update from Chartered Society of Physiotherapists
Screening might pick up one in four hip fractures before they happen ....
Screening for osteoporosis in primary care might potentially stave off more than a quarter of hip fractures in older women, suggests a study of more than 12,000 participants from 100 general practices across England.
A simple questionnaire, combined with bone mineral density measurements for some, would help identify those at risk of hip fracture in general practice, enabling them to be targeted for treatment, say the researchers.
They randomly assigned 12,483 women aged 70+ to either screening (6,233) using the Fracture Risk Assessment Tool (FRAX) or to usual care over a period of five years. Treatment was recommended for 898 (14 per cent) of those screened and deemed to be at high risk of hip fracture. More than three quarters of them (78 per cent) were taking drugs for osteoporosis within six months of screening.
Screening didn’t reduce the incidence of all osteoporosis-related fractures, nor the overall incidence of clinical fractures. But it did reduce the numbers of new cases of hip fracture by 28 per cent, with 54 fewer women sustaining one or more hip fractures in the screening group compared with those in receipt of usual care.
In the UK around 536,000 people sustain fragility fractures every year, including 79,000 hip fractures. And co-author Professor Eugene McCloskey, of the University of Sheffield, said: ‘If the SCOOP screening strategy were taken up in exactly the same way as in the study in all UK women aged 70-85 years, we estimate that the strategy could prevent up to 8,000 hip fractures per year in the UK.’
Lead researcher Professor Lee Shepstone, of the University of East Anglia’s Norwich Medical School, added: ‘A hip fracture can be devastating with a loss of independence, and less than one third of patients make a full recovery. Mortality at one-year post-fracture is approximately 20 per cent.’ Shepstone L, et al. Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. The Lancet 2017.
Pelvic Floor...where it is, how it works....
Laugh out loud as you listen to Elaine Miller, Physiotherapist and Comedian, talking at the Edinburgh Fringe about the Pelvic Floor, How it works, what goes wrong and how to fix it when it leaks!
Pilates, Injury and Low Back Pain ..... There has been a lot of debate over the past 15 years about the effectiveness of Pilates based exercise for the management of Low Back Pain. Unfortunately, Pilates in itself, is not a registered profession, meaning that anyone can call themselves a 'Pilates Instructor' and the client does not have the benefit of a professional standard of conduct. So choosing a Pilates Instructor with an undergraduate qualification in Physiotherapy or similar, can provide greater assurance that the techniques taught will be based in a greater clinical appreciation of dysfunction.
The Health profession over the past decade has worked at researching how a modified programme of Pilates exercises, based on a wider knowledge of anatomy, pain psychology and musculo-skeletal dysfunction, may be beneficial in recovery from a wide range of injuries.
If you have questions or doubts about the efficacy of correctly taught Pilates techniques, below are links to the NICE website where you will find many research articles supporting the benefits of Pilates. NICE is The National Institute for Health and Care Excellence which provides national guidance and advice to improve health and social care.
Here is the evidence:
Understanding How Pain Works.....
Most of us will experience pain at some point in our lives. While some pain has a clear cause that can be remedied with appropriate treatment (this is generally acute pain), other pain can persist consistently or intermittently over a prolong period of time. This is chronic pain.
Low back pain is probably the most common form of chronic pain. Understanding Pain in less than 5 minutes, and what to do about it! is a brilliant presentation helping you to understand the process of chronic pain and how to help yourself manage it.
Stability starts with the feet ....
Our feet are our primary support in static postural stance and dynamic mobility. As humans, we have evolved the ability to stand upright to allow greater prehensile and dexterous development of our hands. Additionally humans have developed the ability to independently move our greater toes from the outer four toes. This important development aids our ability to propulse ourselves forward with greater control and balance.
Check out Dr Spina's video on how to build up your intrinsic foot muscles ... amazing workout that potentially could have repercussions for improved static and dynamic stability. Check out the comments. One suggested Dr Spina must be able to knit with his toes!
Chartered Society of Physiotherapy Falls Campaign ....
Risk of falling is not an inevitable consequence of ageing, but does have a direct correlation to activity levels. Did you know that from the age of 30 years, our muscle mass, on average, decreases by 8% per decade.... that amounts to quite a lot by the tie you reach 70!
The Chartered Society of Physiotherapists recently launched this publicity campaign designed to raise awareness of the need to start slowing this muscle mass loss at an earlier age.
Following the Youtube link to find out more.