Osteoporosis Flashcards
Trabeculae ____ are thin and narrow
rods
Trabeculae ______ are thick and flat
plates
Trabeculae is ____ affected by OP
most
In the ______ stage, osteoclasts break down and remove old bone
resorption
In the ______ stage, osteoblasts build new bone
formation
Peak bone mass occurs around age ___
30
4 determinants of peak bone mass?
- genetics
- hormones
- lifestyle
- nutrition
______ is a critically important time for bone building
puberty
____% of adult bone mineral is accrued in the 2 years around puberty
26
_______ is associated with a rapid decline in bone mass
menopause
Bone strength reflections the integration of which two main features?
- bone density
2. bone quality
A __score shows how much your bone density is higher or lower than the bone density of a healthy 30 year old.
T
A HCP looks at ___ T-sore to dx OP
lowest
A t-score of -__ or above is normal
1
A t-score between -__ and -__ means you have lower bone density or osteopenia
1;2.5
A t-score of -____ or below is a dx of OP
2.5
____ is a term reserved for men and premenopausal women
LBM/D
______ is reserved for postmenopausal women
osteopenia
Several studies have shown that many #’s occur in people with only moderately decreased BMD (T/F)
TRUE
1/3 of all postmenopausal #s occur in women with BMD that don’t categorize them as having OP (T/F)
FALSE ; 1/2!
Bone quality is related to _______ architecture
architecture
More trabecular ___ vs ____ = better quality
plates; rods
Currently there is no standard dx practice of assessing bone quality (T/F)
TRUE
Primary type 1 OP?
women post menopause
Primary type 2 OP?
people over 70 years of age,
Primary type 2 OP occurs _______ in men and women
equally
Secondary OP?
A result of other medical conditions or rx
Secondary OP affects more women than men (T/F)
FALSE (equally)
____% of hip #’s are result of OP
90
An individual with a hip # has a ___% risk of death in following year
25
______ # = # occurring spontaneously or from a minor trauma such as a fall from standing height or less
fragility
4 common OP # sites ?
- spine
- wrist
- hip
- humerus
OP consumes the most hospital beds (T/F)
TRUE
OP has a greater impact on QOL than COPD, heart disease or diabetes (T/F)
TRUE
Dx of OP?
DXA (assesses bone density)
2 common # risk assessment tools?
- CAROC
2. FRAX
CAROC uses age, sex and ___ BMD to ID preliminary # risk
hip
DEXA scans give no info on bone _____
quality
2 types of pharmaceuticals that may be prescribed to people with high risk of OP?
- antiresorptive agents
2. anabolic/bone formation agents
OP meds can reduce #s by __ -__ % depending on medication, pt age and site of bone loss
30-70
3 types of surgical rx?
- joint fixations
- joint replacements
- vertebral surgeries
2 types of vertebral surgeries?
- vertebroplasty
2. kyphoplasty
10 things to include in PT assessment of pt with OP?
- subjective hx
- height and weight
- posture
- breathing pattern
- movement patterns
- strenght
- flexibility
- aerobic capacity
- balance assessment
- functional assessment
4 health and activity questionnaires you may use for subjective hx?
- OPAQ-PF
- BPAQ
- OFDQ
- COPA
______ _____ loss = different between the tallest recalled heigh by the pt and the current measured height
historical height loss (HHL)
Vertebral compression # is suspected if HHL is >__cm
6
_____ _______ loss = difference between 2 measurements up to 3 years apart
prospective height
Vertebral compression # is suspected if prospective height loss is > __ cm
2
2 ways to measure cervicothoracic and / or lumbar deformities ?
- wall-occiput test > 0 cm
2. rib/pelvis different ≥ 2 fingerbreadths
Looking at ____ ____ is also a good assessment tool for posture
plumb line
3 things to assess for breathing?
- chest expansion
- breathing pattern
- IMT
5 mms to focus on for strength/flexibility/special tests ?
- gastroc
- soleus
- pecs
- lat
- hip flexors
2 ways to measure aerobics capacity in OP pts?
- adapted shuttle walking test
2. two minute step test
4 OM to use for measuring balance in OP pts?
- one-leg stand test (b/w parallel bars)
- Tinetti balance assessment tool
- Berg balance
- Fullerton advance balance scale
6 OM for functional assessment of OP pts?
1. OP functional disability questionnatie (OFDQ) 2. Timed chair sit to stand 3. Elderly mobility scale 4. TUG 5. Senior fitness test 6. 20 m timed walk
What 4 domains does the seniors fitness test include?
- upper and lower body strength
- aerobic endurance
- upper and lower body flexibility
- mobility
Senior fitness test is standardized testing for performance standards from ___ - ___ years of age
60-94
Osteogenesis is specific to the site of the _____
strain
What type of exercise has the greatest potential to affect bone?
high impact
____ loads and _____ patterns are more important than number of loading cycles
peak; novel
Research suggests it takes ~ __ months to see results for exercise in pt’s with OP
9
3 movements to focus on for strength / flexibility ?
- spinal extension and rotation
- hip flexion
- shoulder elevation
Our primary concern is that they use movement strategies that don’t overload the ______ _____ _____ and put them at risk for VCF
anterior vertebral bodies
When getting up/down from floor / bed, tell pts with OP to ____ on to their _____
roll; side
How often each week for postural training?
5-10 mins daily
Falls often associated with ____ perturbation
lateral
Control of ____ stability/ _____ stepping is of particular importance for preventing #’s
lateralx2
VCF = ___% asymptomatic
50
___ of pt’s with VCF require treatment
1/3
Treatment for VCF?
back extensor strengthening
CIs/precautions post VCF?
- no external resistance exercise or manual therapy to the spine for 3 months post-VCF
- precaution/CI to many PT treatments, including general screen for OP
Prescription parameters for back extension exercise post VCF?
hold for 5 s, 10s rest, 10 reps per set, 3-5 mins to complete, 1 set per day, 5x a week
3 exercises for low risk fracture pts?
High impact WB exercises that include:
- acceleration / deceleration
- jumping
- variety
3 examples of exercises for mod risk # pts?
- run
- hike
- circuit training
No ____ sports for mod risk # OP pt.
contact
3 exercise for high risk # OP pts?
- brisk walk
- swimming /pool exercise
- stair climbing
Exercises to avoid for the spine for OP pts?
- flexion with resistance, rotation, side-bending and combinations
- high compressive forces
Exercises to avoid for the hip for OP pts?
- forced rotation
2. mindful of surgeons orders
For CV fitness, encourage exercises that have max bone _______ effect but are safer _____ risk zone
building; fracture
Use ____ and ____ as targets for CV fitness
RPE; HR
5 aspects of fall prevention?
- medication
2 footwear - awareness of postural hypotension
- consideration of vision deficits, multifocal glasses
- environment modification tp reduce tripping hazards
Pharmaceuticals do a very good job of building bone ______ but exercise does a better job of building bone ______
density; quality
