Fragility fracture prevention has been historically associated with the diagnosis and treatment of osteoporosis. Given that the strongest determinant of fracture is falls, it is critical to add fall risk into clinical decision-making guidelines for fracture prevention. This special interest paper proposes an algorithm based on 2 validated tools: (1) World Health Organization's Fracture Risk Assessment Tool, which evaluates probability of fracture and (2) Functional Gait Assessment, which evaluates fall risk. Physical therapists can use this algorithm to better identify patients at greatest risk for fracture in order to customize interventions designed to promote bone health, minimize falls, and ultimately prevent fractures. Recommendations for referral, patient education, and exercise are provided for categories of varying fall and fracture risk.
With increasing evidence that life-style is an important influence on health, three nursing faculty members at the University of Minnesota implemented a learning project to enable students to assess, plan, and evaluate their own life-styles. The goal was to have the students attempt to make positive changes. As part of a "health concepts" nursing course, students became much more aware of social, economic, environmental, and cultural factors that either enhanced or detracted from their ability to achieve their ideal life-styles. The students responded favorably to this assignment because of the potential benefits of investing in themselves while pursuing the rigorous program leading to a nursing degree.
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