Anti fall measures in osteoporosis
-
Upload
orthoprinciples -
Category
Health & Medicine
-
view
268 -
download
3
description
Transcript of Anti fall measures in osteoporosis
![Page 1: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/1.jpg)
Anti-Fall Measures in Osteoporosis
Hitesh Gopalan UEditor, www.orthopaedicprinciples.com , Clinical Asst Professor, MOSCMM, Cochin
Visiting Lecturer, Centre for Evidence Based Orthopaedics,McMaster University, Canada
![Page 2: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/2.jpg)
Risk Factors for fractureH/o fracture
Female Sex
White Race
Advanced Age
Dementia
![Page 3: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/3.jpg)
Risk factors for fractureCurrent Cigarette Smoking, Alcoholism
Low Body weight
Oestrogen deficiency, Early menopause
Impaired Eyesight
Inadequate physical Activity
![Page 4: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/4.jpg)
![Page 5: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/5.jpg)
PreventionFalls
Secondary Osteoporosis
Prevention of Primary Osteoporosis
![Page 6: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/6.jpg)
Methods to prevent FallsNocturia: Modify Diuretic Use
Sedative-hypnotic drugs
Orthostatic Hypotension
![Page 7: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/7.jpg)
Prevention of FallsAlcohol Abuse
Avoid stocking feet on wood floors
Check carpet condition periodically
Grab Bars in Toilets
![Page 8: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/8.jpg)
Eliminate exposed wires
curtain strings
slippery rugs
mobile tables
![Page 9: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/9.jpg)
Prevention of FallsAdequate lighting in paths
Vision: Depth Perception
Neurological Disease: Stroke, parkinsonism
![Page 10: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/10.jpg)
![Page 11: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/11.jpg)
FRAXGeographic regionRaceSexWeightHeightPrior fragility fracture
![Page 12: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/12.jpg)
FRAXParent with hip fractureGlucocorticoid use (≥5 mg/day of prednisone
for ≥3 mo ever)Rheumatoid arthritisSecondary osteoporosisCurrent smokingAlcohol intake (≥3 or more drinks/day)
![Page 13: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/13.jpg)
FRAXhttp://www.shef.ac.uk/FRAX/index.htm.
Risk for fracture
Adequate care
10 year probability of fracture
BMD not essential
![Page 14: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/14.jpg)
Peak Bone MassAttained by age 25
Correct Menstrual dysfunction, Amenorrhea
Body Weight
Lane JM, Riley EH, Wirganowicz PZ: Osteoporosis: Diagnosis and treatment. J Bone Joint Surg Am 1996;78: 618-632.
![Page 15: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/15.jpg)
ExerciseMuscle Strengthening
Habit
Impact Loading
Balance Training
![Page 16: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/16.jpg)
ExerciseLow-Moderate levels
Bone mass= Muscle mass
Excessive Exercise: Female athlete triad
![Page 17: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/17.jpg)
ExerciseJogging
Brisk Walking
Stair Climbing
Not recommended: Lifting heavy weights, sit-ups
![Page 18: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/18.jpg)
Endurance TrainingSwimming, Long distance running
Not effective in improving BMD
![Page 19: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/19.jpg)
DietAdequate dietary Calcium
800- 1200mg/day
![Page 20: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/20.jpg)
Tai Chi47 % in fall incidence
Can be practiced by elderly
Province MA, Hadley EC, Hornbrook MC, et al: The effects of exercise on falls in elderly patients: A preplanned meta-analysis of the FICSIT trials. JAMA 1995;273:1341-1347.
![Page 21: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/21.jpg)
Hip ProtectorsThickness of buttock muscle and fat pad(75%
of energy can be absorbed)
Protector Pads
Bulky appearance
![Page 22: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/22.jpg)
Hip Protector Pad
![Page 23: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/23.jpg)
Prevention of Falls in the Elderly Trial(PROFET)Reduction of Medication
Getting up after fall
Education in prevention of falls
Close J, Ellis M, Hooper R, et al. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet 1999;353:93-97
![Page 24: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/24.jpg)
Secondary OsteoporosisCushing’s SyndromeThyrotoxicosisHypogonadal statesGastrectomyLiver DiseaseRA, Ank SponOsteogenesis Imprefecta
![Page 25: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/25.jpg)
Evidence- Alendronate
![Page 26: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/26.jpg)
Does Alendronate Interfere with fracture Healing?NO
Quality of the evidenceLevel I• 2 randomized controlled trialsLevel IV• 1 case seriesNo classification• 14 trials in animals
![Page 27: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/27.jpg)
![Page 28: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/28.jpg)
Calcitonin
![Page 29: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/29.jpg)
VEGF-A
![Page 30: Anti fall measures in osteoporosis](https://reader037.fdocuments.us/reader037/viewer/2022110115/54b7db6a4a79593d748b45a9/html5/thumbnails/30.jpg)