osteoporosis Flashcards
trabecular bone
interior
weaker, softer
more affected by OP
cortical bone
outer
riged, stronger
less affected by OP
resorption stage
osteoclasts (cutters)
formation stage
osteoblasts (builders)
peak bone mass age
30
__ associated with rapid decline in bone mass
menopause
bone strength reflects two main features
bone density and quality
what does T score evaluate
bone density
normal t score
osteopenia t score
osteoporosis t score
-1, 0
- 1–2.5
- 2.5
LBD / D for
men and pre menapausal women
T/F half of post menopausal # occur in women whose BMD doesn’t have OP
T
T/f there is a standard for measuring bone quality
no
primary type 1 osteoporosis
women after menapause
primary type 2 osteoporosis
ppl over 70
m=w
secondary osteoporosis
result of a medical condition
can arise at any age
m=w
fragility fracture
fracture from height or less
common fracture site osteoporosis
spine wrist hip humerus
diagnose osteoporosis
Risk factor assessment
bone density
rule in / out secondary OP
DXA (bone density)
risk factors OP
increased thyroid hormone
age, family, small, female, life, depression
fracture risk assessment tools
CAROC
FRAX
difference CAROC and FRAX
CAROC: age, sex, hip BMD
FRAX: same as above plus height weight family lifestyle and RA
t/f DXA tells you about bone quality
no - just density
what do you do if someone is low mod high risk for fracture
nothing - high impact
other risk factors - non contact sports
meds - walks / minimize falls risk activities
pharmaceuticals for OP
antiresorptive
anabolic / bone formation
antiresorptive agents
slow down osteoclasts
anabolic / bone formation
accelerate osteoclasts
hormone replacement therapy side effects
long term use can inc risk of
breast cancer, stroke,
CV disease
and thromboembolism
three joint surgeries for OP
joint fixation
replacement
vertebral surgery
objective assessed OP
historical height loss prospective height loss posture breathing strength, flexibility, special tests aerobic capacity balance
when is a vertebral compression fracture suspected
> 6cm loss in height
VCF is suspected if prospective height loss of
greater than 2 cm
wall occipital test for
cervicothoracic
rib pelvic distance test for
lumbar deformities
reedco posture for
head shoulder and spine posture
special tests for OP
arm curl
grip
schooners
back scratch
aerobic capacity test for OP
shuttle walk and two min step test
balance test for OP
SL
tinetti
berg
PT treatment for OP
WB
posture training
balance
high impact exercise (jump)
how long to see results for OP exercise
9 months
you don’t want to overload the
anterior vertebral body to risk VCF
how do you squat etc. for OP
hinge from hip
how much posture training do OP need
5-10 min daily
are all VCF symptomatic
no 50%
what to target for VCF
back extensor strength
contras for VCF
no manual therapy for 3 month
flexion , rotation, side bending
high compression forces
surgeon orders
vitamins or calcium from food better
food
