Osteoporosis

Question 1

High Risk Osteoporosis Definitions according to

National Osteoporosis Foundation (NOF)

Answer 1

T-score -2.0 or less (no risk factors) or -1.5 or less (> or = 1 risk factor) or age >80

Question 2

High Risk Osteoporosis Definitions according to WHO

Answer 2

T-score -2.0 or less

Question 3

High Risk Osteoporosis Definition According to Study of Osteoporitic Fractures (SOF)

Answer 3

Prior fracture after age 50 or
T-score -2.5 or less (60-64 yo) Or
Z-score -0.43 or less (65+ yo) and 5 or more risk factors or
80+ yo

Question 4

What is percutaneous vertebroplasty

Answer 4

Minimally invasive procedure involving percutaneous placement of bone into the collapsed or partially collapsed vertebrae; used to treat intractable pain associated with a cute and chronic osteoporotic VCF’s.

–associated with re-fracture at adjacent vertebrae with a year post procedure

Question 5

What exercises are incorporated into the Rehabilitation of Osteoporosis Program-Exercise (ROPE)?

Answer 5

Isometric back extensor strengthening and proprioceptive postural training

Question 6

Osteoporosis: tscore

Answer 6

2.5 SD below the mean BMD

Question 7

Osteopenia: tscores

Answer 7

Tscore 1.0 SD below the mean BMD

Question 8

PAR-Q exercise recommendations for arthritis/inflammation

Answer 8

2) those with highly progressed disease or joint damage should participate in NWB activities to maintain or improve mobility, strength, cardio function. Avoid jumping or high load bearing activities.
3) those recently diagnosed or with acute flare: avoid exacerbation, should perform light to moderate pool-based exercise or light ergometer activity
4) stable, well controlled disease without progressive joint damage: may participate in wide variety of both WB, NWB activities.

Question 9

PAR-Q recommendations for exercise: Osteoporosis

Answer 9

2) Dx of osteoporosis with high risk of fracture (precious fracture OR taking corticosteroids for 3+ months) should not perform trunk flexion exercises
3) Those recovering from hip fracture should not perform more than 15-20 min of PT exercises at initiation. WB started after 18 days and higher intensity reinsurance training initiated 1 month following inpatient rehab.
4) Those with dx of osteoporosis can safely perform variety of aerobic or resistance training, progressed from light to moderate.
5) Dx of osteoporosis should avoid powerful twisting motions of trunk
6) those with osteoporosis and spinal cord injury should avoid max intensity activity (MMT) with electrical stimulation of lower limbs.

Question 10

PAR-Q exercise recommendations for LBP

Answer 10

2) those with nonspecific chronic LBP: initially avoid high impact activity, heavy resistance, or extreme flexion, extension, rotation, in direction that provokes pain.
3) those with acute pain (2da-4weeks): directional preference exercises with use of heat wrap are ideal
4) subacute LBP (4wk-8wk): walking, cycling, stretching, trunk/limb strengthening, posture and progressive strength training.
5) spondylolysis/spondylolisthesis: can safely perform progressive strengthening and postural training of back/abdomen. Athletes should cease sport for at least 3 months when symptomatic.
6) 1 year postsurgery for disc herniation: can safely perform isometric core and progressive activity involving aquatics, dynamic back, hip extension, and abdominal exercises.
7) pregnant women can safely perform aquatic exercise, low impact aerobics, and pelvic muscle exercises.

Question 11

What are the most common fracture sites for individuals with osteoporosis?

Answer 11

Vertebrae, hip, wrist

Question 12

3 established fall risk factors

Answer 12

Quad strength, balance, functional mobility.

Question 13

Best mode of exercise for eliminating decline of BMD

Answer 13

Strength training

12-18 months
3x a wk, 2-3 sets