Better Bones: Osteoporosis education for fitness instructors…and more

Osteoporosis is the most common bone disease in the United States.  As the American population ages, the incidence of osteoporosis continues to grow, as well as its consequences on independence and quality of life.  While there is improved recognition and management of osteoporosis, many older adults with or at risk for osteoporosis are not aware of appropriate exercise guidelines to stay safe and prevent fractures.  Furthermore, not all fitness instructors and personal trainers are adequately educated about the disease and considerations for prescribing exercise.  These circumstances provide an opportunity for physical therapists to intervene in a manner that may improve health outcomes for individuals with osteoporosis.

The majority of members of the Wellness Center adjacent to the outpatient clinic I work in are adults over the age of 60.  Having observed older adults performing unsafe exercises in the workout area, I initially delved into the idea of an osteoporosis education and exercise program during the Health & Wellness class.  “Healthy Bones” is a project proposal that could be implemented at a future date with appropriate resources: Healthy Bones.

In investigating the feasibility of “Healthy Bones”, I realized that many older adults access gyms or wellness centers directly to begin a fitness routine without obtaining specific guidelines from their physician or a physical therapist.  Therefore, it is important for all staff who instruct these older adults to be knowledgeable about osteoporosis and associated exercise guidelines.  I saw this need as an opportunity to share information about this disease and implications for exercise with the Wellness Center staff (personal trainers and group fitness instructors).  To do so, I created the “Better Bones” presentation: Better Bones.

Literature reviewed as the basis of this project has been summarized in the following evidence tables: fracture prevention and bone mineral density.

The presentation was made on April 3^rd with a pre/post-test (quiz) to assess learning.  The average score went from 12.8/20 to 17.5/20 indicating improved knowledge about osteoporosis and management.  The questions that were most commonly missed following the presentation informs me which points need to be better emphasized during future presentations.

To supplement the presentation, I created a tri-fold handout for members explaining exercise guidelines for osteoporosis.  This handout is available to the general membership and can be distributed to new members who identify osteoporosis or osteopenia in their medical history on the application form. Member handout.

In constructing the instructional presentation and handout, consideration was given to make the presentation “user friendly” and to incorporate the concept of health literacy for older adults as described in this document: Presentation and Health Literacy Assessment.

All of the outpatient physical therapists within my hospital system have been invited to an inservice I am giving on May 1^st with details about the literature reviewed for this project and the exercise guidelines that need to be given to patients with osteoporosis.  Sharing this knowledge with the other therapists will help ensure we are providing evidence-based care to our patients and setting them on the right path for long-term disease management.

I recently learned that May is National Osteoporosis Awareness and Prevention Month!  After discussing an idea with the Wellness Center manager and dietitian, I am looking forward to offering an educational presentation to members and patients in late May.  This will include a modified version of “Better Bones”, the dietitian providing a presentation about nutritional intake and additional information about fall prevention.

This Capstone project provided educational opportunities for the Wellness Center staff, members and Outpatient Rehab therapists to improve their knowledge about osteoporosis and exercise guidelines.  Hopefully this leads to “bone safe” exercises being incorporated into fitness routines and fractures being prevented for years to come!