Peter A. Huijbregts, DPT, OCS, FAAOMPT
Abstract: Osteoporosis is diagnosed by identification of risk factors, diagnostic imaging modalities, and urinary or serum levels of certain bone biomarkers. Treatment goals for patients at risk for or diagnosed with low bone mineral density are achieving and maintaining peak bone mass and attenuating or reversing pathologic, age-related, and postmenopausal bone loss. To achieve these goals, medical treatment may consist of nutritional and pharmacological interventions; physical therapy treatment consists of exercise. Current research allows for tentative conclusions with regards to optimal exercise parameters.
Key Words: Osteoporosis, Diagnosis, Treatment, Exercise
In the first article of this two-part series on osteoporosis, I discussed the epidemiology of osteoporosis, the histology of bone, the influences on bone remodeling, and a classification of osteoporosis into primary and secondary forms. This second article uses that information as a basis for discussion of diagnosis and management of patients at risk for or diagnosed with decreased bone mineral density (BMD). The goal of this article is to enable the physical therapist to effectively screen patients for low BMD and to develop appropriate exercise interventions for patients at risk for or diagnosed with low BMD. This article is also meant to increase the therapist’s knowledge of diagnostic modalities and interventions outside of the scope of physical therapy practice in order to facilitate and improve on patient education by the therapist. Conservative and surgical management of osteoporosis-related fractures is outside the scope of this article.