Bone Health Protection Strategies Best Practices

1. Bone Health Protection StrategiesBest Practices • Hip protectors • Decrease the impact of a fall on the hip by either absorbing or shunting energy away from the hip • For those at risk of falling or have fallen, osteoporosis, have broken a hip, unsteady walking, dementia, independent transfers • Only work if they are on • Effective at reducing the risk of hip fracture, cost-effective treatment option women over 70 years1-4 • Need 23 residents wearing hip protectors to prevent 1 hip fracture4 Canadian Agency for Drugs and Technologies in Health (CADTH) 2010 Policy Guidance on Hip Protectors in Long-Term Care Colon-Emeric CS, Lyles KW, House P, et al. Randomized trial to improve fracture prevention in nursing home residents. Am J Med. 2007; 120:886-892 Colón-Emeric CS, Datta SK, Matchar DB. An economic analysis of external hip protector use in ambulatory nursing facility residents. Age Ageing 2003;32(1):47-52. Sawka AM, Boulos P, Beattie K, Thabane L, Papaioannou A, Gafni A, et al. Do hip protectors decrease the risk of hip fracture in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials. Osteoporos.Int. 2005 Dec;16(12):1461-1474. 1

2. Bone Health Protection StrategiesBest Practices • Activity and exercise Walking and weight-bearing exercises can • improve residents’ balance, muscle strength, physical endurance, body posture, bone mass, and • reduce pain and the risk for future fracture Weight bearing exercises • For residents who are mobile and can weight bear, beneficial exercise programs should focus on resistance, strengthening, balance, coordination and postural exercises • Take every opportunity to encourage residents to walk to meals and activities Giangregorio LM, Thabane L, Debeer J, Farrauto L, McCartney N, Adachi JD, et al. Body weight-supported treadmill training for patients with hip fracture: A feasibility study. Arch Phys Med Rehabil. 2009 Dec;90(12):2125-30. Papaioannou A, Adachi JD, Winegard K, Ferko N, Parkinson W, Cook RJ, et al. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int. 2003 Aug;14(8):677-82.Colón-Emeric CS, Datta SK, Matchar DB. An economic analysis of external hip protector use in ambulatory nursing facility residents. Age Ageing 2003;32(1):47-52. Webber CE, Papaioannou A, Winegard KJ, Adachi JD, Parkinson W, Ferko NC, et al. A 6-mo home-based exercise program may slow vertebral height loss. J ClinDensitom. 2003 Winter;6(4):391-400. Cameron ID, Murray GR, Gillespie LD, Robertson MC, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev. 2010 Jan 20;(1)(1):CD005465. 2