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•   Osteoporosis is a decrease of
    bone mass. The small
    structures that form the bone
    matrix gradually become
    smaller and thinner, increasing
    the spaces between them
•   As a result, the bone become
    more weaker, less dense and
    more porous (spongy bones)
•   The fractures (broken bones)
    typically occur in the hip,
    spine and wrist
        Causes of the problem
• There are two types of specialized bone cells:
  Osteoblasts, which are bone building cells and
• Osteoclasts, which break down old bone material
• These two type of bone cells act in harmony with
  each other and bone remains healthy, as old bone
  is broken down by the osteoclasts and new bone is
  built by the osteoblasts
• This balance is altered when osteoporosis occurs,
  favoring the osteoclasts cells, which lead to
  progressive bone breakdown
        Causes of the problem
• Controllable factors:
• Inadequate diet
• Lack of calcium intake, vitamin D3,
  phosphorous, and supplements
• Lack of physical activity (strength training,
  cardiovascular exercise, range of motion)
• Smoking,
• Excessive alcohol consumption
         Causes of the problem
• Uncontrollable factors:
• Genetics
• Gender
• Race
• Age
• Bone loss secondary to disease
• Family history of osteoporosis
• Decrease of estrogens (Pre/post menopausal
• Certain medical conditions (Rheumatoid arthritis,
  osteoarthritis, fibromyalgia and other related
• Medication and radiation (cancer patients)
          Who is most at risk?
• Osteoporosis is more      • Among city-dwellers than
  common:                     country-dwellers
• Among women than men      • Among white women than
                              black women
• Postmeopausal than
                            • In countries where the diet
  premenopausal women         contains a significant
• In women who weigh less     proportion of milk, cheese,
  than 110 pds than in        and other dairy products
  heavier women               than in countries where
• In developed countries      the consumption of dairy
                              products is small or
  than in developing ones     nonexistent
          Who is most at risk?
• One in two women         • One in 8 men develop
  develop osteoporosis       osteoporosis
• Osteoporosis causes      • 10 million individuals
  more than 1.5 million      already has
  bone fractures a year,     osteoporosis
  of which 300.000 are     • 18 million individuals
  hip fractures              will have an
• 20 percent of              osteoporosis-related
  osteoporosis cases         fracture in their
  occur in men and 80%       lifetime
  of the cases occur in
Women and bone loss

• Osteoporosis is considered a silent disease
  until a bone break causes pain
• Spontaneous fractures especially in
  vertebrae of the mid to lower thoracic spine
  and loss of height are the most common
             Functional losses
• A person with osteoporosis reduces his/her
  functional capacities. When osteoporosis is
  present the person develops:
• Immobility
• Lack of strength
• Bad posture (can lead to a bent, stooped posture,
  protruding abdomen and can hasten aging or
• Inability to keep up with ADL
• Lack of endurance
• Debilitating and chronic pain
        Why is physical therapy
• The person needs to
  restore part of his or her
  functional capacities
• To restore mobility to a
  certain degree
• Physical therapy is
  necessary also for persons
  who are paralyzed or
  immobilized to develop
  strength, endurance and
  minimize pain and muscle
• Intake of calcium
• Calcium carbonate
  w/sodium, Calcitonin
• Phosphate supplements
  and vitamins (D3)
• Estrogen replacement
• Exercises
• Analgesics/relaxants
• Surgery (hemipelvectomy,
              Physical Therapy
• Type of intervention:
• Exercises to restore range of motion to a certain
  degree of function
• Strength training, endurance exercises
• Purpose of intervention:
• Alleviate the pain
• Help the patient to restore full or partial mobility
• Guide the patient through his or her activities of
  daily living
   Intervention of other medical
• When some of the organs are affected by
  osteoporosis it is necessary the intervention of
  specialists doctors such as:
• Cardiologist (heart)
• Respiratory therapist (lungs, bronchii)
• Medical doctors (general health issues)
• Oncologist (cancer, radiation)
• Gynecologist (menstrual, menopause problems)
• Pulmonary doctors
Healthcare providers working as
 a team to benefit the patient

• Depends of type of
  severity of bone loss
• Age
• Mobility
• Complications related
  to fractures
• Result of treatment
     • A balanced diet ( intake of
       vitamins D, calcium, C,
       Phosphorous and
     • Physical activity
     • Including non-traditional
       medicine (yoga, tach chi,
       pilates) are thought to be
       beneficial in the treatment
       for osteoporosis
     • Medication if you have
       other related conditions
                 Health promotion
• Educate yourself and your
  loved ones about
• Have annual bone density
• Start now by taking time
  for a moderate and joyful
  physical activity
• Keep yourself informed,
  stay away from smoking
  and drinking, which also
  contribute to this disease,
  and by doing this you can
  enhance and prolong the
  quality of your life

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