• “Bone Building and Protection Program: Evidenced Based Physical Therapy Program for People with Osteoporosis” presented by Stephanie Olson PT

• Treasurer – Janice Devine-Ruggles: 
  • $1892.26 – checking account
  • NWD donated money; previous Central WI Ortho Study Group donated $1200
  • Ethics course Oct 2009 cost $222 more than income due to food and mileage
  • Allotment from WPTA slightly less than last year
• Branding Representative – Stephanie Mikolicek
  • Starting work locally and planning to work throughout district as year progresses

• Videoconferences: 5 sites currently
  • Local contacts: Dave Smith (lead contact) – Marshfield, Dennis Kaster (Stevens Point), Denise Kearns-Legoo (Minocqua), Amy Pearson (Park Falls), Brad Jordan (Weston)
  • Looking to add sites but keep manageable (? Rhinelander, Wisconsin Rapids, Ashland area)
    • Attendees from Wisconsin Rapids voiced that drive to Stevens Point is workable
  • Increase participation from outreaches of district – Ashland area/up north
    • Stephanie Mikolicek proposed attending staff meetings or having meetings at facilities in those areas to reach out
  • Members encouraged to pass word along to colleagues
• WPTA update
  •  purchased building/office in Madison – investment
• Legislative Update (Brett Roberts)
  • PT Examining Board Bill –  out of Assembly, expecting Senate passage and Governor to sign in near future
  • WATA/LAT Bill –  WPTA now neutral on bill
    • Redefined language through negotiations; see WPTA website for details
  • Needle EMG no longer threatened in Wisconsin
  • Future issues:
    • Orthotists/Prosthetists organizing for potential control of specific CPT codes
    • Naturopathic Physicians organizing
  • Thanks to Jason Johns (WPTA lobbyist) for all his work
  • Erik Jacobs (Conduit Co-Chair) – recommended members consider donation to assist legislative efforts
• CEU requirements: due in February 2011
  • Prorated for year: PT 20 hours (4 hours Ethics); PTA 13 hours (4 hours Ethics)
• NCD Ethics Course – discussion about options/plans
  • 2 or 4 hour courses; 1 or 2 courses?
  • ? videoconference option – can generate many sites with one speaker, but poor feedback in past in NWD; good feedback for NCD conference this past fall (no videoconference)
  • Goal is to do a course this coming fall
• Social Event - Discussion
  • WPTA Spring Conference in Green Bay (April 15-17) – Teresa Timmerman to contact WPTA; email notice for plan to follow from NCD Secretary, Dave Smith

• 3^rd Tuesday of February, May, and November of each year
• Possible CEU courses also, specifically Ethics
• NEXT MEETING: May 18, 6-8 pm

Bone Building and Protection Program:

Evidence Based Physical Therapy Program for People with Osteoporosis

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This physical therapy program has been designed for people who have osteoporosis, either recently diagnosed or long standing. It is based on results of controlled research studies of physical therapy interventions which showed:

1. Stimulation of bone growth and increased bone mineral density (BMD). BMD will stay the same or increase 2 to 3%  

      (Note: These results were independent of response to osteoporosis medications.)

2. Improved function in daily activities
3. Reduce the risk of  fractures
4. Reduce the risk of injury causing falls

This program has been designed with four levels of difficulty to allow the therapist to safely treat clients with different levels of severity:

Acute Fracture: Hospitalized with acute fracture and pain. Client needs assist with      ADL’s and mobility.

Frequency of treatment: Twice a day, Monday through Friday, daily on weekends and holidays. Work with nursing for positioning and safe mobility.

Level 1: Person with an acute compression fracture or person with a history of multiple

             compression fractures of the spine and moderate to severe postural deformity.

Frequency of treatment: once or twice per week until functional goals are met, usually 6 weeks post fracture.

Level 2: Healed compression fracture, mild postural deformity

Frequency of treatment: once or twice a week for 2 to 3 weeks until goals are met and client demonstrates understanding and compliance with program.

Level 3: Healed compression fracture (or other fracture such as hip) with no postural deformity.

Frequency of treatment: One or two sessions over 2 to 4 weeks for instruction and demonstration of understanding and compliance.

Level 4: Diagnosed with osteoporosis but no fractures

Frequency of treatment: One or two sessions over 4 weeks for instruction and

            client demonstration of understanding and compliance.

The therapy program will include:

1. Instruction in proper body mechanics with focus on positions and motions which increase the risk of fracture in osteoporotic bone.
2. Postural instruction
3. Balance exercises to reduce fall risk
4. Safe stretches and stretches to avoid
5. Impact loading to stimulate bone growth and increase bone mineral density
6. Safe strengthening exercises, specifically designed for each level of severity and modified for each client’s personal needs and limitations

Key References:

Ayalon, J., Simkin, A., Leichter, I. & Shlomit, R.; Dynamic Bone Loading Exercises for Postmenopausal Women: Effect on the Density of the Distal Radius; Arch Phys Med Rehabil, Vol 68, May 1987.

Braith, R.W., Magyari, P.M., Fulton, M.N., Aranda, J., Wlaker, T., Hill, J.A.; Resistance Training and Alendronate Reverse Glucocorticoid Induced Osteoporosis in Heart Transplant Recipients; Journal of Heart and Lung Transplantation, Vol. 22, no 10, pp1082-1090.

Cussler, E., Lohman, T.G., Going, S.B., Houtkooper, L.B., Metcalfe, L.L., Glint-Wagner, H.G., Harries, R.B. & Teixeira, P.J.; Weight Lifting in Strength Training Predicts Bone Changes in Postmenopausal Women; Medicine & Science in Sports & Exercise; Sept, 2002, pp 10-17.