Osteoporosis

Question 1

what is osteoporosis?

Answer 1

a sytemic, metabolic bone disease characterized by low bone mass, impaired bone quality, and increased susceptibility of low-trauma fracture

Question 2

How is it diagnosised?

Answer 2

Lumbar spine and hip DEXA scan

Question 3

What is the Bmd T score for the diagnosis of osteoporosis?

Answer 3

haveing a T score -2.5 or bellow at the spine or hip.

Question 4

What is the significance of osteoporosis?

Answer 4

Worldeide an osteoporotic fracture occurs every 3 seconds
And fractures lead to excess mortatility and increased morbidity decreased QOL and loss of autonomy

Question 5

Wolff’s Law

Answer 5

bones adapt to mechanical loading
Loading strengthens bone; it tells your bone to lay down more bone
Subotimal load weakens bone

Question 6

PT management of patients with suspected or confirmed osteoporosis: A CPG from the Academy of Geriatric PT

Answer 6

Developed by a volunteer guideline group appointment by APTA Geriatrics

Exercise physiologist

6 physical therapists

Based on a systematic review of existing clinical practice guidelines

Target population

Pre/postmenopausal women and

Men with confirmed or suspected osteoporosis

Aim

Provide evidence-based recommendations on exercise interventions that impact BMD and thereby reduce the risk of fracture in individuals with confirmed or suspected osteoporosis

Slow the regression of/ maintain / improve BMD

Question 7

What were the interventions considered in the osteoporosis article?

Answer 7

Static WBing

SLS

Dynamic WBing – low force

Walking

Dancing

Tai Chi

Dynamic WBing – high force

Standing weightlifting

Weighted vest stair climbing

Jogging

Skipping

Jumping

Hoping

Running

Dancing

Vibration platform

Non-WBing – low force

Seated progressive low load repetition resistance training

Non-WBing – high force

Seated progressive high load resistance training

Combo

More than one of the previous exercises approaches

Question 9

What was the letter grade stregtnh of these recomedations?

Answer 9

Grade B moderate

Question 10

For pre and postmenopausal women what were the results?

Answer 10

Impact protocols combined with resistance training can reduce BMD decline at both the femoral neck and the lumbar spine

Question 11

Results for men?

Answer 11

The lack of adverse effects supports a recommendation to encourage implementing lifelong fitness and bone health strategies such as those for women of corresponding ages.

Question 12

For transgender individuals?

Answer 12

A recent review concluded that treatment of osteoporosis in transgender persons follow the same guidelines as cisgender persons.

Question 13

Adapted exercise recommendations for postmenopausal women to slow BMD decline at the hip and femoral neck

Answer 13

Static WBing exercises

SLS balance

Non-WBing – High force (70%-85% 1RM) progressive resistance strength training alone or in combo with

Dynamic WBing – Low force – walking, dancing, tai chi

(grade B, recommendation based on moderate evidence)

Question 14

Adapted exercise recommendations for postmenopausal women to slow BMD decline at the lumbar spine

Answer 14

Dynamic WBing – low force : walking, dancing, tai chi

Non- WBing High force (70%-85% 1RM) progressive resistance strength training

(grade B, recommendation based on moderate evidence)

Question 15

Adapted exercise recommendations for Premenopausal women to slow BMD decline at the femoral neck and lumbar spine.

Answer 15

Non-WBing – High force (60% 1RM) progressive resistance training

Dynamic WBing – High force progressive resistance strength training

Dynamic WBing – High force impact training: jogging, hopping, stairclimbing

(grade B, recommendation based on moderate evidence)