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KIN 187 Clinical Exercise Physiology > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Older Adults are considered

A

> or equal to 65 yr
or individuals that are 50-64 years with clinically sig conditions or physical limitations that affect movement, physical fitness, or PA

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2
Q

Todays average life expectancy

A

80 years

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3
Q

Health Status

A

considered a better indicator of ability to engage in PA than chronological age
if an individual has a chronic disease they need consultation and prescription

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4
Q

Physical Status of Older Adults

A

the least physically active of all age groups
there is a slight improvement of PA engagement
only 25% engage in regular PA

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5
Q

Aging effects on selected physiologic and health-related variable (chart)

A

Decrease in peak O2 transport of 5 ml/kg/min per decade b/w 25 and 65 years of age
25% decrease in peak muscle force and lean tissue from age 40 to 65
7% loss of flexibility per decade of adult life
Progressive decrease in bone calcium and deterioration of bone matrix beginning at age 25

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6
Q

Benefits of PA in older adults

A

Slowing physiologic changes of aging that impair exercise capacity
Optimizing age-related changes in body composition
Promoting psychological and cognitive well-being
Managing chronic diseases
Reducing the risks of physical disability
Increasing longevity

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7
Q

Initial workload for exercise testing

A

<3 METs
small increments
Naughton treadmill protocol
Treadmill workload needs to be adapted to walking ability by increasing grade not the speed

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8
Q

Adding a treadmill handrail support

A

if the patient had reduced balance, decreased muscular strength, poor neuromotor coordination and fear, gait abnormalities
*but this will reduce the accuracy of estimating peak MET capacity based on the exercise duration or peak workload achieved

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9
Q

A cycle ergometer testing

A

use for patients with poor balance and neuromotor coordination, impaired vision, impaired gait, weight-bearing limitations and/or foot problems
Muscle fatigue may be a factor for premature test termination

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10
Q

Prescribed medications might ___ during exercise

A

influence ECG readings and hemodynamic responses to exercise

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11
Q

Oldest segment of the population

A

> or equal to 75 yr and individuals with mobility limitations, has one or more chronic medical conditions

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12
Q

Other exercise limitations for older adults

A

likelihood of physical limitations increase with age

exercise-induced dysrhythmias are more frequent in older adults

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13
Q

Senior Fitness Test

A 
30 s chair stand 
30 s arm curls 
8 ft up and go test 
6 min walk test 
2 min step test 
sit and reach 
back scratch test
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14
Q

Continuous scale performance test

A

long and short versions
performing ADLs in environments that have physical domains, scores range from 0-100 with higher scores representing better functioning

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15
Q

Characteristics of senior fitness test

A

Designed to meet practical and psychometric properties
Convenient and practical
Norm-reference standards
Currently used in several countries
Assesses a wide range of physical abilities
Continuous-scale scoring
Older adults are able to perform safely without need for medical release in most cases and without undue fatigue

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16
Q

Aerobic Frequency

A

> or equal to 5 days per week for moderate intensity
or equal to 3 days/wk vigorous intensity
3-5 d/wk for a combination of moderate and vig. intensity

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17
Q

Aerobic Time

A

30-60 min/day (mod)

20-30 min/day (vig)

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18
Q

Aerobic Type

A

Any modality that doesn’t impose excessive orthopedic stress (like walking)
aquatics and cycling are good for those who have limited weight-bearing engagement

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19
Q

Aerobic Intensity

A

5-6 physical exertion for mod. intensity and

7-8 for vig intensity

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20
Q

Frequency Resistance

A

> or equal to 2 days/wk

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21
Q

Intensity Resistance

A

light (40-50%) of 1 RM (mod)
60-80% 1 RM for vig
5-6 exertion for moderate and 7-8 exertion for vigorous

22
Q

Time Resistance

A

8-10 exercises, 1-3 sets, 8-12 reps

23
Q

Type Resistance

A

Progressive weight training programs or weight-bearing calisthenics, stair climbing, and other strengthening activities that use the major muscle groups

24
Q

Neuromotor Exercises for frequent fallers

A

balance, agility and proprioceptive training

effective in reducing and preventing falls if it is performed 2-3 days/wk

25
Q

General recommendations for older adults

A

progressively difficult postures that gradually reduce the base of support (two legged stand, semitandem stand, tandem stand, one-legged stand)
Dynamic movements that perturb the center of gravity (tandem walk and circle turns)
stressing postural muscles groups
reducing sensory input (standing with eyes closed)
Tai chi/yoga

