Clinical Management of the Older Adult with Osteoporosis

presented by Kathryn Brewer, PT, DPT, MEd, Geriatric Clinical Specialist Emeritus

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Fifty-four million Americans are living with, or at risk of, osteoporosis and low bone mass, resulting in two million fractures every year. This course, the first in a three-part series presented by Dr. Kathryn Brewer, focuses on the clinical management of the older adult with osteoporosis. Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength leading to an increased risk of fracture. This definition emphasizes the role of bone strength as a key to understanding fracture risk; one in two women and up to one in four men over the age of 50 will have an osteoporosis related fracture in their lifetime. Physical therapists have a vital role in contributing to patient education and intervention both before and after fracture to improve posture, core and spinal extension strength, balance/coordination, and muscle strength, ultimately reducing fall risk and risk for fracture.

Meet Your Instructor

Kathryn Brewer, PT, DPT, MEd, Geriatric Clinical Specialist Emeritus

Dr. Brewer graduated with her degree in physical therapy from The Ohio State University and received her Master of Education degree from the University of Cincinnati. Her doctorate degree is from Temple University. She has been certified as a geriatric specialist by the American Board of Physical Therapy Specialists since 1994. Dr. Brewer currently practices…

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1. Pathophysiology

The first chapter in this course identifies factors of bone physiology across a lifespan. Dr. Kathryn Brewer discusses which factors influence bone fragility or strength, as well as the role of bone microarchitecture in bone strength, bone regulation, bone adaption, and bone banking.

2. Epidemiology

In this chapter, Dr. Brewer discusses the prevalence of decreased bone mineral density and the sequela of fracture. She presents shocking statistics of the incidence of osteoporosis, and how frequently it leads to fractures. The outcomes of hip fractures, the most devastating of those fractures due to osteoporosis, are reviewed.

3. Characteristics and Populations

Chapter Three provides a description of the health behaviors and comorbidities that influence bone fragility. Dr. Brewer discusses the intrinsic characteristics and health behaviors that increase the risk of decreased bone mass, as well as potential signs for osteoporosis requiring further therapy examination or referral. At-risk populations are also considered.

4. History, Subjective, and Application to the ICF Model

In this chapter, Dr. Brewer reviews critical factors in baseline history and current subjective statuses related to activity and participation in lifestyle behaviors. Participants will learn about pertinent health history that contributes to current status, as well as subjective reporting through interviews and asking critical questions. The ICF Model is also introduced as a guide to assessment.

5. Functional Assessment and Outcome Tools

Chapter Five provides a selection of appropriate tests and measures to establish structural and functional limitations for older adults with osteoporosis. Included are assessments for muscle performance, posture, and joint integrity. Participants will also review functional tests, the pain scale, range of motion tests, and balance assessments.

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