Osteoporosis. By Amanda Neilson

Transcription

1 Osteoporosis By Amanda Neilson

2 Overview Definition Epidemiology Clinical Aspects Treatments Effects on Exercise Exercise Testing Exercise Prescription Summary and Conclusion References

3 Definition Breakdown Osteo- means to do with bones Porosis- means a porous condition Osteoporosis- Means Porous Bones

4 Definition Osteoporosis- is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to bone fragility and increased risk of fracture

5 Definition Video

6 Epidemiology Estimated 10 million Americans have osteoporosis 80% Woman 20% Men Most common in Post menopausal woman 34 million Americans have low bone mass Likelihood of having an Osteoporotic fracture in lifetime after age 50: 1 in 2 woman 50% 1 in 4 men 25%

7 Clinical Aspects Symptoms Pain/ Joint pain Swelling Falling Poor posture Loss of Height People may not know they have Osteoporosis until they fall Risk Factors Gender (female) Older Age Family History Low Estrogen Levels in Woman History of Fractures Inadequate physical activity Smoking Alcohol consumption Low dietary calcium intake Vitamin D insufficiency Certain medications Certain Diseases and Conditions

8 Diagnosis Bone Densitometry Bone Mineral Density (BMD) measured by Central Dual- Energy X-ray Ultra Sound Quantitative Computed Tomography (qct Scan) T- score >-1 BMD is normal T-score -1 to -2.5 BMD low bone mass T-score -2.5 or less osteoporosis Central Dual Energy Xray Video

9 Treatment Therapeutic Options Hormone therapies (HT) Medications Antiresorptive Medications: Bisphosphates- Bone Forming Medications For high fracture risk Wear brace for support No cure for low bone mass or osteoporosis but successful management is possible!

10 Effects on Exercise Limitations Orthopedic Limitations Limited locomotor abilities Poor Balance Fear of falling More prone to fall Deconditioned Pain in joints

11 Effects on Exercise Effects of Exercise Training up to 1 year walking programs have shown preservation of BMD Jumping exercise increase hip BMD while HT in premenopausal woman exercise can improve and maintain BMD in men exercise reduces risk of falling

12 Exercise Testing Aerobic Testing Cycle testing: 3 Min Stage Treadmill : can be unsafe Measure: BP, RPE (6-20), METs, 12-lead ECG, HR Strength Weight machines Free weights Handheld Dynamometer Neuromuscular Gait test Balance Test Endpoint: Pain or fatigue

13 Exercise Testing Functional 6 minute walk: Distance Tandem gait speed: Speed Step Test: Count Timed Chair sit to Stand: Try without use of arms ADL/ Functional Performance Tests ADL- activities of daily living Posture Flexicurve to determine index of kyphosis (IK) (hump on back) Endpoint: pain or fatigue

14 Exercise Prescription Aerobic Mode Large muscle activity: walking, cycling, swimming, water walking Goal- Maintain bone mass Improve and maintain work capacity Intensity/Frequency/Duration 40-70% peak HR 3-5 days/ week min/sessions

15 Exercise Prescription Strength Mode Dumbbells Weight machines Cuff weights Floor calisthenics Vibrating machines Intensity/ Frequency/Duration 75% of 1RM, 8-12 reps 2 sets of 8-10 reps 2-3 days/week min Goals Improve strength Improve posture Maintain Bone Mass Decrease fall Risk

16 Exercise Prescription Flexibility Mode Stretching Chair exercises Goals Increase ROM Intensity/Frequency/ Duration 5-7 days a week Functional Mode Activity Specific exercises Brisk Walking chair sit to stand Balancing Exercises Goals Increase Maintain ADLs Improve Balance Decrease fall Risk Duration 3-5 days/week 2-3 days/week

17 Summary Osteoporosis means Porous Bones Estimated 10 million Americans have Osteoporosis 80 % woman 20% men 34 million Americans have low bone density Risk Factors can be age, gender, Family History, History of falls, low estrogen levels in woman, smoking, alcohol consumption.. Etc BMD diagnoses is based from T- scores T- score >-1 BMD is normal T-score -1 to -2.5 BMD low bone mass T-score -2.5 or less osteoporosis Medication is the usual treatment Exercise has shown to maintain bone mineral density

18 Test Senior Fitness Test

19 References American College of Sports Medicine Position stand. Physical Activity and Bone Health. Med. Sci. Exercise. 36 (11): Durstine, Larry J, Moore, Geoffrey E, Painter, Patricia L, Roberts, Scott O. (2009). ACSMs Exercise Management for Persons with Chronic Diseases and Disabilities. American College of Sports Medicine. Third Edition. Pages Looker AC, Melton LJ, Harris TB, Borrud LG, Shepherd JA. (2010). Prevalence and Trends in Low Femur Bone Density Among Older US Adults. NHANES. 20:64-71 MacLaughlin, E. J. (2010). Improving osteoporosis screening, risk assessment, diagnosis, and treatment initiation: Role of the health-system pharmacist in closing the gap. American Journal of Health-System Pharmacy, 67S4-S8. doi: /ajhp Olszynski, W. P., Shawn Davison, K. K., Adachi, J. D., Brown, J. P., Cummings, S. R., Hanley, D. A., &... Yuen, C. (2004). Osteoporosis in men: Epidemiology, diagnosis, prevention, and treatment. Clinical Therapeutics, 26(1), 15. Retrieved from EBSCOhost. Shiel, William C Jr.(2009). Osteoporosis. EmedicalHealth.