1. Osteoporosis Dave Zanghi M.S., MBA, ATC/L, CSCS

2. Patients With Osteoporosis l These patients experience bone wasting that eventually leads to pathological fractures of the long bones and the vertebral column - a $ 7 billion health care problem.

3. Type I Osteoporosis l Type I Osteoporosis : occurs with menopause in female patients and is associated with an accelerated loss of trabecular bone. l It is characterized by crush fractures of the spine within 20 years after the onset of menopause (Ages 50 - 75).

4.  Type I osteoporosis is associated with : l estrogen deficiency l increased bone resorption activity l too much glucocorticosteroid intake l alcoholism

5. Type II Osteoporosis l Type II osteoporosis is associated with advancing age (> 70) and involves the loss of trabecular and cortical bone. l It is characterized by fractured hips and wedge fractures of the vertebral bodies (Ages 70 +).

6. l Other factors effecting osteoporosis : l Smoking l Sedentary - no exercise l Excessive ETOH consumption l Low dietary calcium intake l Prolonged amenorrhea l Nulliparity - women who bore no children

7.  By the age of 80 years, 1 out of 3 women will fracture their hips while only 1 out of 6 men will experience a fractured hip.  By the age of 90, women have lost 50% of their trabecular bone while men have lost only 20% - 25% of their trabecular bone mass.

8. Some Solutions……... l Estrogen replacement therapy reduces bone resorption by 50% - 60% - is enhanced with progesterone l Calcium supplementation - calcium carbonate is the best supplement - 1500 mg/day

9.  Fosamax - encourages osteoblasis  Vitamin D - 800 IU per day  Calcitonin - inhibits osteoclasis  Thiazide diuretics cause calcium resorption from the glomerular filtrate

10.  Testosterone - increases bone mass in men and women  Parathyroid hormone - in combination with estrogen helps bone mass

11.  Bisphosphonates - etidronate, residronate, alendronate all inhibit bone resorption  Exercise is helpful in blunting the onslaught of osteoporosis

12. l A Suggested Starting Ex. Program l Mode : Aerobic & Weight Bearing l Frequency : 3 - 5 days a week l Duration : 20 - 30 minutes l Intensity : 50% - 70% of Max HR l Borg Scale : 10 - 14 RPE

13. l Exercise should be weight bearing l Types of exercise should be varied to take continual stress off of the same joints

14. l Water aerobics, swimming, kick boards and wogging are all good for conditioning even though they are not weight bearing l Water exercises are helpful because they increase ROM and increase muscle strength