In osteoporosis risk management, which combination best describes the recommended PT strategy?

• A. Encourage rapid increases in spinal loading.
• B. Place a primary focus on core strengthening without addressing loading patterns.
• C. Implement fall prevention, avoid extreme spinal flexion/rotation, and use progressive loading.
• D. Avoid any loading and rely on passive therapy.

Answer: (C)

In osteoporosis, the physical therapy approach centers on strengthening the body while guarding against fractures, using safe, progressive loading and strong fall-prevention measures. Progressive loading leverages how bone adapts to stress: gradually increasing weight-bearing and resistance helps bone density and muscle support improve over time, provided the movements stay within safe limits. At the same time, avoiding extreme spinal flexion and rotation protects the fragile vertebrae from bending and twisting forces that can trigger fractures. Pairing this with fall-prevention strategies—balance and gait training, safe home modifications, and control of risky movements—reduces the chance of a fracture if a fall does occur. Purely letting the spine rest or relying on passive therapy misses the stimulus bone needs and the functional gains from loading, while rushing high loads or restricting loading altogether can increase fracture risk. The best plan integrates safe, progressive loading with proactive fall prevention to improve both bone strength and functional safety.