bones, falls & fractures

Question 1

2 types of bone tissue

Answer 1

spongy or trabeculae
cortical bone

Question 2

characteristics of trabeculae bone

Answer 2

porous
contains red bone marrow where blood cells are made
weaker and easier to fx

Question 3

factors affecting bone strength

Answer 3

• bone density
• bone quality
• bone geometry

Question 4

what is bone density

Answer 4

mass of bone per unit of volume

Question 5

% of resistance of fx from bone density

Answer 5

50-80%

Question 6

estimated rate of bone loss after menopause

Answer 6

1% and 2% per year for the first 10 years (later = dec 0.3 to 0.5%/year)

Question 7

brittle bone disease

Answer 7

osteogenesis imperfecta
not enough collagen/abnormal

role to support the whole body

Question 8

2 major components that inc structural integrity of bone

Answer 8

minerals
collagen

Question 9

major minerals in bone ir order of quantity

Answer 9

1- calcium
2- magnesium
3- sodium
4- potassium

Question 10

what do minerals provide to bone

Answer 10

rigidity and strength

Question 11

what happens to collagen and mineral with aging

Answer 11

in our bones become less resistant to mechanical loading

Question 12

what happens to bon geometry with aging

Answer 12

diameter of bone changes
which affects bone strength
larger diameter for same thickness is stronger then smaller diameter

Question 13

what compensates for BMD loss in OA

Answer 13

process called peeriosteal apposition

Question 14

what is periosteal apposition

Answer 14

the addition of tissue along the outer surface of the bone

Question 15

what 3 factors can e affected by training (bone framework)

Answer 15

density
geometry
integrity

Question 16

how is the bone strong and lightweight

Answer 16

interior made of bone fibers that crisscross each other in layers
align to carry the forces of tension and compression

Question 17

osteopenia

Answer 17

condition characterized by lower then normal bone density; may be the precursor for osteoporosis

Question 18

osteoporosis

Answer 18

a disease where bone mass and structure decline to a point where there is a significant inc in fragility and susceptibility to fx

Question 19

established osteoporosis

Answer 19

preferred term for those with osteoporosis and having one or more fragility fractures

Question 20

fragility fx

Answer 20

any fall form a standing height or less, that results in a fx

Question 21

common areas of fragility fx

Answer 21

hip
spine
wrist

Question 22

fraction of OA who recover from hip fx

Answer 22

less than 1/3

Question 23

% of women suffering from hip fx

Answer 23

40%

Question 24

change in posture with osteoporosis

Answer 24

kyphosis

Question 25

7 principles for maximizing the influence of exercise on bone

Answer 25

1- bone adapts best to dynamic rather than static mechanical stim 2- if a bone is to respond to training, the stimulus be at a supra threshold level 3- the response of bone to exercise is improved by brief but intermittent exercise 4-bone responds best when the exercise employs a pattern that differs from usual loading pattern 5- the response that any bone has a mechanical stimulus such as exercise is proportional to the loading cycle (freq of stim) 6- for boe to adapt, it must have sufficient energy to rebuild itself 7-for exercise to work there should be abundant calcium and vitamin D availability

Question 26

the message that tells bone to grow in response to mechanical loading is most likely from...

Answer 26

fluid flow through the canalicular channels and around the bone trabeculae

Question 27

synonyme of bone growth

Answer 27

osteogenesis

Question 28

what has greater effect on bone density

Answer 28

resistance training

Question 29

intensity needed for rt and effect on bone growth

Answer 29

>75% of 10 rep maximum

Question 30

numb of days to split work performed for best osteogenic effect

Answer 30

5days/wk

Question 31

what is imp to vary in RT programming

Answer 31

- amount of resistance - method used to provide resistance - directions in which the force is applied

Question 32

the book drill _-goal - contraction - variations

Answer 32

goal: balance training (ADL situation) contraction: dynamice variation: direction in which the force is applied

Question 33

number of loading cycles with positive effects (max)

Answer 33

40 cycles

Question 34

2 major dietary problems OA may face

Answer 34

low energy intake (especially low prot) low calcium intake

Question 35

role of calcium on bone

Answer 35

major raw mineral used to build bone, along w/ phosphate and mg

Question 36

role of vitamin D on bone

Answer 36

vit D facilitates the absorption of calcium, phosphate, and magnesium ions through the intestinal wall and into the bloodstream

Question 37

ACSM guidelines for preserving bone health in adulthood

Answer 37

- mode: weight-bearing endurance activities - intensity: mod to high - freq: weight-bearing endurance act 3-5x/wk AND resistance exercise 2-3x per week - duration: 30-60 min/day

Question 38

ACSM guidelines for elderly women and men w/ diagnosed osteoporosis

Answer 38

1-3 step 5-8 reps of 4-6 weight bearing exercises - bw= resistance - 2/3days /wk - additional weight can be added w/ vest - therabands & rubber tubing may be used to facilitate ROM - avoid impact exercise, spinal flexion vs resistance, spinal ext, compression force, quick trunk rotation

Question 39

Are compression fractures likely to cause nerve or spinal cord damage in OA with osteoporosis?

Answer 39

no

Question 40

leading cause of injuries in 65+ canadians

Answer 40

falls 20-30% experience falls each year cause of 95% of hip fx 20% cause death

Question 41

falls and hospitalization

Answer 41

falls - 85% of hospitalizations in seniors l

Question 42

areas where fall occur most at home

Answer 42

stairs and bathroom

Question 43

vicious cycle

Answer 43

fall = fear of falling = reduced PA = loss of m. mass and strength = inc risk of fall

Question 44

what dec with inc age

Answer 44

- nerve conduction velocity (10-15%) - proprio @ foot and ankle ( - vestibular func (dizzy)

Question 45

factors affecting the incidence of falls in OA

Answer 45

- impaired position sense - foot position awarness

Question 46

what can maximize foot proprio

Answer 46

footwear with low heals and thin, hard soles

Question 47

age-related change in vision

Answer 47

- dec visual acuity - loss of vision mainly due to anatomic changes in visual system - vision loss

Question 48

vision loss in OA

Answer 48

dec - peripheral vision - glare sensitivity - dark adaptation - depth perception

Question 49

what is responsible for night vision

Answer 49

rods

Question 50

functional implications of vision and hearing impairments

Answer 50

- well lighted area - instruction spoken clearly and slowly - instructior face participant and observe their comprehension - external support for fall risk pt