercise programs, since the latter is the cause of such falls. In conducting an exercise program for the elderly, it is important to make it enjoyable as well as safe.