osteoporosis. what is osteoporosis? a disease that causes bones to become brittle and fragile...
TRANSCRIPT
What is Osteoporosis?
• A disease that causes bones to become brittle and fragile
• Literally means “porous bone”
• The consequence of long-term bone demineralization
Who gets it and why?
• There are different types of osteoporosis classified by the cause
• Primary Osteoporosis: type I and type II
• Secondary Osteoporosis
Primary Osteoporosis
Type I : Post-menopausal• 25% of Post-menopausal women will
develop it
• Due to drop in estrogen
• Most common between 50-70 yrs
• Incidence increases with age
Primary Osteoporosis
Type II: Age Related • Bone loss due to aging process
• Men and women generally over 70 yrs
Secondary Osteoporosis
May be caused by: • Steroids (corticosteroids) • Anticoagulant• Anticonvulsants • Result of disease or disorders (kidney disease,
anorexia, hyperthyroidism) • Impairment of calcium absorption • Immobilization• Inflammatory arthritis
Risk Factors
• Low calcium intake• Sedentary lifestyles• Tobacco use• Being underweight• Amenorrhea • Estrogen deficiency• Decreased bone-mass mineral content, as detected
by a bone-mass density test• Genetics/family history
Prevention• Weight bearing exercise (walking is the
easiest form)• Important to start during developing years, before
25, to build strong dense bones
• Continue into adulthood to prevent density loss
• Diet • High calcium and vitamin D to help absorb the calcium\
• Vitamin supplementation
Maintain appropriate body weight• Being too thin increases risk
Signs of Osteoporosis
• Decreased height over time
• Hunched back
• Broken bones
• Back pain
• Tooth loss
Diagnosis:
• Bone density is evaluated through various types of radiation technology
• Bone density evaluated by number of standard deviations between bone mineral density and peak bone mass
Normal loss: 0-1 Osteopenia: – 1-2 Osteoporosis: < –2 Severe osteoporosis: > –2.5
Symptoms of Osteoporosis
• Joint pain swelling
• Fractures due to minor trauma
• Bone deformity
• Debilitation
Treatment
• There are a wide range of treatment options• Once out of developmental years (past 25
years), reversal is unlikely, but goal is to prevent further loss
• Various drug treatments in combination with weigh bearing exercise and dietary adjustments to include vitamin D and calcium are most common
Important Considerations for Physical Activity
• Par-Q and medical release must be completed• Adjust loading if osteoporosis is present due to
increased risk of fractures (Include resistance often hip or wrist)
• Include strength training/weight bearing activity in programs for all ages, in all populations for prevention
• Target Extensor groups to prevent common deformity
Contraindications to Physical Activity?
• It is widely accepted that physical activity helps to prevent further bone loss and helps to increase flexibility, balance, and strength helping to decrease the chance of falls
• However, precautions must be taken to avoid fractures:
• Avoid Twisting and bouncing movements• Avoid heavy lifting • Use proper lifting technique, even for light loads• Stop immediately if pain is experienced• Age considerations (older adult population exercise
contradictions from pervious week) • Use padded garments
Special Considerations
• Although most common in older women, Osteoporosis is not gender or age specific
• When prescribing exercise may encounter:• Individuals immobilized for long periods of time
• Female athletes
• Corticosteroid users
Immobilization
• May Cause Disuse Osteoporosis• Long term immobilization may cause degeneration of
bone • Due to limited weight bearing and muscle activity • Bone loss can be detected as early as 2 weeks after
immobilization
• Prevention: • Isotonic and isometric exercises during immobilization
• Treatment: • Losses may be regained after remobilization with
increased weight bearing exercise
Female Athletes
The Female Triad • Triad of disorders commonly found in young
female athletes • Disordered Eating, Amenorrhea, Osteoporosis• Most common in sports requiring ideal body weight
(gymnastics, figure skating, cross-country running, diving, swimming, and ballet)
• Does not only effect female athletes• Usually caused by desire to be ultra thin to improve
performance or physical appearance
Female Athletes• How it works:
• Eating disorders cause amenorrhea and lack of minerals and vitamins for bone growth
• Amenorrhea with continued lack of vitamin intake accelerates bone loss causing osteoporosis
• Prevention:• Education• Early recognition of eating disorder
• Counseling • Monitor body weight (maintain healthy weight)• Supplementation
Corticosteroids • What are they?
• Drugs used to alleviate swelling, redness, warmth, and pain or joints or organs
• Who uses them?• Most commonly arthritics and asthmatics
• Adverse Effects:• Long term use may cause sever bone density loss• Up to 7.5mg/day for 6 months may decrease
trabecular bone volume up to 20%, with continued but slower loss if longer use
• Side effects are not age specific
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References