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ISO2026: Integrating Functional Strength and Rehabilitation in Osteoporosis Care
This session presents a practical framework for integrating functional strength training and rehabilitation into the care of patients with low bone density and osteoporosis, with the goal of moving patients from fear of movement to confident, capable function. It defines functional exercise as the fundamental movement patterns of daily life, including pushing, pulling, sitting to standing, squatting, hip hinging, carrying, and impact, and it connects these patterns to common activities of daily living. The session reviews how to stratify patients by fall risk and fracture risk using medical history, bone mineral density, FRAX, and direct observation, and it offers guidance on the appropriate exercise setting and level of supervision for each risk level, ranging from independent activity to personal training to supervised physical therapy. It describes the assessment tools used to establish a baseline and guide programming, including the thirty second chair rise, the one leg stance test, floor transfer, wall push up, and cervical range, alongside DXA, trabecular bone score, and vertebral fracture assessment. Using patient cases across the risk spectrum, the session details the three components of a comprehensive bone health program, namely progressive resistance training, weight bearing impact, and balance training, and it explains how to prescribe and progress each through load, intensity, duration, and frequency while monitoring exertion. It closes with the movements that are contraindicated in osteoporosis and the modifications that allow patients to continue training safely.
Target Audience
This continuing education activity is intended for use by health professionals who participate in the care of patients at risk for or suffering from osteoporosis, in the areas of primary care, endocrinology, geriatrics, gynecology, internal, obstetrics, orthopedics, osteopathy, pediatrics, physiatry, radiology, rheumatology and physical therapy.
This includes physicians, nurse practitioners, registered nurses, pharmacists, physician assistants, technologists, researchers, public health professionals and health educators with an interest in osteoporosis and bone health.
Learning Objectives
Upon completion of this session, participants will be able to:
1. Define functional exercise in terms of fundamental daily movement patterns, including push, pull, squat, hip hinge, carry, and impact, and explain how these patterns translate to activities of daily living.
2. Apply fall risk and fracture risk assessment tools, including the thirty second chair rise, the one leg stance test, and movement screens, to determine an appropriate exercise setting and level of supervision for patients across low, moderate, and high fracture risk categories.
3. Describe the three components of a comprehensive bone health exercise program, namely progressive resistance training, weight bearing impact, and balance training, and explain the role of each in stimulating bone formation and preventing falls.
4. Apply principles of progressive overload and intensity monitoring, including repetition and load prescription, the ten percent weekly progression rule, and rating of perceived exertion, to advance a program safely without provoking injury.
5. Identify exercises and movements that are contraindicated in osteoporosis, including loaded spinal flexion, deep or end range twisting, and high impact loading in patients with very low femoral neck bone density, and select appropriate modifications.
Name of Individual | Individual's Role(s) in Activity | Name of Ineligible Company(s) | Nature of Relationship(s) |
| Justine Bernard, DPT | Speaker | N/A | N/A |
Lisa Grimmer, DPT | Speaker | N/A | N/A |
| Amy Mitchell, MSN, FNP-C | Planner/Accredited Provider Program Director & Content Expert | Amgen & Radius Health | Speaker’s Bureau, Scientific Advisory Board, Consulting |
Ami Patel | BHOF Staff, Vice President of Science & Education | N/A | N/A |
Andrea Medeiros | BHOF Staff, Vice President of Public Health & Policy | N/A | N/A |
Disclosures:
● Receives compensation from ISO for presenting
● No other financial support or sponsorship related to this presentation.
● The presenter has no relevant conflicts of interest to disclose related to the content of this presentation.
Accreditation Statement
The Bone Health and Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Bone Health and Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
CME Program Eligibility
Method of Participation in the Learning Process: Clinician learners will view and analyze the subject matter, conduct additional informal research through related internet searches on the subject matter, and complete a post-test assessment of knowledge and skills gained as a result of the activity.
After participating in this activity, the reader has the option of taking an evaluation for this activity. It is estimated it will take 0.75 hour(s) to complete the reading and take the evaluation. Continuing education credit will be available for two years from the date of publication.
Disclosure of Commercial Support
It is the policy of the Bone Health & Osteoporosis Foundation (BHOF) to ensure balance, independence, objectivity, and scientific rigor in all its sponsored publications and programs. BHOF requires the disclosure of the existence of any significant financial interest or any other relationship the sponsor, Editorial Board or Guest Contributors have with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. All authors and contributors to this continuing education activity have disclosed any real or apparent interest that may have direct bearing on the subject matter of this program.
Please be advised that BHOF’s accreditation status with ACCME and ANCC does not imply endorsement by BHOF, ACCME or ANCC of any commercial products displayed in conjunction with this activity or endorsement of any point of view.
Refund Policy
BHOF offers no returns or refunds on online internet CME activities purchased through our store. All sales are final. Meeting and workshop registrations will be refunded in accordance with the cancellation policy of the meeting and/or workshop, as outlined at registration.
Available Credit
- 0.75 AMA PRA Category 1 Credit™The National Osteoporosis Foundation is an approved Accreditation Council for Continuing Medical Education (ACCME) accredited CME provider through March 2023. ACCME accreditation accelerates learning, change and improvement in the field of osteoporosis. The National Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The National Osteoporosis Foundation designates educational activities for AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 0.75 ANCCThe mission of the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is to promote excellence in nursing and health care globally through credentialing programs. The National Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The National Osteoporosis Foundation designates educational activities for continuing nursing education credit(s).
- 0.75 Participation
- 0.75 Participation/AttendanceA certificate of attendance will be provided to all other attending healthcare professionals. Nurse practitioners and physician assistants may request AMA PRA Category 1 Credit(s)™ certificate of participation. Please refer to your provider to determine whether this program will qualify for other categories of continuing education credits. The American Academy of Physician Assistants (AAPA) also accepts educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the Accreditation Council for Continuing Education (ACCME).