Evidence-based Exercise Program for Osteoporotic Fracture Prevention [Interview][Transcript]

Guest: Dr. Belinda Beck

Presenter: Tabetha Moreto

Guest Bio: Belinda Beck is a Professor at Griffith University in the School of Allied Health Sciences and the Menzies Health Institute Queensland and a Director of The Bone Clinic. She graduated from The University of Queensland (BHMS[Ed]) and from the University of Oregon (MSc and PhD) where she studied sports medicine and exercise physiology. She completed a postdoctoral research fellowship in the Stanford University School of Medicine (CA, USA). Her work, primarily related to the effects of mechanical loading on bone, has involved both animal and human models, from basic to clinical research. Her particular focuses have been exercise interventions for the prevention of osteoporosis and fracture in old age, and the prevention and management of bone stress injuries in the military. Her work has involved observational and clinical trials in exercise and vibration training across the lifespan. She recently co-founded The Bone Clinic, an innovative translational research facility and health service with a focus on safe and efficacious exercise for osteoporosis.

Segment overview: In today’s Health Supplier Segment, we welcome The Bone Clinic co-founder Dr. Belinda Beck here to share information about the research and exercise program they have been conducting. The Bone Clinic is the first of its kind in Australia (actually the world), and provides inclusive care from physical evaluation to practical treatment; including bone density tests, supervised exercise programs, dietary guidance, and education – all in one location. Ahead of its second birthday, The Bone Clinic invited long-term clients to assess their progress after following their individualised programs for over a year. They predict that the evidence-based exercise program is decreasing the amount of falls by 70% per year and fractures by 95% within 12 months.

TRANSCRIPT

Tabetha Moreto: Hello everyone. You’re listening to Health Professional Radio. I’m your host for today Tabetha Moreto. Our guest today is Dr. Belinda Beck. She recently co-founded the Bone Clinic which is an innovative translational research facility and health service with a focus on safe and effective exercise for osteoporosis. With all that said, welcome to the show Belinda. It’s a pleasure to have you here.

Dr. Belinda Beck: Thanks. It’s a pleasure to be here.

T: So Belinda, can you please explain exactly what is osteoporosis and what causes this?

B: Well in lay terms, osteoporosis is a condition where people have reduced bone and what that means is they are more at risk of fracture from things that ordinarily wouldn’t cause a fracture and we call them ‘minimal trauma fractures’. So, sometimes when it’s very bad, people can even fracture just by sneezing but things that are a little more related to strength would be perhaps picking up a grandchild or carrying very heavy shopping bags. So, oftentimes those factors occur in the spine and they can result in that Dowager’s hump shape that we’re all familiar with. But more and more dramatic kind of fractures at the hip and that is the one that most of us are very concerned about, because that really reduces people’s independence and their quality of life.

T: I see. So can you please share with us what is the latest development happening at the Bone Clinic?

B: Well, the Bone Clinic is a translational research facility where we apply the outcomes of an evidence-based exercise intervention to enter the real world basically. If we use, we’ve studied the effects of exercise on bone and on osteoporosis and the results have been pretty unremarkable and many doctors think that because of those results that exercise is not really a useful therapeutic intervention but the reality is, in the past, we’ve been testing the wrong kind of exercise. So, we think that we have finally found the right recipe and it’s a pretty high-intensity form of exercise and the reason why we have opened the clinic is because it’s a bit of a catch-22 because we have very low biomass predisposing to an increased risk of fracture, if you do high-intensity exercise, you must do it when you’re supervised and using very correct technique. So, the Bone Clinic provides the location to do that with highly trained coaches on an 8:1 ratio. So, we don’t have these huge exercise classes. Everybody is watched and we deliver this evidence-based exercise program to improve people’s bone and reduce their risk of fracture.

T: Wow, it sounds like you’re doing wonderful things at the Bone Clinic. I’m very fascinated with this information. So, can you tell me, how can I find out for example if I have weak bones and what can I do to prevent osteoporosis?

B: Well, if you’re clever, you consult your doctor and he’ll ask you about certain risk factors that you may have for example family history or those kinds of things. If there’s a risk, then they will send you for a bone density test. And that scan will tell you whether you’ve got high or low bone mass and how that compares to people who are roughly your own age and gender. And if it’s low, then there are actually criteria that will categorize you as osteoporosis. And then, your doctor would probably refer you to a facility either like ours. There are not terribly many of those I have to say, or they’ll prescribe medications and probably talk to you about your diet.

T: Very good information. So Belinda, can you tell me what specific kind of people are more prone in getting osteoporosis? Is it based on gender? Do more women get it than men?

B: Yes. There are definitely some very distinctive risk factors. Age is the biggest risk factor because as we age, we tend to lose bone. We have the most bone we’re ever going to have really between the age of 20 and 30. And after that unfortunately, it’s all downhill. So, age is the biggest risk factor. Being female is also a very profound risk factor and if you look at your parents, and your grandparents, see anybody that has that typical Dowager’s hump that means that genetically, you’re probably predisposed. If you find as you’re aging that you’re losing height, a considerable amount of height, then that may also be indicative of some vertebral fractures and osteoporosis.

