Osteoporosis/traction

Question 1

What is Osteoporosis

and the incidence

Answer 1

• decreased mineral content - weakening of bone
• 10 million americans –80% women
• 30-40% of women and 13% of males at lifetime risk of fracture
• common in the T/S

Question 2

Diagnosis/quantifying osteoporosis

Answer 2

• DEXA scan: Dual energy X-ray absorbtiometry
• T-score (number of SD’s below a standard value
• osteopenia: -1 to -2.4 SD
• osteoporosis: -2.5 SD or greater
• 1 SD = 10-12 % BMD loss

Question 3

Primary Osteoporosis risk factors

Answer 3

• decreased estrogen followng meopause
• caucasian
• asian
• family history
• decreased BW
• smoking
• reduced activity

Question 4

Secondary risk factors for Osteoporosis

Answer 4

• GI disorders
• hyperthyriodism
• chronic kidney disease
• medication induced glucocorticoids (long term) and certain anticonvulsants
• immobilization
• tobacco/alcohol abuse
• decreased calcium intake

Question 5

Osteoporosis treatment

Answer 5

• strength training plus medication
• bisphosphonates
• increase BMD by 3rd decade=> peaks around 30

Question 6

Osteoporosis prevention

Answer 6

• diet rich in calcium and vitamin D
• weight-bearing exercise
• healthy lifestyle
• test bone for density and medication

Question 7

Generally what does osteoporosis with exercise research show

Answer 7

• walking programs show BMD increase in the femoral neck
• spinal extension training especially thoracic focused can help to increase the time period between the first fracture and a refracture
• fast walking is effective on spine and hips as well as resisted and weight bearing exercises

Question 8

NOF recommendations for exercise

Answer 8

• WB exercise; NW exercise
• strength 8-10 exercises targeting major muscle groups 2-3 days per week targeting major muscle groups
• aerobic: 5 or more days/week for 30 minutes walking and 20 minutes running

Question 9

Weighted vest resistance

Answer 9

• exercise 3 times a week for 6 weeks
• 4-8% of BW in weighted vest
• demonstrated increased bone synthesis and reduced reabsorption
• improved balance

treatment for Osteoporosis

Question 10

General osteoporosis and exercise principles

reguarding changes and gains in BMD

Answer 10

• exercise induced BMD changes are site specific
• changes in BMD will take 3-4 months of exercise stimuli
• gains in BMD will reverse if exercise ceases

Question 11

where is traction more effective

Answer 11

cervical spine

Question 12

Indications for traction

Answer 12

• nerve root compression
• unable to centralize with repeated motion of positioning

Question 13

Traction contraindications

Answer 13

• structural disease that compromises stability
• vascular compromise

Relative contraindications:

• acute sprains/strains
• instability
• pregnancy

Question 14

Lumbar traction parameters

Answer 14

• 1/4 to 1/2 BW (cervical 15#)
• 120 lb or approximately 1/2 BW for separation
• disc 60sec hold with 20 sec relax (8-10 minutes total)
• hypomobility = shorter hold longer duration