How does chronic systemic corticosteroid use influence physical therapy management?

How does chronic systemic corticosteroid use influence physical therapy management?

• A. Increases risk of osteoporosis and slows tissue healing; adjust loading.
• B. Increases risk of osteoporosis, tendon weakness/rupture, infection, and slower tissue healing; modify loading and monitor bone health.
• C. Decreases infection risk and speeds healing; increase loading.
• D. Only increases energy levels.

Answer: (B)

Chronic systemic corticosteroid use affects bone health, tendon integrity, and tissue healing, which changes how you approach loading and monitoring in physical therapy. Steroids increase osteoporosis risk by inhibiting bone formation and remodeling, and they impair collagen synthesis and immune function, leading to slower soft-tissue healing and a higher infection risk. They also weaken tendons, raising the possibility of rupture under load. In practice, you modify loading to avoid aggressive, high-load or rapid progression early on, use gradual, low-impact, progressive resistance, and protect joints at risk; you also monitor bone health (screen for osteoporosis, consider bone-health strategies) and watch for signs of infection, adjusting the plan as healing progresses. This combination best reflects the need to address osteoporosis, tendon weakness/rupture, infection risk, and slower healing, rather than assuming normal healing or no systemic effects.