1. Chapter 71 Chapter 71 Physical Therapy, Physical Modalities, and Exercise Regimens in the Management of Osteoporosis Copyright © 2013 Elsevier Inc. All rights reserved.

2. FIGURE 71.1 Kyphosis measurement using flexicurve ruler. 2

3. Copyright © 2013 Elsevier Inc. All rights reserved. FIGURE 71.2 Measurements of posturea. a. Rib–pelvis distance test. b. Wall–occiput distance (WOD). 3

4. Copyright © 2013 Elsevier Inc. All rights reserved. FIGURE 71.3 A, Normal posture with natural cervical lordosis, thoracic kyphosis, and lumbar lordosis. B, Hyperkyphosis and head-forward posture typical of individual with osteoporosis and vertebral fractures. 4

5. Copyright © 2013 Elsevier Inc. All rights reserved. FIGURE 71.4 Examples of exercises to promote best posture. A, Cervical posture correction with cervical retraction and axial elongation; B, corner stretch for lengthening of the anterior shoulder girdle; C, Scapular retraction for upper back/shoulder girdle strengthening; D, mini-press up to decrease thoracic hyperkyphosis; E, prone spine extension strengthening; F, stair lunge for anterior hip stretch. 5

6. Copyright © 2013 Elsevier Inc. All rights reserved. FIGURE 71.5 Unsafe movements and safe alternatives. A, unsafe toe touch for hamstring stretching with spine flexion; B, safe supine hamstring stretch with neutral spine maintained; C, unsafe abdominal curl up with spine flexion; D, safe abdominal isometric in supine; E, unsafe loaded trunk rotation with resistance in sitting; F, safe unloaded trunk rotation in supine. 6