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Effects of a resistance and balance exercise programme on physical fitness, health-related quality of life and fear of falling in older women with osteoporosis and vertebral fracture: a randomized controlled trial

  • B. StanghelleEmail author
  • H. Bentzen
  • L. Giangregorio
  • A.H. Pripp
  • D. Skelton
  • A. Bergland
Original Article

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.

Keywords

Exercise Health-related quality of life Osteoporosis Physical fitness Vertebral fracture 

Notes

Acknowledgements

We are grateful to the participants for their contribution to the study and to the physiotherapists involved in the intervention and testing of the participants.

Funding

The study received internal funding from OsloMet-Oslo Metropolitan University. The funding body has no role in the design of the study, writing the manuscript, collecting data, analysis and interpretation of data. The study has no external funding.

Compliance with ethical standards

Conflicts of interest

None.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study has been approved by The Regional Committee for Medical Research Ethics in South East Norway (Ref. 2014/2050).

Informed consent

Written, informed consent was obtained from all individual participants included in the study.

Supplementary material

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2020

Authors and Affiliations

  1. 1.Institute of Physiotherapy, Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway
  2. 2.Leader of the Institute of Physiotherapy, Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway
  3. 3.Department of KinesiologyUniversity of Waterloo, Schlegel-UW Research Institute for AgingWaterlooCanada
  4. 4.Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway
  5. 5.School of Health and Life SciencesCentre for Living, Glasgow Caledonian UniversityGlasgowUK
  6. 6.Institute of Physiotherapy, Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway

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