Class 9 - Bone, Falls, and Resistance

Question 1

What are the two types of bone?

Answer 1

Compact and spongy

Question 2

What are the three main factors that affect bone strength?

Answer 2

1. Bone density
2. Bone quality
3. Bone geometry

Question 3

What percent does bone density contribute to a bones resistance to a fracture?

Answer 3

50-80%

Question 4

What is the estimated rate of bone loss after menopause?

Answer 4

1% and 2% for the first 10 years. Then it decreases 0.3-05% per year

Question 5

What are the two major components that increase the structural integrity of bone?

Answer 5

Collagen & minerals

Question 6

What are the 4 major bone minerals (in order of quantity)?

Answer 6

1. Calcium
2. Magnesium
3. Sodium
4. Potassium

Question 7

T/F: for the same bone thickness, a bone with a smaller diameter is more resistant to a fracture.

Answer 7

False, larger diameter

Question 8

What is the compensation for a loss of BMD called?

Answer 8

Periosteal Apposition

Question 9

What is the criteria for osteopenia?

Answer 9

Lower than normal BMD (1-2.5 SD below normal)

Question 10

What are the criteria for osteoporosis?

Answer 10

1. Significant increase in fragility and susceptibility to fractures
2. BMD more than or equal to 2.5 SD blow norm

Question 11

What is the criteria for established osteoporosis?

Answer 11

Has osteoporosis and has had one or more fragility fractures

Question 12

Most common areas for a fragility fracture?

Answer 12

Hip, spine, wrist

Question 13

T/F: less than 1/3 of those who fracture their hips recover sufficiently to perform BADL and IADLs

Answer 13

True

Question 14

What is the percent that women will experience a fracture in their lifetime

Answer 14

40%

Question 15

What are the 7 principles for maximizing the influence of exercise on bone?

Answer 15

1. Bone adapts best to dynamic rather than static mechanical stimulation
2. For bone to respond, stimulus must be at a suprathreshold level
3. Response is improved by brief but intermittent exercise
4. Response is best when stimulus employs a pattern that differs from usual loading pattern
5. Response is proportionate to loading cycle (frequency)
6. Bone must have sufficient energy to rebuild
7. Abundant vitamin d and calcium should be available

Question 16

Where does the fluid flow in bone?

Answer 16

Canilicular channels and bone trabeculae

Question 17

Which is better for bone density: high impact or high intensity?

Answer 17

High intensity

Question 18

What should the intensity be for improving BMD?

Answer 18

Greater than 75% of 10 RM

Question 19

T/F: similar volume but more frequent exercise bouts are more effective?

Answer 19

True, greater osteogenic effect

Question 20

What are the main variables of RT programming?

Answer 20

1. The amount of resistance
2. The methodof resistance used
3. The directions of the force applied

Question 21

What is the limit of loading cycles per day for positive effects?

Answer 21

40, after that little effect

Question 22

What are two major dietary problems that OA face?

Answer 22

Low energy intake (low protein) and low calcium intake

Question 23

Vitamin D facilitates the absorption of what?

Answer 23

Calcium, phosphate, magnesium

Question 24

What are the exercise recommendations for OA with diagnosed osteoporosis?

Answer 24

1-3 sets with 5-8 reps of 4-6 WB exercises using body weight.

2 to 3 days per week

Question 25

What exercises should be avoided with OA with osteoporosis? (5)

Answer 25

1. Impact 2. Spinal flexion against resistance 3. Spinal extension 4. High compressive forces on spine 5. Quick trunk rotation

Question 26

What is the leading cause of injuries in Canadians 65+ ?

Answer 26

Falls

Question 27

What percent of Canadian dwelling seniors experience one fall per year?

Answer 27

20-30%

Question 28

Research suggests that falls are the direct cause of __ % of all hip fx. Leads to death in __% of cases.

Answer 28

95%, 20%

Question 29

Falls account for __% of OA injury related hospitalizations.

Answer 29

85%

Question 30

About half of all falls leading to hospitalization occur in the house. Where are the two most common sites?

Answer 30

Bathroom, stairs

Question 31

What is the fear of falling cycle?

Answer 31

1. Fall 2. Fear of falling 3. Reduced physical activity 4. Loss of muscle mass and strength

Question 32

What continuous and progressive declines in OAs contribute to falls? (3)

Answer 32

1. Decreased nerve conduction velocity (10-15%) 2. Decreased proprioception (Decreased response of muscle spindles) 3. Poor vestibular function (dizziness)

Question 33

What two factors affect the incidence of falls?

Answer 33

1. Impaired position sense 2. Foot position awareness

Question 34

What 4 factors of vision loss occur in OA?

Answer 34

1. Peripheral vision 2. Glare sensitivity 3. Dark adaptation 4. Depth perception

Question 35

What 3 audible factors decline with age?

Answer 35

1. Acuity 2. Localization of sound 3. Ability to mask extraneous sound

Question 36

What accommodations can be made for OA with sensory issues? (4)

Answer 36

1. Well lit exercise area (unless done on purpose for a challenge) 2. Instructions spoke clearly and slowly 3. Instructor should face participants and observe their comprehension 4. External support can be given during exercise (chair, wall. Etc)