Osteoporosis

Question 1

What is osteoporosis?

Answer 1

The excessive loss of bone mass as a result of micro-architectural deterioration of bone tissue.

Question 2

True or false - fractures can occur as a result of minimal trauma in individuals with osteoporosis

Answer 2

TRUE

Question 3

What percentage of men and women does osteoporosis affect?

Answer 3

25% of women and 8% of men

Question 4

How often is a bone broken in Australia? What percentage of these fractures occurs in men?

Answer 4

Every 3.4 minutes. 30% in men.

Question 5

What percentage of Australians have poor bone health?

Answer 5

2/3rds

Question 6

Cost of osteoporosis on Australia’s healthcare system?

Answer 6

$3.5 billion

Question 7

Who is at risk?

Answer 7

Women (esp menopausal - estrogen depleted)
Older age
Smokers
Alcoholics
Low calcium intake
Corticosteroid users
Sedentary individual

Question 8

Relative energy deficiency in sport

Answer 8

Low BMD
Amenorrhea
Disordered eating

Question 9

Symptoms of osteoporosis

Answer 9

Back pain
Pain on weight bearing
Loss of height
Fracture of the wrist and hip bones
Bowing of the spine

Question 10

Common site for fractures in osteoporosis

Answer 10

Hip and wrist

Question 11

What are the two main types of bone

Answer 11

Cortical & Trabecular

Question 12

Where is cortical bone found

Answer 12

Shaft of long bones

Question 13

Where is trabecular bone found

Does it have the greatest rate of turnover and fragility?

Answer 13

Flat bones
Cuboid bones
End of long bones

Yes.

Question 14

How does the decrease in estrogen (during menopause) affect BMD decline?

Answer 14

1% per year decline increases to 5% + per year

Question 15

What age is peak BMD

Answer 15

30

Question 16

40-50 what is the decline of BMD

Answer 16

0.5-1% per year

Question 17

55-60 what is the decline of BMD

Answer 17

1-2% year

Question 18

Determinants of falls risk

Answer 18

POWER
Strength
Balance
Vision
Postural hypotension
Environment
Footwear

Note: postural hypotension is the drop in BP when an individual stands after lying down.

Question 19

Mortality rate after hip fracture

Answer 19

12-20% after 1 year

Question 20

What percentage of people never regain independence after a hip fracture

Answer 20

50%

Question 21

What percentage of bone deposition is laid during puberty?

Answer 21

90%

Question 22

Medications

Answer 22

Estrogen (supresses osteoclasts)
Bisphosphonates

Question 23

How much calcium should an individual be consuming per day?

Answer 23

1200mg + Vit D

Question 24

Max Ca/Serving

Answer 24

500mg

Question 25

True or False - Soy products should be consumed to help prevent osteoporosis

Answer 25

TRUE

Question 26

Fall prevention strategies

Answer 26

Balance training - recently pertubation training has been shown to be more effective

Question 27

Prevention of osteoporosis

Answer 27

Foods high in calcium
Vit D intake (sunlight)
Weight bearing exercise
Consider hormone replacement therapy (estrogen at menopause to supress bone loss)

Question 28

What are the categories of scores on DEXA scans

Answer 28

Normal BMD > -1
Osteopenia -1 to -2.5
Osteoporosis < -2.5

Question 29

True or false - osteoporosis patients shouldn’t do max fitness testing

Answer 29

TRUE (should be submax)

Question 30

What type of training should be completed for healthy osteopenia patients

Answer 30

High intensity

Question 31

What type of training is the focus for frail osteoporosis patients

Answer 31

Functional performance and balance focus

Question 32

What joint is important for power in osteoporotic patients

Answer 32

Hip Power

Question 33

Exercise prescription for cardio

Answer 33

3-5/week, 40-85% of HRR >150 mins/week

Question 34

Exercise prescription for strength

Answer 34

2/week, 8RM-12RM progress to 3 sets then increase intensity

Question 35

Exercise prescription for balance

Answer 35

Twice minimum (ROM 5-7 balance)

Question 36

What axis should the load be distributed over when strength training

Answer 36

The long axis of the bone