chap 8 Flashcards
other name of spongy bone and what does it contains
trabecular, very porous and contains red bone marrow
where does blood cells are made
red bone marrow
which one between cortical and spongy bone is more easy to fracture
spongy
factors affecting bone strength
- bone density
- bone quality
- bone geometry (morphology)
bone density accounts for _ to _% of bone resistance to fractures
50-80
what is bone density
mass of bone per unit of volume
Estimated rate of bone loss after menopause is between
1% and 2% per year for the first 10 years (later + dec .3% to .5%/yr
at what age is there a slow loss of bone density(growth) and what age is there a rapid loss
slow loss: 35-50
rapid: 50-60
_ is a main part of connective tissue that connects and supports the whole body, including the bones
collagen
what is osteogenesis imperfecta
condition where there’s not enough collage or the collagen is abnormal
The 2 major components that increase the structural integrity of bone are:
collagen + mineral
The major minerals in bone, in order of quantity are:
calcium, magnesium_, _sodium , and potassium
role of mineral in bone strength
give rigidity and strength
T/F With aging, collagen and mineral tissues in our bones become less resistant to mechanical loading
T
T/F As we age, the diameter of our bones changes and this affects our bone’s strength
T
For the same bone thickness, the bone with the _ diameter is more solid vs smaller diameter
greater
In OA, the loss of BMD is compensated by a process called
periosteal apposition
what is periostea apposition
the addition of tissue along the outer surface of the bone
what is of roof trusses and bone
A comparison of normal, osteoporotic, and trained bone matrix
The strength of bone is affected by more than its density. It is also affected by the
geometry and integrity of the bone framework. Training can affect all 3 factors
what is osteopenia
A condition characterized by lower than normal bone density; may be the precursor for osteoporosis
what is osteoporosis
A disease where bone mass and structure decline to a point where there is a significant increase in fragility and susceptibility to fracture
what is the preferred term for those with osteoporosis and having one or more fragility fractures
established osteoporosis
what is the value for osteoporosis
</= -2.5 s.d
what is the value for osteopenia
-1 to -2.5 s.d
what is a fragility fracture (established osteoporosis)
A Fragility Fracture is any fall from a standing height or less, that results in a fracture
OA suffering hip fractures often experience a loss of independence; less than_ of those who fracture their hips recover sufficiently to perform basic and instrumental ADLs”
1/3
women have _% chance of sustaining a fracture during their lifetime
40%
Many OA with osteoporosis are advised to reduce physical activity by their physicians to prevent fractures but …. Is that the way we go?
no
Bone adapts best to _ rather than _ mechanical stimulation
dynamic, static
The message that tells bone to grow in response to mechanical loading is most likely fluid flow through the _ and around the _
canalicular channel, bone trabeculae
Hormonal responses promoting bone growth are amplified by _ and by differences in_ patterning
intensity, exercise
synonyme of bone growth
osteogenesis
. If a bone is to respond to training, the stimulus must be at a _ level
suprathreshold
which type of training have greater effect on bone density
High-intensity RT = greater effects on bone density vs. high impact aerobic training
what is the intensity of resistance training to have effect on bone density
> 75% of 10 reps
The response of bone to exercise is improved by _ exercise
brief but intermittent
Dividing the total volume of work performed /week across 5 days has a greater osteogenic effect than doing _
the same volume of work in a fewer day
Short, intense exercise bouts build bone more effectively than _ do. If the goal is to reduce exercise time, it is better to _ each exercise session than to reduce the number of sessions performed
longer session, shorten
Bone responds best when the exercise employs a pattern that differs from _
the usual loading pattern
Tissue adapts when it is faced with a challenge that is beyond those _ . This overload is the stimulus for tissue change
encountered in everyday life
goal of the book drill + contraction
balance training in ADL situation
dynamic
goal of ladder drills
agility training
The response that any bone has to a mechanical stimulus such as exercise is proportional to the _
loading cycle
based on the scientific literature, the number of loading cycle appears to have a positive effect up to approximately _ cycle per day. After that, adding more cycle has little or no effect
40
The 2 major dietary problems that OA may face
Low energy intake (especially low protein intake)
Low calcium intake
For bone to adapt, it must have sufficient _ to rebuild itself
energy
For exercise to work there should be abundant _ and _ availability
calcium and vitamin D
what is the major raw mineral used to build bone, along with phosphate and magnesium
calcium
_ facilitates the absorption of calcium, _phosphate, and magnesium ions through the intestinal wall and into the bloodstream
vitamin D
Frequency and durationof Weight-bearing endurance and resistance activities
3-5 times per week; resistance exercise 2-3 times per week -> 30-60min
ACSM guidelines for elderly women and men with diagnosed osteoporosis
- 1 to 3 sets with 5 to 8 repetitions of 4 to 6 weight-bearing, upper- and lower-body strength exercises using body weight as resistance
- Activities performed 2 to 3 days/week
- Additional resistance may be applied gradually and conservatively (up to 10 lbs.) with weighted vest
- Therabands & rubber tubing may be used to facilitate range-of-motion exercises
what to avoid for elderly with diagnosed osteoporosis
Avoid impact exercise, spinal flexion against resistance, spinal extension, high compressive forces on the spine, quick trunk rotation
For most fractures:
damages are limited to the front of the vertebral column =
rarely associated with
spinal cord damage
Are compression fractures likely to cause nerve or spinal cord damage in OA with osteoporosis?
no
If bone density is the problem, _ are the mechanism by which that problem is transformed into injury”
falls
what is the leading cause of injury among Canadians 65+
falls
_ to _% of community-dwelling Canadian seniors experience one fall each year
20 to 30
Research suggests that falls are the direct cause of _% of all hip fractures, leading to death in _% of cases
95, 20
Falls account for ______% of seniors’ injury-related hospitalizations, making this the leading cause of injury-related admissions for seniors
85
Apart from personal suffering, loss of independence and ↓ QofL, the costs of seniors’ injuries are enormous:
+- 2 billions/years
± half of all falls that lead to hospitalization in OA occur at _. _are the areas in our homes where most falls occur
home, bathroom and the stair
by limiting activities, they are likely to lose _ and _ and increase their risk of falling again
strength and flexibility
Older adults may make more errors whey they are required to move _ than their ability to move _”
faster, accurately
age-related continuous and progressive decrease in:
- Nerve conduction velocity (dec by 10% to 15%)
- Proprioception (sense of limb position and movement) at the foot and ankle (↓ response from muscle spindles)
- Vestibular function (dizziness)
Factors affecting the incidence of falls in OA:
- Impaired position sense (orientation of the body in space + position of body parts relative to each other)
- Foot position awareness
what can make a huge difference in foot position awareness
footwear with low heels and thin, hard soles maximizes proprioception
visual acuity _ with age
decrease
Loss of vision mainly due to
anatomic changes in visual system
what are the thing that are loss in vision
- peripheral vison
- glare sensitivity
- dark adaptation
- depth perception
which one between rods or cones is for night vision
rods
Interpretation of sounds depends on:
Acuity
Localization of sound
Ability to mask extraneous sound
Hearing impairment can be complicated by
tinnitus and speaking to fast
exercise with OA that have vision and hearing impareiment should be done how
- Exercise area should be well lighted _to compensate for vision impairments of OA
- Instructions should be spoken clearly and slowly
- Instructor should face_ participants and observe their comprehension
- For participants with an history of frequent falls or postural instability, an external support (e.g., chair, wall bars, walker, etc.) can be quite useful for safety and confidence
explain the diagram of better balance and agility
explain the better balance and agility diagram from Ann perspective
