Abstract

Summary

Exercise is recommended for people with osteoporosis, but the effect for people who have suffered vertebral fracture is uncertain. This study shows that a multicomponent exercise-program based on recommendations for people with osteoporosis improved muscle strength, balance, and fear of falling in older women with osteoporosis and vertebral fracture.

Introduction

Guidelines for exercise strongly recommend that older adults with osteoporosis or osteoporotic vertebral fracture should engage in a multicomponent exercise programme that includes resistance training in combination with balance training. Prior research is scarce and shows inconsistent findings. This study examines whether current exercise guidelines for osteoporosis, when applied to individuals with vertebral fractures, can improve health outcomes.

Methods

This single blinded randomized controlled trial included 149 older women diagnosed with osteoporosis and vertebral fracture, 65+ years. The intervention group performed a 12-week multicomponent exercise programme, the control group received usual care. Primary outcome was habitual walking speed, secondary outcomes were physical fitness (Senior Fitness Test, Functional Reach and Four Square Step Test), health-related quality of life and fear of falling. Descriptive data was reported as mean (standard deviation) and count (percent). Data were analyzed following intention to treat principle and per protocol. Between-group differences were assessed using linear regression models (ANCOVA analysis).

Results

No statistically significant difference between the groups were found on the primary outcome, walking speed (mean difference 0.04 m/s, 95% CI − 0.01–0.09, p = 0.132). Statistically significant between-group differences in favour of intervention were found on FSST (dynamic balance) (mean difference − 0.80 s, 95% CI − 1.57 to − 0.02, p = 0.044), arm curl (mean difference 1.55, 95% CI 0.49–2.61, p = 0.005) and 30-s STS (mean difference 1.85, 95% CI 1.04–2.67, p < 0.001), as well as fear of falling (mean difference − 1.45, 95% CI − 2.64 to − 0.26, p = 0.018). No statistically significant differences between the groups were found on health-related quality of life.

Conclusion

Twelve weeks of a supervised multicomponent resistance and balance exercise programme improves muscle strength and balance and reduces fear of falling, in women with osteoporosis and a history of vertebral fractures.

Trial registration

ClincialTrials.gov Identifier: NCT02781974. Registered 25.05.16. Retrospectively registered.

中文翻译：

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抵抗与平衡锻炼计划对骨质疏松症和椎骨骨折老年妇女身体健康，健康相关生活质量和跌倒恐惧的影响：一项随机对照试验

摘要

概要

建议骨质疏松症患者进行运动，但对于椎骨骨折的患者效果尚不确定。这项研究表明，针对骨质疏松症患者的一项基于建议的多组分运动计划可改善患有骨质疏松症和椎体骨折的老年妇女的肌肉力量，平衡能力和跌倒的恐惧感。

介绍

运动指南强烈建议患有骨质疏松症或骨质疏松性椎体骨折的成年人应参加一项多组分运动计划，其中包括阻力训练和平衡训练。先前的研究很少，并且发现不一致的结果。这项研究检查了当前针对骨质疏松症的运动指南，如果将其应用于椎骨骨折患者，是否可以改善健康状况。

方法

这项单盲，随机对照试验包括149名65岁以上被诊断患有骨质疏松症和椎体骨折的老年妇女。干预组进行了为期12周的多成分运动计划，对照组接受了常规护理。主要结局是习惯性的步行速度，次要结局是身体适应性（高级适应能力测验，功能触及和四方形步幅测验），与健康相关的生活质量和对跌倒的恐惧。描述性数据报告为平均值（标准偏差）和计数（百分比）。按照意向性原则和方案对数据进行分析。使用线性回归模型（ANCOVA分析）评估组间差异。

结果

两组在主要结局，行走速度方面均无统计学差异（平均差异为0.04 m / s，95％CI-0.01-0.09，p  = 0.132）。在FSST（动态平衡）上发现了有统计学意义的干预差异（均值-0.80 s，95％CI-1.57至-0.02，p  = 0.044），臂弯（均值1.55，95％CI 0.49） –2.61，p  = 0.005）和30-s STS（平均差异1.85，95％CI 1.04–2.67，p  <0.001），以及害怕跌落（平均差异− 1.45，95 ％CI − 2.64至− 0.26，p  = 0.018）。在与健康相关的生活质量上，两组之间没有统计学上的显着差异。

结论

在患有骨质疏松症和椎体骨折病史的女性中，有十二个星期进行了有监督的多成分抵抗和平衡运动计划，可以改善肌肉力量和平衡，并减少跌倒的恐惧感。

试用注册

ClincialTrials.gov标识符：NCT02781974。注册25.05.16。追溯注册。