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PHTY2230 Prac Exam (Balance and Vestib) > L9c: Exercise Prescription for Bone Health > Flashcards

L9c: Exercise Prescription for Bone Health Flashcards

1
Q

When does bone loss start?

A

Once skeletal maturity is achieved Osteoclasts become more active than osteoblasts

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2
Q

When does bone loss occur due to menopause?

A

No longer producing oestrogen

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3
Q

What is osteoporosis?

A

pathological loss of bone mineral density

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4
Q

What are 2 reasons for exercise prescription when optimising bone health in old age?

A

Non-osteoporotic groups

  • Bone loading

Osteoporotic patients

  • Preventing falls & fractures
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5
Q

Bone loss is highest particularly several years immediately post-_____

A

menopause

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6
Q

What are 3 results for bone mineral density scans?

A
  1. Normal
  2. Osteopenia
  3. Osteoporosis
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7
Q

What are 3 factors that management of bone health depends on?

A
  1. Scans of bone mineral density
  2. Age
  3. Functional status
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8
Q

What is the aim (in a non-osteoporotic woman)?

A

Maintain or improve bone mineral density by loading bone

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9
Q

What are the 2 aims (in an osteoporotic older person)?

A
  1. Shifts from loading bone
  2. Preventing falls and improving function
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10
Q

What is Wolff’s Law?

A

If loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading

Bone will respond to loading with osteogenesis

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11
Q

What is osteogenesis?

A

the formation of new bone

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12
Q

When are 2 scenarios when osteogenesis is most effective? Why?

A
  1. Bone loading is varied Incorporates numerous forces and activities (to which the bone is not normally accustomed)
  2. Bone responds to novel exercise so movements or loading patterns that are not usual practice
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13
Q

What are 6 of the most common osteoporotic fracture sites?

A
  1. Vertebrae
  2. Pelvis
  3. Proximal Femur
  4. Ribs
  5. Proximal Humerus
  6. Distal Radius
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14
Q

↑ Habitual loading should promote ↑ bone mass; but ___ and ____ loading is key

A

novel; varied

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15
Q

Sedentary older adults will benefit from a(n) _____ (increase/decrease/no change) in habitual loading

A

increase

Any exercise or any increase in loading

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16
Q

Older adults with established exercise regimes will require ‘____’ exercises to stimulate an effect

A

new

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17
Q

What are the exercise guidelines for osteoporotic patients?

A
18
Q

What are 4 effective mechanical loading for bone health?

A
  1. Intermittent dynamic (e.g. jumping), rather than static loads
  2. Loads which are high in magnitude and applied at a high strain rate
  3. Few loading cycles/repetitions needed to elicit bone formation
  4. Novel loading patterns to which the bone is not typically accustomed
19
Q

What exercise is contraindicated for people with osteoporosis / fracture history?

A

High-impact exercise

Jumping, bounding exercises

  • Stair-climbing
  • Dancing
  • Gymnastics
  • Skipping
  • Aerobics
20
Q

What are 3 reasons why jumping, bounding exercises are contraindications for people with osteoporosis / fracture history?

A
  1. Impact upon landing
  2. Ground reaction forces, > bodyweight
  3. Acceleration & deceleration forces
21
Q

What is muscle pull?

A

Progressive resistance training

Direct action of the muscle pulling on bone

22
Q

What is the intensity for muscle pull exercises?

A

High loads, low repetitions

Speed of contraction and force of contraction (short and fast contractions –> power = greatest osteogenic effect)

70-80% 1RM (Progressively work up to this! (even in elderly))

23
Q

What are 2 ways osteogenesis is stimulated?

A
  1. Direct action of muscle pulling on bone
  2. ↑ Effect of gravity acting on bone when the skeleton supports heavy weights
24
Q

What are 7 examples of progressive resistance training?

A
  1. Triceps extension
  2. Forearm pronation/supination
  3. Leg Press
  4. Partial Squats
  5. Hip abduction/adduction
  6. Hamstring curl
  7. Hip flexion/extension
25
Q

What are 2 examples of how exercise can include loading through weight bearing?

A
  1. Push ups against wall (partial WB)
  2. Activities in 4 point kneeling
    • Allows progression Isolate WB through both or one LL
26
Q

What are 8 aims for exercise for osteoporotic patients?

A
  1. Low impact
  2. Falls prevention
  3. Function
  4. Posture
  5. Flexibility
  6. Pain relief
  7. Education
  8. Mobility
27
Q

_____ re-education and dynamic _____ for the trunk and limb girdles is important for osteoporosis. This is important for normalising ______forces

A

Postural; stabilisation; mechanical

28
Q

Usually patients with osteopenia/osteoporosis present with _____.

A

Thoracic kyphosis

29
Q

What are 3 treatment aims of osteoporotic patient with thoracic kyphosis?

A
  1. Minimise flexion loads of spine
  2. Encourage extended postures
  3. Improve chest expansion
30
Q

What are 4 characteristics of exercises designed for a osteoporotic patient with thoracic kyphosis?

A
  1. Encourage diaphragmatic breathing
  2. Strengthen hip, back and neck extensors and scapular retractors
  3. Stretch major upper and lower limb muscles
  4. Having stronger back extensors = smaller thoracic kyphosis
31
Q

Why is postural re-education important?

A
32
Q

What are 4 features in balance and falls prevention?

A
  1. Limits of stability
  2. Reaching
  3. Stepping tasks
  4. Novel balance challenges
33
Q

What exercise is beneficial for balance and falls prevention?

A

Tai Chi

34
Q

When a patient has difficulty taking a protective step when trying to regain balance, what is something to work on?

A

Specifically work on training reactive stepping

35
Q

When a patient has balance deficits when performing daily activities (eg. reaching from a high shelf), what is something to work on?

A

Require patient to move COM to limits of stability while reaching

36
Q

What is important to understanding when training balance?

A

balance challenges are enough to bring out a training effect

Eg. reach outside BOS, provide targets that will really stretch them

Encourage patient to move outside there comfort zone

37
Q

What are 3 exercises to avoid in osteoporotic patients?

A
  1. Hight impact loading
  2. Abrupt or explosive movements
  3. Trunk flexion, twisting movements and dynamic abdominal exercises
38
Q

Why are:

  • Hight impact loading
  • Abrupt or explosive movements
  • Trunk flexion, twisting movements and dynamic abdominal exercises

exercises to avoid?

A

Risk of wedge/compression fractures

39
Q

Why are forward flexion exercises something to be avoided?

A

Increase anterior compression of spine

40
Q

Avoid movements or postures that cause the patient to adopt a slumped, head forward posture, forward flexion of the waist, rotating the spine to a point of strain, reach too far (item on high shelf) which will result in loss of ____ or increase _____ and lead to a potential ____.

A

balance; compression; injury

PHTY2230 Prac Exam (Balance and Vestib) (12 decks)

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