# PWR-034 — Bone adaptation: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 11 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Common household or practice equipment — Qualified provider and stable rack or approved loading device; Fixed-height heavy box or bench; Provider-selected bar/load and safety supports; Training log plus site-specific DXA/clinical record when ordered; A bone-loading record for site-specific goal, exercise, rack and box setup, stance, load, spotting, repetitions, technique, symptoms and separately scheduled bone outcomes. Space: Room-scale practice space Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Bone adaptation is change in bone density, geometry or fracture outcome at a named site over time. This lesson teaches one provider-controlled loading method used inside a broader bone-health programme: a squat to a fixed box with the load chosen and spotted by a qualified professional. The learner sets the feet, receives the load, sits the hips down under control, touches the box without collapsing, stands through the feet and returns the load on command. The provider controls clinical clearance, exercise choice, load, depth, repetitions, impact exposure and progression. Target outcome: The learner completes the provider-prescribed squat-to-box set with stable stance, controlled depth and return to the rack, while load and symptoms are recorded separately from site-specific DXA outcomes. ### Authority and setup conditions - Tell the provider about osteoporosis/osteopenia, fracture, falls, pain, balance limits, surgery and medicines affecting bone or dizziness. - Confirm box height, stance, load, rack/safety positions, repetitions and rack command. - Practise the unloaded path and safe abort before receiving any load. - Set the rack height, fixed box, stance and spotting position before loading. Rehearse a controlled box touch at an easy resistance and continue only when the whole setup matches the bone-loading plan. - Rehearse receiving the load, sitting the hips toward the fixed box and standing without rocking at an easy provider-selected resistance. ### Required or supplied materials - Qualified provider and stable rack or approved loading device - Fixed-height heavy box or bench - Provider-selected bar/load and safety supports - Training log plus site-specific DXA/clinical record when ordered - A bone-loading record for site-specific goal, exercise, rack and box setup, stance, load, spotting, repetitions, technique, symptoms and separately scheduled bone outcomes. ## 1. Set rack and box The provider fixes box height and safety supports, then the learner places feet on recorded marks before taking load. Why: Depth and safety equipment define the task. Success check: The box, rack and stance match the plan. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The box, rack and stance match the plan.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Receive and settle the load Take the provider-selected load in the taught position, step or position only as instructed and become still before squatting. Why: Movement under an unsettled load increases loss-of-balance risk. Success check: The load is centred and the learner confirms ready. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The load is centred and the learner confirms ready.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Begin with hips and knees Bend hips and knees together, keep the whole foot planted and let knees track with toes; breathe using the provider-taught pattern. Why: A controlled descent keeps the load over the support base. Success check: Feet stay flat and the trunk remains inside the taught range. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Feet stay flat and the trunk remains inside the taught range.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Touch the box without collapsing Descend only until a light controlled box touch; do not drop, fully relax or rock backward. Why: The box is a depth marker, not a seat for momentum. Success check: Contact is quiet and body tension remains controlled. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Contact is quiet and body tension remains controlled.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Stand through the floor Push through both feet and extend hips and knees together without knees collapsing or one side leading. Why: Uneven or twisting ascent changes the loading pattern. Success check: The learner rises smoothly to the declared finish. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner rises smoothly to the declared finish.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Reset or stop Take the prescribed breath/reset at the top and repeat only while stance, depth and speed meet the rule; stop at first technical failure. Why: Bone-loading dose should not be filled with uncontrolled repetitions. Success check: Every counted repetition is valid; the visible 'Reset or stop' check is satisfied. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Every counted repetition is valid; the visible 'Reset or stop' check is satisfied.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Rack only on command After the set, wait for the provider's rack cue, move into the support and confirm the load is secure before releasing it. Why: The return is a high-consequence part of the lift. Success check: Both supports hold the load and the learner steps clear safely. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Both supports hold the load and the learner steps clear safely.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.