Lecture 8

Question 1

common musculo-skeletal conditions

Answer 1

• Osteoporosis
• Osteoarthritis
• Rheumatoid arthritis
• Joint replacement (hip and knee)

Question 2

what is osteoporosis

Answer 2

“…a disease characterized by low bone mass and deterioration
of bone tissue. This leads to increased bone fragility and risk of
fracture (broken bones), particularly of the hip, spine, wrist and
shoulder.”

Question 3

who gets osteoporosis

Answer 3

o Female, petite
o Post-menopausal (or other hormone dysfunctions) over 50
o Low calcium, vitamin D intake
o Sedentary
o Family history
o Broken bones or height loss
o Too much protein, sodium and/or caffeine
o Smoker
o Too much alcohol
o Certain medications

Question 4

it is common? osteoporosis

Answer 4

yes

Question 5

how does exercise improve bone density

Answer 5

• Our bodies respond to the loads placed on it…
• Impact
• Gravitational pull
• Muscle pull

Question 6

first timers fab five

Answer 6

• squats
• heel raises
• wall pushups
• bow and arrow pulls for upper back and biceps
• lateral raises shoulders back and arms

Question 7

can i do yoga with osteoporosis

Answer 7

-yes with no history of spine fracture

Question 8

movements to limit or avoid

Answer 8

• Unsupported front or side flexion (ab curls, side bends for
example)
• High risk to fall activities – ie. changing direction too
quickly
• Weighted overhead lifting (or any overhead lifting if
kyphotic)
• Do weights or bands have to be on the floor?
• Laying on back if kyphotic (if so, support head with pillow
or rolled towel)

Question 9

osteoarthritsis

Answer 9

• Arthritis is the most prevalent health condition of older adults
(consists of over 100 different kinds)
• A significant proportion report difficulties with ADLs ie:
errands, housework…and report needing assistance
• 1 in 4 women and 1 in 6 men are diagnosed with arthritis in
Canada (1 in 2 people over 65)
• Sometimes regression occurs
• Symptoms: pain, redness, swelling, heat

Question 10

rheumatoid arthritis

Answer 10

• inflammatory disease that can affect multiple joints
• autoimmune disease where the body’s immune system
mistakenly attacks the synovial lining of the joints
(etiology unknown)
• Pain, stiffness, swelling of one or many joints – often
symmetrical over time
• Also fatigue, fever, weight loss, poor appetite
• 1 in 100 Canadian adults (often dx between 40-60),
2-3 times more likely in women
• Most common joints affected: hands, feet, wrists,
elbows, knees and ankles

Question 11

treatment

Answer 11

Medication
• Surgery
• OT
• PT

Question 12

functional consequences of osteoarthritis

Answer 12

• Joint stiffness and pain
• Immobility
• Loss of stability
• Reduced joint range of motion
• Increase in sprains, strains, tendon rupture and
balance challenges
• Grip loss

Question 13

arthritis and exercise

Answer 13

• “Exercise is considered the most effective non-drug
treatment for reducing pain and improving movement in
patients with osteoarthritis”.
• Each of these modes plays a role in management:
• Aerobic
• Resistance training
• Flexibility

Question 14

considerations

Answer 14

• Amount of exercise
• Type of exercise/equipment
• Exercise positions (floor exercise)
• Bracing/splinting

Question 15

hips and knee replacements

Answer 15

• There are very strict rules for working with an
individual who has had a joint replaced
• Initial rehab is physiotherapy – inpatient and
outpatient
• Hip rules:
• Don’t cross legs over midline
• Don’t bend hip past 90
• No internal rotation of the hip (walking pigeon-toed)

Question 16

total knee replacements

Answer 16

PT care post-op to approx. 90 degrees
• No kneeling initially
• Rehab exercises daily (you start moving your new knee the day
after surgery)
• Don’t allow the patient to fall!!!