T: Okay. Thank you for sharing that information. Now Belinda, can you tell me what is the biggest misconception about osteoporosis that you want to clear today?

B: Well, I suppose the one that’s most relevant to us is this misconception that exercise can’t help you. Most people think that the best that exercise can do is help you sort of maintain bone. But we know now that just a very specific kind of exercise can make you grow bone. But most importantly, we know that the majority of osteoporotic factors are a direct result of our fall and the reason why falls occur is because of muscle weakness, lower extremity muscle weakness. So, not only are the exercises really important for building bone but they’re important for building muscle strength and preventing fall.

T: Wow. That’s very interesting. Thank you so much for clearing up that misconception Belinda because to tell you the truth, I myself believe that misconception before regarding you can’t exercise when you have osteoporosis or you can’t move too much. So, thank you very much. I really appreciate you clearing up that misconception.

B: You’re welcome.

T: So, now Belinda, this is interesting. What got you interested in the Bone Clinic and osteoporosis?

B: Well, I suppose, as an academic and a scientist for years, I’ve been interested in the effect of mechanical loading on both. Partly because as an athlete, I used to suffer from stress fractures and so, I began looking at the effect of too much exercise on bone. But it became very obvious to me throughout my research career that problem of osteoporosis was a far more profound one. Stress factors will eventually heal themselves but osteoporosis, if nothing is done will just get worse. And in fact, for men, having an osteoporotic factor at the hip has a relatively high likelihood of causing death particularly as men at very old age. So, it can be a really very mortal injury, not possibly acutely, but the effects of somebody becoming bedridden or losing their independence, certainly many people end up in nursing homes after they’ve had a hip fracture. It is a condition that I see my friends and relatives developing and so, I suppose just wanting to make a difference, make sure I head with those research directions. I have many students who are also interested in the field and so we look at all sorts of other elements in relation to the disease such as vitamin D and calcium and their relationship to somebody’s risk for developing the condition.

T: A while ago, you mentioned about the importance of exercise and physical activity. So, can you explain why is physical activity very important when it comes to managing osteoporosis?

B: Well, I suppose there’s definitely two ways to look at that question. The first one is, if you load bone up, it tends to adapt. If you unload bone, like you send an astronaut into space, you lose bone because the skeleton perceives that it doesn’t need to be strong. But if you load it up with extra exercise, it recognizes that it needs to be strong so it’s not injured. So, the very natural response and we can harness that to treat osteoporosis by loading the bones so to adapt. But as I mentioned before, falls are so incredibly important to the cause of osteoporotic fracture. Exercise is absolutely vital for maintaining lower extremity strength by exercising the muscle and that way preventing falls, that actually causes the fractures. I mean 90% of hip fractures are a direct result of a fall. You may have very loud bone mass but if you never fall you may not ever really suffer from one of these osteoporotic fractures. So, the falls are absolutely vital and I can’t emphasize that enough.

T: Yes. Thank you so much Belinda for sharing this information with us. Now, can you tell us what is your main takeaway message to all of our listeners out there?

B: Well, you are never too old to exercise even if you have a diagnosis of osteoporosis. Exercise is extremely important to preventing osteoporotic fracture. If you want to exercise to the extent that you will grow bone, you need to do that in a supervised manner and that’s the sort of exercise that we do at the Bone Clinic. But, if you just want to prevent falls and virtually, any form of muscle strengthening exercise will be good for you and is highly recommended. If you’re very, very frail and you’re not able to walk a lot and then you have to make sure that you walk with somebody that can help prevent you from falling.

T: Fantastic message Belinda. Thank you so much. And now for our last question for today, what’s the best way to contact you guys at the Bone Clinic?

B: Well, there’s a couple of ways. If you’re local, you can call our our phone number which is 3391 5510. But otherwise, just going to our Bone Clinic website which is just theboneclinic.com.au. We’ve got all the information on there. Lots of information about what we do, what our exercise schedule is, how we run the research side of things, who our staff are, where we are of course and also some really important testimonials from people who go talking about their experience there and the results that they’ve gained after training with us.

T: Okay. Thank you so much Belinda and thank you for coming on the show. I really appreciate your time.

B: You’re welcome. My pleasure.

T: Ladies and gentlemen, and that was Belinda Beck from the Griffith University in the School of Allied Health Sciences and co-founder of the Bone Clinic. We been just talking about the Bone Clinic and osteoporosis. If you like this interview, transcripts and archives are available at www.hpr.fm. We are on all social media platforms so don’t forget to follow, like and subscribe. We’re also available for download on SoundCloud and iTunes. I’m Tabetha Moreto and you’re listening to Health Professional Radio.

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