"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Tuesday, November 30, 2010

Physical Therapy in the Prevention and Treatment of Osteoporosis

Osteoporosis might not have the public spotlight like many other widespread diseases, but it’s a serious problem for over 75 million people in the U.S., Europe, and Japan.

The International Osteoporosis Foundation states that one in three women and one in five men over the age of 50 will experience osteoporotic fractures – so why don’t preventative measures and treatments get more attention?

Based on the number of individuals affected by this serious disease, there should be an equally large demand for information, supplements, treatment options, and physical therapy and exercise regimens.

But because osteoporosis is a silent disease, only those who are suffering from its worst complications are aware of it. Fortunately, physical therapy can help treat some of these complications – and it can also help to prevent osteoporosis.

Although it’s not the first form of treatment that tends to pop into someone’s head when the word “osteoporosis” is spoken, it’s highly effective and has been proven to be one of the best courses of action against the disease.

How Physical Therapy Fights Osteoporosis

For those who already have the disease or are at risk for developing it, physical therapy is often a recommended form of treatment – and it can even be practiced on patients who have sustained fractures.

A patient’s road to beating or managing osteoporosis begins with a thorough evaluation, enabling the physical therapist to identify an individual’s activity limits. This is based on a close study of the patient’s bodily movements that shows imbalances, restrictions, and both what the patient is capable of doing and what is obviously beyond his or her limits. The physical therapist then takes this information into consideration while drawing up a customized program for the patient.

Physical Therapy Program Components

A patient’s physical therapy program might be comprised of prescribed exercises, pain management through heat and ice, massage and manual therapy, bone-strengthening activities like tai chi and yoga, and other types of weight-bearing exercise.

There are several important components of exercise in physical therapy because osteoporosis can be a delicate disease to treat.

Exercises should be weight-bearing to build bone mass and strengthen bone-supporting muscles, but this type of exercise alone can be detrimental to someone who’s already experiencing the fragility caused by osteoporosis. To counter this, physical therapists employ exercises that teach patients about body balance, mechanics, and posture – these types of exercises ease the stress on bones to reduce the risk of new fractures.

Good balance and posture are also essential to preventing falls, which are the cause of many fractures. Exercises that promote flexibility (such as yoga and tai chi) and working to improve patients’ gaits are additional concerns that physical therapists include in each exercise program.

Consultation and Patient Responsibility

Finally, physical therapists consult with their osteoporosis patients to identify potentially harmful activities at home or at work.

Many patients struggle with fear of sustaining fractures and limit their daily activity more than they need to. Physical therapists can help these patients to gradually build activity back into their lives by showing them which types of activity are healthy and what might be considered risky activity. Patients may even be reluctant to practice exercises at home because of their fear, but it’s important to follow the physical therapist’s instructions to the letter.

Even with the most successful physical therapy program, patients are ultimately responsible for practicing the prescribed exercises at home and avoiding any activity that might increase their risk of osteoporotic complications.

Patients can also supplement their physical therapy treatment plans by increasing calcium, vitamin D, and vitamin K intake – all of these contribute to the process of building or maintaining bone mass. When combined with the appropriate forms of weight-bearing exercise, supplements like these can promote optimum bone mass growth, which is an important part of treating and preventing osteoporotic complications.

Bio: Maria Rainier is a freelance writer and blog junkie. She is currently a resident blogger at First in Education, where recently she's been researching different physical therapy assistant schools and blogging about student life. In her spare time, she enjoys square-foot gardening, swimming, and avoiding her laptop.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

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