Bone Health Flash
April 2024 – Welcome to Spring and opportunities to grow your knowledge in bone health!
Osteoporosis Awareness and Prevention Month – May
Bone Health and Osteoporosis Foundation (BHOF)
Consider connecting your patients with some virtual options for learning more about primary and secondary fracture prevention in May: https://www.bonehealthandosteoporosis.org/awareness-month/.
On-demand webinars and podcasts are available at this link, as well, to provide your patients more information on exercise, nutrition, and mindfulness to address bone health.
Also, check back for additional resources, including a Social Media Toolkit, to share awareness about bone health in your community and network.
Steps to Strong Bones™ – Connect your patients, or even join yourself, to a monthly Zoom meeting (first Monday of the month, 12 pm ET) to learn from motivational speakers and like-minded individuals on how to manage and progress bone health.
Interdisciplinary Symposium in Osteoporosis (ISO2024) Join like-minded professionals June 13 – 15 in Washington DC to expand your knowledge, connect, and engage in interprofessional discussions on OP management. 2024 Registration – ISO2024.
Expand your Library and Knowledge:
FRAX®…updating the fracture risk assessment tool
Osteoporosis management is often measured by assessing bone mineral density (BMD) with the use of dual energy absorptiometry x-rays (DXA). But, the FRAX® online resource tool can guide intervention decisions by providing more information on fracture risk. However, the FRAX® tool has been criticized for not recognizing additional risk factors (i.e. falls), additional medical conditions associated with fracture risk (i.e. type 1 and 2 diabetes), duration of exposure with risk factors (i.e. glucocorticoids), and greater representation of gender and ethnicity in data. A systematic review was performed using 64 cohort studies to determine quality of findings for integration into the current algorithm.1
A history of falls was addressed in 46 of these cohorts. Findings indicate a fall in the past year is associated with a significant increase risk of any subsequent fracture, with men having a 10-30% higher risk than women, despite the fact women fall more frequently than men. The risk varied between 36 and 59% dependent on fracture outcome and sex. But fracture risk was also shown to decrease with age, HR of 2.63 at age 40 to HR 1.09 at age of 90.2 And one or more previous falls was associated with an increased risk of death for both genders.
It appears we may see the integration of fall risk into the FRAX® risk assessment tool in the near future. Watch for further analysis of additional risk factors to be considered in the update.
- Vandenput L, et al. 2022. Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan. Osteoporos Int. 2022 Oct;33(10):2103-2136. doi: 10.1007/s00198-022-06435-6. Epub 2022 May 31. PMID: 35639106. https://pubmed.ncbi.nlm.nih.gov/35639106//
- Vandenput L, et al, 2024. A meta-analysis of previous falls and subsequent fracture risk in cohort studies. Osteoporos Int. 2024 Mar;35(3):469-494. doi: 10.1007/s00198-023-07012-1. Epub 2024 Jan 17. PMID: 38228807. A meta-analysis of previous falls and subsequent fracture risk in cohort studies - PubMed.
What’s Happening in the SIG
General Body Meeting
We held our last meeting on April 2 and addressed the following topics:
– CSM: Brief recap of CSM topics and opportunities for future CSM bone health topics.
– Bone Health Toolkit: Sneak peek toolkit, available now on the BHSIG website.
– Survey: review of findings from survey to find out a bit more about our members and interests to guide future action steps and develop collaborations.
– Journal Club: Plan to highlight APTA CPG for OP management. Interested in providing a complimentary Case Study to be highlighted in the January GeriNotes
– Opportunities to Collaborate: To find out how you can contribute or for you to provide suggestions or your expertise, contact lisahamiltonpt@gmail.com.
In the Spotlight
Joanne Fagerstrom, PT, CFP, has been a practicing PT since 1978, (Hunter College, NY), and worked in various Philadelphia area teaching hospitals before launching her private practice, Mindful Physical Therapy, LLC, in 2012.
After being diagnosed with osteoporosis in 2009, Joanne began the research and development of her comprehensive bone health program, Strong Bones, where she specializes in working with active adults with osteoporosis or low bone mass. Joanne places a strong emphasis on wellness and prevention in her treatment programs, and her certification in the Feldenkrais Method (2004) adds a unique dimension to her practice of physical therapy. In 2018, she augmented her work by completing a certificate program in nutrition through Cornell University.
In addition to private consultations, Joanne teaches weekly Strong Bones exercise classes both online and in-person and regularly offers public bone health workshops. In 2015, she produced and released her educational Strong Bones exercise video; the second edition was released in 2021.
Educational Offering
In 2023, Joanne launched her bone health course that she created not only for PTs seeking to earn CEUs while expanding their own practice in the field, but also for anyone interested in finding evidence-based answers about their bone health. This course, titled Comprehensive and Holistic Physical Therapy Management of the Active Adult with Osteoporosis/Low Bone Mass: A Whole-Body Approach, has been approved by the Pennsylvania State Board of Physical Therapy for 7 contact hours. It is a recorded webinar designed to be self-paced. She is currently applying to several additional states for CEU approval.
To learn more, please go to: ced.ourstrongbones.com
Want to be featured in the next Flash? send information to: Kathlene.camp@unthsc.edu
Kathlene Camp, PT, DPT
Board Certified Specialist in Geriatric Physical Therapy
Vice Chair, BHSIG