Attività fisica e riabilitazione

SUMMARY Physical activity is one of the most effective strategies to facilitate the achievement of an adequate bone peak, the maintenance of qualitative and quantitative properties of bone tissue for functional needs, as well as therapeutic option for pediatric osteoporosis. However, the term physical activity is generic and includes daily life activities as well as sports. The osteogenic effect of physical activity depends both by muscle contraction and by the impact forces generated during exercise. Physical activities that result in the greatest osteogenic effect are generally those characterized by high loads in short times. It is important to distinguish two categories of subjects with pediatric osteoporosis, regardless its pathogenesis: children who have low bone mass without fragility fractures, and children presenting osteoporotic fractures. In the first case, the rehabilitation plan will be based on a modulation of the physical activity or sport aiming to increase the bone quantity and quality or limit the bone loss when other factors, including pharmacological treatments detrimental for bone health, may hinder those benefits. On the other hand, in the case of a child who has already reported one or more fragility fractures, the rehabilitative intervention requires the formulation of an Individual Rehabilitation Project, which will take into account both the skeletal fragility and any other complications due to fracture. This intervention will therefore be based on specific therapeutic exercise aiming not only to improve the bone quality and quantity, but above all to increase the functional performance and quality of life of osteoporotic children.