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*CLINICAL EXERCISE PHYSIOLOGY > EXAM3/CH25/33- Older Adults + Osteoporosis > Flashcards

EXAM3/CH25/33- Older Adults + Osteoporosis Flashcards

(56 cards)

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1
Q

osteoporosis

A

a skeletal disorder characterized by compromised bone strength, predisposing individuals to an increased risk of fracture

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2
Q

bone mineral density for osteoporosis

A

T score 2.5 standard deviations below the mean

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3
Q

osteopenia

A

less severe form of disease

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4
Q

bone mineral density for osteopenia

A

T score between 1-2.5 standard deviations below mean

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5
Q

majority of bone mass is accured when

A

in childhood

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6
Q

peak bone mass is generally attained by ____ years old

A

20

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7
Q

bone development is influcned by what

A

-genetics
-physical activity
-diet
-hormone balance (estrogen inhibits bone resorption)

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8
Q

____ inhibits bone resoprtion

A

estrogen

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9
Q

when does prevention of osteoporosis begin

A

in childhood

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10
Q

bone remodeling

A

naturally occuring process
-bone resorption followed by bone formation

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11
Q

bone resorption

A

breakdown of bone by osteoclasts

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12
Q

bone formation

A

production + mineralization of bone by osteoblasts

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13
Q

osteo

A

bone

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14
Q

clast

A

break

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15
Q

blast

A

develop

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16
Q

osteoclasts

A

responsible for bone resorption/breakdown

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17
Q

osteoblasts

A

responsible for bone development/formation

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18
Q

what is required to have good bone health

A

equal amounts of bone resportion + formation

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19
Q

bone loss occurs when

A

bone resorption exceeds formation

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20
Q

osteoporosis is symptomatic/asymptomatic

A

asymptomatic

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21
Q

first sign of osteoporosis

A

often a fracture

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22
Q

possible risk factors for osteoporosis

A

-sedentary
-diet
-post-menopause

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23
Q

what may be a red flag in determining osteoporosis

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A

-abnormally-caused fracture (fall from standing height)
-vertebral fractures (height loss, protruding abdomen, hyperkyphosis, or other postural changes; may not be noticeable until multiple vertebral fractures have occurred)

24
Q

what helps to strengthen bones

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A

physical activity

25
history + physical exam
-medical history, medications, comorbid conditions, + contraindications to exercise -fracture risk (FRAX) -fall risk -physical performance -standing posture -barriers to + facilitators of physical activity
26
long term use of ____ is detrimental to bone health
corticosteroid -causes bone to break down
27
osteoporosis affects which part of spine
cervical spine -do a postural assessment for osteoporosis
28
fracture risk assessment (FRAX)
-extends beyond BMD by looking at other patient risk factors -age, gender, oral glucocorticoids, history of fracture -ten-year probability of fracture is calculated based on algorithms from large populations -risk of fracture is emphasized over the use of terms osteoporosis or osteopenia
29
downfall of FRAX
only for ages 40-90
30
if patient is sedentary, what do we click yes for on FRAX
secondary osteoporosis
31
bone mineral density (BMD)
-most common measure for diagostic testing -uses dual-energy absorptiometry (DXA) -femoral hip BMD is used for diagnosis of osteoporosis + determination of 10 yr risk -lumbar spine measures can assist with diagnosis
32
does DXA provide a T-score
yes
33
____ can help increase or maintain bone mass
exercise
34
nonpharmacologic + pharmacologic agents are available to increase bone mass or slow loss
-calcium supplementation -vitamin D supplementation -bisphosphonates (decrease osteoclast activity) -parathyroid hormone (increased bone turnover) -calcitonin (decrease osteoclast activity) -estrogen (or hormone) replacement therapy (decrease osteoclast activity)
35
exercise testing considerations
-determine an appropriate exercise prescription -make certain that any potential benefits outweigh the risks
36
exercise testing contraindications
-ACSM does not view osteoporosis as an absolute or relative contraindication -osteoporosis + osteopenia: avoid exercise testing that involves high-impact skeletal loading such as jumping/stepping/running
37
what mode is good for osteoporosis/osteopenia patients
cycle ergometer or arm ergometer -fall prevention
38
goals of exercise prescription
-reduction of fractures (via prevention of falls) -reduction of bone loss -promotion of spine-sparing strategies (proper form)
39
current experimental knowledge indicates that an osteogenic exercise regimen should include what
load-bearing activities at high magnitude with few repetitions
40
fall prevention
1. reducing base of support (feet together, stand on one foot) 2. shifting your weight within your limits of stability (leaning forward + back, shifting weight heel to toe) 3. reducing contact with support objects (if holding on to an assistive device while standing or doing exercises, reduce that contact gradually) 4. changing sensory input (closing eyes)
41
where/when can fall prevention exercise be done
anywhere + as often as you want
42
Dr. Gardner's take aways
-NO TWO CLINICAL PATIENTS ARE EXACTLY ALIKE!! -start with program that is doable for patient + then progress -at the absolute minimum, program should include -cardiorespiratory *10 minutes per bout of exercise *2-3 days per week -resistance training *2-3 days per week -flexibility + balance *as often as possible
43
gerontology
study of the aging process
44
geriatrics
the branch of clinical medicine that encompasses the diagnosis + management of older individuals
45
older adults- signs + symptoms
-dependent primarily on specific physical conditions + chronic disease -pain (arthritis), dyspnea (deconditioning, heart or lung disease)
46
older adults- history + physical examination
-general H&P should be performed -pay careful attention to typical conditions of aging (e.g., heart disease, arthritis, lung disease) -always assess medications for proper use -assess gait disorders -assess cognitive deficits
47
exercise testing for HEALTHY older adults (controlled BP + HR, no CV events)
can begin low- to moderate-intensity exercise without a stress test
48
when is a stress test needed for older adults
if high risk or desiring to do high intensity exercise (greater than 60% peak VO2)
49
what tests should be performed if older adult desires to begin resistance training
strength + ROM
50
just because someone is an older adult doesn't mean we have to do exercise testing
51
polypharmacy
taking many medications
52
44% of older men + 57% of older women take ____ prescription medications
5+ -this leads to confusion on what to take + the timing of when to take it
53
what is crucial for CEP to understand for older adults
medication interactions + effect(s) of medication on exercise measures (i.e. HR, BP, respiration)
54
exercise program should be tailored to what
individual's ability + desires
55
why should a warm-up be performed
to optimize chronotropic responses, increase perfusion to muscles, + maximize vessel responses
56
why should a cool-down be performed
may assist to attenuate vascular pooling, decreasing hypotension, + to lessen arrhythmias

*CLINICAL EXERCISE PHYSIOLOGY (18 decks)

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