26
Q

Special Considerations for older adults

A

muscular strength decreases with age
They need proper instruction for weightlifting machines
start with weight lifting, endurance physical activities and then move to aerobic endurance
incorporate behavioral strategies
Provide regular feedback, positive reinforcement, and other behavioral/programmatic strategies to enhance adherence

27
Q

What is osteoporosis

A
  • skeletal disease
  • low bone mineral density
  • changes in the microarchitecture of bone that increases susceptibility to fracture
  • BMD T score of < or equal to 2.5 at lumbar spine, femoral neck, forearm
28
Q

Stats about osteoporosis

A

More than 10 million individuals in the US (50+) have it and 34 million are at risk
occurs mostly in postmenopausal women and then 50+ men

29
Q

Primary osteoporosis Type 1

A

Most common in postmenopausal women

30
Q

Primary Osteoporosis Type 2

A

Decline in bone density and strength by aging (senile osteoporosis)

31
Q

Secondary Osteoporosis

A

Caused by something else, like a medical condition

32
Q

Osteopenia (BMD)

A

T score -1 to -2.5 low bone density, not yet osteoporosis

33
Q

Osteoporosis (BMD)

A

T-score less than -2.5

34
Q

Risk Factors for Osteoporosis

A

Sex, age, certain races, family history, low BMI, low estrogen, history of fractures, amenorrhea, low sex hormones, inadequate PA, smoking, alcohol, low calcium, VIt D deficiency, Excessive intake of protein, sodium, caffeine and VIT A , certain meds/diseases, loss of height

35
Q

Cortical Bone

A 
Compact or solid bone 
Dense mineral deposits 
long bones, 80% of bone mass
20% of bone surface area
Thin wall, more porous, pores develop in the shaft walls
36
Q

Trabecular Bone

A

Spongy or cancellous bone
bone marrow fills the space
ends of long bone, vertebral bodies and calcaneus
20% of bone mass, 90% o bone surface area
fewer of them, thinner, vacant/space

37
Q

Osteoporosis and bone resorption

A

Bone resorption > bone formation

38
Q

Normal bone (resorption)

A

bone resorption = bone formation

39
Q

Osteopetrosis

A

Bone resorption < bone formation

40
Q

Osteoporosis Drugs

A

Antiresorptive medications

Anabolic drugs

41
Q

Antiresorptive medications

A

action on the osteoclasts
bone loss is slowed
new bone is still made at the same pace
biphosphonates, calcitonin, denosumab, estrogen and estrogen antagonists/agonists

42
Q

Anabolic Drugs

A

Action on osteoblast
increase the rate of bone formation
teriparatide (only one kind of FDA)

43
Q

PA and osteoporosis

A

-may reduce the risk for osteoporotic fractures
enhances the peak bone mass
slows rate of bone loss and reduces the risk of falls
-inversely associated with risk of hip and spine fracture
-exercise training can increase or slow the decrease in spine and hip BMD

44
Q

Leg ergometry osteoporosis

A

alternative to the treadmill

use in patients with severe vertebral osteoporosis for whom walking is painful

45
Q

Vertebral compression fractures…

A

can lead to a loss of height, spinal deformation, compromised ventilatory capacity, and result in forward shift in the center of gravity

46
Q

Avoid ___ types of exercise

A

explosive movements, or high-impact loading should be avoided, no twisting, bending or compression of the spine should also be avoided

47
Q

Activities that improve balance

A

should be incorporated for older women and men that are at risk for fall

48
Q

Other important notes about osteoporosis

A

even the frailest elderly should remain as physically active as his or health permits to preserve musculoskeletal integrity
There are no established guidelines regarding contraindications for exercise for individuals with osteoporosis.

49
Q

Lifestyle Changes to help prevent osteoporosis (or its effects)

A

Get enough calcium and VIT D
engage in regular weight bearing and resistance training
ovoid tobacco and excessive alcohol
become educated about bone health
DXA scan and take medications if recommended

50
Q

Bottom line (osteoporosis)

A

Weight bearing aerobic and resistance exercise are essential to individuals at risk for and with osteoporosis
It is difficult to quantify the magnitude o bone loading forces, but they generally increase in parallel with exercise intensity
PA plays an important role in prevention

51
Q

General recommendation for Ex Rx

A

moderate intensity exercise that does not cause or exacerbate pain, and avoid the said exercises

KIN 187 Clinical Exercise Physiology (16 decks)

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