LECTURE: OSTEOPOROSIS AND REHABILITATION
PRESENTER: DR RAHMAN DATE: 10/3/2023
What is definition of osteoporosis?
- a skeletal disorder characterized by compromised bone strength predisposing a person to
an increased risk of fracture
BONE BONE BONE
STRENGTH DENSITY QUALITY
- Bone density = determined by peak bone mass and amount of bone loss
- Bone quality = architecture, turnover, damage accumulation, and mineralization of the bone
What is sarcopenia?
- loss of muscle mass (which cause loss of strength)
- replaced with more fat/adipose tissue
- loss of bone tissue
What is sarcopenic obesity?
Obesity + Sarcopenia
Testing: hand dynamometer (grip strength is reduced in sarcopenic obesity)
Treatment: reduce calorie intake first, tx takes longer time so inpatient rehab is preferred
How does osteoporosis lead to fracture?
- fragility falls (common in aging population)
Where are the most common sites of fracture in fragility falls?
- Distal radius, spine, hip
- these are also sites where BMD test is done: hip and spine (weakest spots)
What is the mortality rate in fragility falls?
- 30% within the first year
- the high mortality rate is caused by respiratory complications (orthostatic pneumonia,
immobilizations) + complicated with pressure injury
What is frailty?
Loss of functional capabilities along with loss of strength/other impairments
What are risk factors of fragility?
- Metabolic syndrome
- Dismobility syndrome (sedentary lifestyle)
- Obesity
- Sarcopenia
- Osteoporosis
, Who should be screened for osteoporosis?
- Hx of prior low-trauma fractures (low trauma fractures are fractures that are not from high
velocity, osteoporotic # are low-velocity in nature)
- those with clinical risk factors
- secondary osteoporosis
- height loss
- Falls risk
- all postmenopausal women ≥50 years old
Risk factors of fall?
Fall prevention strategies?
- Remove trip & slip
- Vision (do they need glasses?)
- Install grab bar
What are the clinical risk factors of osteoporosis?
MODIFIABLE RISKS NON-MODIFIABLE
1. Low calcium and/or vitamin D intake 1. Advancing age
2. Sedentary lifestyle 2. Ethnic group (Oriental & Caucasian)
3. Cigarette smoking 3. Female gender
4. Excessive alcohol intake (≥3 units/day) 4. Premature menopause (<45 years) including
surgical menopause
5. Excessive caffeine intake (≥3 drinks/day) 5. Family history of osteoporotic hip fracture in first
6. Low body weight (body mass index<19 kg/m2) degree relatives
7. Estrogen deficiency 6. Personal history of fracture as an adult
PRESENTER: DR RAHMAN DATE: 10/3/2023
What is definition of osteoporosis?
- a skeletal disorder characterized by compromised bone strength predisposing a person to
an increased risk of fracture
BONE BONE BONE
STRENGTH DENSITY QUALITY
- Bone density = determined by peak bone mass and amount of bone loss
- Bone quality = architecture, turnover, damage accumulation, and mineralization of the bone
What is sarcopenia?
- loss of muscle mass (which cause loss of strength)
- replaced with more fat/adipose tissue
- loss of bone tissue
What is sarcopenic obesity?
Obesity + Sarcopenia
Testing: hand dynamometer (grip strength is reduced in sarcopenic obesity)
Treatment: reduce calorie intake first, tx takes longer time so inpatient rehab is preferred
How does osteoporosis lead to fracture?
- fragility falls (common in aging population)
Where are the most common sites of fracture in fragility falls?
- Distal radius, spine, hip
- these are also sites where BMD test is done: hip and spine (weakest spots)
What is the mortality rate in fragility falls?
- 30% within the first year
- the high mortality rate is caused by respiratory complications (orthostatic pneumonia,
immobilizations) + complicated with pressure injury
What is frailty?
Loss of functional capabilities along with loss of strength/other impairments
What are risk factors of fragility?
- Metabolic syndrome
- Dismobility syndrome (sedentary lifestyle)
- Obesity
- Sarcopenia
- Osteoporosis
, Who should be screened for osteoporosis?
- Hx of prior low-trauma fractures (low trauma fractures are fractures that are not from high
velocity, osteoporotic # are low-velocity in nature)
- those with clinical risk factors
- secondary osteoporosis
- height loss
- Falls risk
- all postmenopausal women ≥50 years old
Risk factors of fall?
Fall prevention strategies?
- Remove trip & slip
- Vision (do they need glasses?)
- Install grab bar
What are the clinical risk factors of osteoporosis?
MODIFIABLE RISKS NON-MODIFIABLE
1. Low calcium and/or vitamin D intake 1. Advancing age
2. Sedentary lifestyle 2. Ethnic group (Oriental & Caucasian)
3. Cigarette smoking 3. Female gender
4. Excessive alcohol intake (≥3 units/day) 4. Premature menopause (<45 years) including
surgical menopause
5. Excessive caffeine intake (≥3 drinks/day) 5. Family history of osteoporotic hip fracture in first
6. Low body weight (body mass index<19 kg/m2) degree relatives
7. Estrogen deficiency 6. Personal history of fracture as an adult
