Osteoporosis in Adult Patients with Intellectual and Developmental Disabilities: Special Considerations for Diagnosis, Prevention, and Management

Osteoporosis Knowledge and Awareness Among Patients and Accompanying Attendants: A Cross-Sectional Study in a Physical Medicine and Rehabilitation Department

INTRODUCTION

Osteoporosis is a common yet underdiagnosed condition that increases fracture risk and disability. It is particularly prevalent in individuals with musculoskeletal and neurological disorders due to factors like immobility and disuse. Despite its impact, awareness of osteoporosis remains low, especially in this high-risk population. This study aims to assess the knowledge of osteoporosis among patients with neurological and musculoskeletal disorders attending a Physical Medicine and Rehabilitation outpatient department (OPD). Using tools like the Osteoporosis Knowledge Assessment Tool- Hindi (OKAT-H), the study seeks to identify knowledge gaps and promote prevention and early detection.

MATERIALS AND METHODS

A cross-sectional study was conducted, involving 300 participants, including patients and accompanying attendants, who visited the OPD of Physical Medicine and Rehabilitation, aged 40 years and above. The sample size was calculated based on data from a previous study, resulting in a target of 292 participants. Socioeconomic status was assessed using the Modified Kuppuswamy scale, classifying participants into five classes. Osteoporosis awareness was measured using the OKAT-H.

RESULTS

 The mean OKAT-H score was found to be 9.82 out of 20 (49.1%), with a standard deviation of 5.06, ranging from a minimum score of 2/20 to a maximum of 20/20. Significant differences in OKAT-H scores were found in rural and urban populations (P value=0.001) and among the classes of socioeconomic status (P value=0.001) of the participants based on the Modified Kuppuswamy scale.

CONCLUSION

Our study using the OKAT-H scale revealed a significant knowledge gap regarding osteoporosis among individuals with neurological and musculoskeletal disorders, as well as their caregivers. This lack of awareness increases the risk of fractures and related complications. To address this, targeted educational programs should be implemented in the OPD of Physical Medicine and Rehabilitation departments, focusing on improving knowledge of osteoporosis, raising awareness of its risks and prevention, and educating individuals on fall prevention measures, the use of mobility and orthotic aids, and necessary home and workplace modifications.

Preparticipation and Sideline Evaluation of Athletes with Intellectual and Developmental Disability

ABSTRACT

Individuals with intellectual and developmental disability face several barriers to participation in sports and physical activity. Fortunately, there are opportunities for athletes with intellectual and developmental disability to participate in sport. Special Olympics continues to be the most prominent opportunity. Unfortunately, many physicians and other health care providers may feel underprepared to evaluate and treat athletes with intellectual and developmental disability. While national and international events often have a large number of resources available, access to medical care for athletes at local, regional, and state events can be variable. This paper will review medical coverage for state and regional Special Olympics events, including preevent preparation, preparticipation examination, common medical conditions among athletes with intellectual and developmental disability, and common injuries evaluated at local and state events.

The Effect of Bone Morphogenetic Protein 2 (BMP-2)/Estrogen Composite Nanoparticles on the Differentiation Function of Osteoporotic Bone Marrow Mesenchymal Stem Cells (BMSCs)

The menopausal hormone abnormal changes such as estrogen deficiency and increased FSH secretion in female patients in old age may cause osteoporosis which is plagued by patients. The pathogenesis of osteoporosis is not yet fully understood. BMP in the transforming growth factor-β superfamily is a key member in the process of bone growth and development, among which BMP-2 exerts critical roles. Impaired osteogenic differentiation of bone marrow mesenchymal stem cells (BMSC) contributes to the progress of osteoporosis. BMSC plays an indispensable role in treating osteoporosis and can develop into different directions through induction. As the regenerative medicine nanotechnology has become a new medical method, it is believed that BMSC can be used to treat osteoporosis and other related diseases. Our study analyzed the effects of BMP-2/estrogen composite nanoparticles on the proliferation and differentiation of osteoporotic BMSC cells to provide a reliable reference for the future treatment. Our results showed that BMP-2/estrogen composite nanoparticles promoted BMSC cell proliferation, increased ALP activity, decreased apoptosis rate, increased the expression of Col-1, Runx2 and Osterix, upregulated the osteogenic marker BMP-2. As confirmed by Alizarin Red staining, it could differentiate into osteoblasts and the content of Trap was decreased. In conclusion, our study confirms that BMP-2/estrogen composite nanoparticles can promote BMSC cell proliferation, osteogenic differentiation, and inhibit osteoclast differentiation, thereby providing new treatments and theoretical reference basis for treating osteoporosis.