Osteoporosis Bobby Parker

Overview Definitions Epidemiology Symptoms Treatment Effects of Exercise Testing Prescription Conclusion References http://www.beautyhealthwomen.com/benefits-in-women

Video http://www.youtube.com/watch?v=rHyeZhcoZcQ

Definitions Osteoporosis is a bone disease that thins skeletal bone tissue losing bone density over time There is no cure for low bone mass and osteoporosis, successful management is possible Osteoporosis is directly related to Osteopenia referring to bone mineral density (BMD) that is lower than normal peak BMD

Epidemiology Currently it is estimated that over 200 million people worldwide suffer from this disease Researchers estimate that about 1 out of 5 American women over the age of 50 have osteoporosis. About half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra (bones of the spine). Women can lose up to 20% of their bone mass in the five to seven years after menopause

Epidemiology Approximately 30% of all postmenopausal women have osteoporosis in the United States and in Europe In 2005, the cost associated with osteoporosis-related fractures was estimated at $19 billion By 2025, the costs are expected to rise to approximately $25.3 billion.

Epidemiology Image http://www.iofbonehealth.org/bonehealth/epidemiology

Symptoms There are no symptoms in the early stages. You will not notice any pain or changes as the bones become thinner! In the later stages, symptoms include bone pain/tenderness, fractures, loss of height, low back/neck pain due to fractures of the spinal bones, Stooped posture (kyphosis) Since your bones are getting thinner, there is an increase risk of breaking a bone because the bone is less dense.

Osteoporosis Images Normal bone Matrix Osteoporosis http://www.doctortipster.com/1333-osteoporosis.html

Risk Factors Older age Gender (females have a higher percentage) Family History Smoking Alcohol Consumption Low Calcium and Vitamin D intake Low lean body mass Diseases (anorexia, bulimia, asthma, cystic fibrosis, celiac disease, etc.)

Diagnosis DEXA Scan (Dual X-ray Absorptiometry) is the most common Quantitative computed tomography (QCT) The World Health Organization (WHO) Fracture Risk Assessment Tool (FRAXTM). It’s available online and can be used to determine the 10-year probability of a major osteoporotic fracture

Images http://www.gorhams.dk/html/what_is_dexa_scanning.html

Prescription The National Osteoporosis Foundation suggest the following five steps that together optimize bone health and help prevent osteoporosis Obtain the recommended, age-related amount of calcium and vitamin D per day Engage in regular weight-bearing and muscle strengthening exercises Avoid Tobacco and excess alcohol Education about bone health Having a bone density examination/taking medication when recommended

Medication Antiresorptive medications: Bisphosphonates (alendronate and alendronate plus vitamin D3) Selective estrogen receptor modulators (SERMs) or estrogen agonists Raloxifene, which is FDA approved for osteoporosis in post menopausal women) Bone Forming (Anabolic) medications: Teriparatide (Forteo which is a form of parathyroid hormone) Limited time on for postmenopausal women and men with very low bone mineral density

Effects on Exercise Mechanical limitations imposed on respiratory muscle functions in individuals with severe thoracic kyphosis For those who only complication is low bone mass, standardized exercise testing with precautions to minimize the risk of falling during the test is recommended Regular aerobic, weight-bearing, and resistance exercise training has been shown to have a positive effect on the bone mineral density (BMD) of the spine in post menopausal women

Exercise Testing Methods Measures Aerobic Cycle (ramp protocol 5-20 W/min; staged protocol 25-50 W/3min stage) Treadmill (1-2 METs/stage) 12-lead ECG, HR BP RPE (6-20) METs Strength Weight machines Free Weights Handheld dynamometer Pain Fatigue Neuromuscular Gait analysis Balance

Exercise Testing (cont.) Methods Measure Functional 6 min walk Tandem gait speed Step test Timed chair sit to stand test ADL/functional performance tests Posture Quality of life Scales Distance Speed Count Try without use of arms Flexicure to determine the index of kyphosis (IK)

Exercise Programming Modes Intensity/Frequency/Duration Aerobic Large muscle activities (Walking, Cycling, Elliptical, Running, etc. 40-70% peak HR, METs 3-5 days/week 30-60 min/session Strength dumbbells, weight machines, etc. 75% of 1RM, 8-12 reps 2 sets of 8-10 2-3 days/week for 20-40 min Flexibility Stretching, Chair exercises 5-7 days/week with prolonged holding (30s as tolerated) Functional Activity-specific exercise, brisk walk, chair sit, balancing exercises 2-3 days/week

Postmenopausal Osteoporosis http://www.youtube.com/watch?v=CluxTHfi-AE&feature=fvst

Summary and Conclusion Osteoporosis is the thinning of the bone tissue and loss of bone density over time There is no symptoms in the early stages There is no cure Exercising and eliminating risk factors can help prevent and manage Osteoporosis and Osteopenia

References American College of Sports Medicine. (2009). L. Dustrine, P. Painter, G. Moore & S. Roberts (Eds.), Illinois : Human Kinetics. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/ http://www.iofbonehealth.org/bonehealth/epidemiology http://www.medscape.com/viewarticle/410461 http://www.medscape.org/viewarticle/502984_5 http://www.hazletonhealthandwellness.org   http://www.webmd.com/osteoporosis/guide/osteoporosis-diagnosis-tests