133. Osteoporosis and Fracture Prevention w/ Lora Giangregorio
Jan 30, 2024
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Expert in osteoporosis and fracture prevention, Lora Giangregorio, discusses the diagnosis, assessment, and treatment options for osteoporosis. They explore exercise as a management strategy and the challenges faced by individuals in accessing suitable rehabilitation programs. The importance of nutrition, medication, and functional training for osteoporosis management is highlighted.
Exercise, particularly balance and functional training, can reduce the risk of falls and fractures in individuals with osteoporosis.
Individualized exercise programs that consider a person's risk factors, fitness level, and goals are crucial for managing osteoporosis.
Addressing the lack of accessible rehabilitation and exercise programs specifically tailored for osteoporosis is necessary to support individuals with the condition.
Deep dives
Exercise as a Management Strategy for Osteoporosis
Exercise, particularly balance and functional training, has been shown to reduce the risk of falls and fractures in individuals with osteoporosis.
Types of Exercise and their Effects on Bone Density
Impact exercise combined with resistance training may have a positive effect on bone density, although the evidence is not high certainty. Other forms of exercise, such as walking, Nordic walking, yoga, and Pilates, have been studied but showed less significant effects.
Importance of Individualized Exercise Programs
Individualized exercise programs that consider a person's specific risk factors, fitness level, and goals are crucial for managing osteoporosis. It is recommended to seek guidance from exercise professionals knowledgeable about osteoporosis to design and modify exercise programs based on individual needs.
Challenges in Accessing Rehabilitation and Exercise Programs
There is a lack of access to rehabilitation and exercise programs specifically tailored for osteoporosis. Many individuals have to pay out of pocket for exercise professionals or rely on limited community resources. Addressing these challenges and providing accessible exercise guidance is necessary to support individuals with osteoporosis.
Exercise Selection and Balance Training
When it comes to balance training, it's important to choose exercises that challenge the individual's balance without causing a risk of falling. Exercises can vary based on the person's ability, such as leaning while holding onto objects or doing toe taps on a step. Flexibility of joints, particularly ankles and hips, should also be addressed to reduce fall risk. For resistance training, simplicity is key. Select a few categories of exercises, such as push, pull, squat, hinge, press, and carry, and choose one exercise in each category. Aim for moderate to high effort and focus on form before increasing intensity. Increasing volume and intensity are important for resistance training, and focusing on back extensor muscles and scapular stabilizers can be beneficial for improving posture.
Considerations for Management and Misconceptions
In addition to exercise, nutrition and medication play important roles in managing osteoporosis. It is crucial to ensure adequate intake of calcium and vitamin D, but excessive supplementation is not necessary if nutritional requirements are met. Protein intake should also be sufficient, particularly for older adults engaging in resistance training. Medications may be necessary for individuals at high risk for fractures, and careful consideration should be given to the type of medication based on individual needs and risks. It is essential to be critical of alternative devices or treatments claiming to increase bone density, as there is often misleading or insufficient scientific evidence. Educating patients to navigate through misleading claims is vital in the era of abundant information.
Chris sat down with Lora Giangregorio to discuss all things osteoporosis and fracture prevention. We dive into the recently updated Canadian Clinical Practice Guideline for the management of osteoporosis and fracture prevention. We cover the diagnosis, assessment, and treatment options for osteoporosis and fracture prevention and the evidence surrounding various forms of exercise as a management strategy.
