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Studies have shown how Bisphosphonates treatments, especially the Pamidronate injections, are more effective when detected early in infants and for those with moderate-to-severe cases of osteogenesis Imperfecta

This is critically important for infants with OI as positioning them in certain postures can reduce potential fractures from occurring(6). For example, when placing OI infants to bed, one of the best and safest positions for them to sleep in is the supine position as the position allows for infants to breath better and have less stress on their bones than being placed within the prone position. However, if the infant suffers from skull deformities due to OI, then the prone position may be the better option than the supine position (7). Moreover, the handling of infants with OI must be done with the upmost care.

However, it is essential for children with OI to be able to perform physical activity or physiotherapy, especially for young adults who are either going through puberty or sedentary in wheelchairs.[54] During puberty, uncontrollable hormonal changes can attribute to uncontrolled weight gain, especially for young girls during menopause. Moreover, since estrogen levels and the complementary hormone estradiol are decreased during menopause, weight gain usually occurs as less estradiol is available to regulate the girls’ metabolism levels. Likewise, the increase in weight will add more pressure to the girls’ bones and potentially worsen their OI conditions. Similar to weight gain during puberty, weight gain while being sedentary in wheelchairs also leads to increased levels of obesity and can worsen OI conditions. Thus, the importance for incorporating tolerate physiotherapy treatments for children with OI is critical for their long-term health. As mentioned earlier, hydrotherapy provides one of the best treatment exercises for not only children with OI but also adults with OI. Since hydrotherapy is performed in water, the pain from exerting oneself during exercise is mostly neutralized due to swimming being a low impact exercise and less stressful to one’s bones and muscles. [55]Furthermore, hydrotherapy is more tolerable than most other exercises for children with OI to participate in without the fear of feeling pain.

Treadmills used during physiotherapy provide one of the best opportunities for those with OI to safely train and improve their health while being supervised