Influence of physical activity on individuals with fibrous dysplasia - implications for sports participation, trauma risk and rehabilitation – a narrative review

Background. Fibrous dysplasia (FD) is a rare disease caused by postzygotic mutations in the GNAS gene, which lead to replacement of normal bone with pathological fibro-osseous tissue. These lesions can cause pain, deformities, impairment of physical function and higher susceptibility to bone fractures. This raises the question of how the disease influences physical activity and the ability of affected people to participate in sports. Aim. The aim of this review was to summarize available data regarding the influence of the physical activity in people with fibrous dysplasia, especially focusing on participation in sport and risk of trauma. Material and methods. A narrative review of 20 journal articles and one book chapter identified in PubMed. Results. Available data indicate that higher skeletal disease burden is associated with physical limitations and decreased quality of life. Bone fractures pose a significant complication of the disease, especially in people with higher Skeletal Burden Score and extensive skeletal involvement. At the same time physical activity can support maintaining fitness, strength and hip mobility. Such activities as aquatic exercises and stationary cycling are suggested as appropriate forms of rehabilitation. However, there is a lack of studies directly comparing specific sports and risks connected with participation in them. Conclusions. Physical activity in people with fibrous dysplasia should be chosen individually, taking into consideration the location and extent of skeletal lesions, deformities, history of fractures and coexisting endocrinopathies. Based on the available data it is currently impossible to create universal recommendations for all patients. Further studies are needed to establish more specific recommendations for sports participation in this population.