Osteoporosis

Question 1

Osteoporosis

Answer 1

A systemic skeletal disease characterized by:

• low bone mass
• microarchitectural deterioration of bone

Leading to:

• enhanced bone fragility
• increase in fracture risk

Question 2

Most Common Fractures

Answer 2

Spine

Hip

Wrist

Question 3

OsteoClasts

Answer 3

…degrade bone

Question 4

OsteoBlasts

Answer 4

…create bone

Question 5

Bone Turnover

Answer 5

80% of bone turnover = Trabecular bone

20% of bone turnover = Cortical bone

Question 6

Risk Factors

Answer 6

Gender (W>M)

Ethnic (caucasions)

Low BMI

Menopause

Physical Inactivity

Nutritional Factors

Low Vitamin D

Longterm Corticosteriod Use (RA, Asthma, Implants)

Question 7

Type I Osteoporosis

Answer 7

Postmenopausal

Hormone Driven

Cancellous Bone

Vertrbral and Colles Fractures

50ish

Question 8

Type II Osteoporosis

Answer 8

Both Genders

Age-realted after 70

Cancellous and Cortical bone

Hip Fractures

Increased morbidity and mortality

Question 9

T-Scores

Answer 9

• 1+ = Normal
• 1 to -2.5 = Low Bone Mass

< -2.5 = Osteoporosis

< -2.5 and one or more fractures = Established osteoporosis

Question 10

Bisphosphonate Adverse

Answer 10

Acute Phase Response

Upper GI

Rash

Iritis

Renal Impairment

Jaw Osteonecrosis

Question 11

Paravertebral Muscle Spasm

Answer 11

Result of fracture

Often severe

Radiates around the chest wall

Caused by sympathetic muscl contraction

RARELY due to nerve root compression

Question 12

Exercise for Acute Fracture

Answer 12

Deep Breathing

Log Roll

Ambulation

Chair Squats

Hell Cord Stretches

AROM UE and LE

Posture training

Question 13

Functional Strength

Answer 13

Spine

Shoulder Girdle

Lower Extremities

Question 14

Muscle Imbalance

Answer 14

Length

Strength

Isolate hip from pelvis

Isolate glenohumeral from scapulothoracic

Question 15

Gait, Pain, and ADLs

Answer 15

FIM

TUG

Functional Body Mechanics

Pain Profile

RPE

Dynamic Balance

Gait

Assistive Devices Assessment

Question 16

Physical Therapy Intervention

Answer 16

Patient Education

Pain Relief

Exercise

Question 17

Patient Education

Answer 17

Disease Process

Body Mechanics

Balance Issues

Activity Issues

Maintenance of stable pelvic base

Joint protection and Energy conservation

Question 18

Pain Relief

Answer 18

E-stim

US

Hot or cold packs

Soft tissue massage

Question 19

Exercise

(strengthening)

Answer 19

Strengthening

• Suboccipital flexion
• Pelvic tilts

Seated isometric trunck extension

• Seated pushups

Repeated sit-to-stand

Shoulder girdle retraction

Question 20

Exercise

(stretching)

Answer 20

Stretching

• Suboccipital muscles
• Anterior thorax
• Trunk extension (lateral bending)

Hip Flexors

Hamstrings

Heel Cords

Question 21

Osteopososis Summary

(all programs should include)