Effects of an 18-month community-based, multifaceted, exercise program on patient-reported outcomes in older adults at risk of fracture: secondary analysis of a randomised controlled trial

Abstract

Summary This study identified that an 18-month community-based, multifaceted, exercise program consisting of resistance, weight-bearing impact, and balance/mobility training combined with osteoporosis education and behavioural support can improve health-related quality of life (HRQoL) and osteoporosis knowledge in older adults at risk of fracture, but only for those adherent to the exercise regime. Purpose To evaluate the effects of an 18-month community-based exercise, osteoporosis education and behaviour change program ( Osteo-cise: Strong Bones for Life ) on HRQoL, osteoporosis knowledge and osteoporosis health beliefs. Methods This was a secondary analysis of an 18-month randomised controlled trial in which 162 older adults aged ≥ 60 years with osteopenia or increased falls/fracture risk were randomized to the Osteo-cise program ( n = 81) or control group ( n = 81). The program consisted of progressive resistance, weight-bearing impact and balance training (3 days/week); osteoporosis education to facilitate self-management of musculoskeletal health and behavioural support to enhance adherence to exercise. HRQoL, osteoporosis knowledge and osteoporosis health beliefs were assessed using the EuroQoL questionnaire (EQ-5D-3L), Osteoporosis Knowledge Assessment Tool and Osteoporosis Health Belief Scale, respectively. Results Overall, 148 participants (91%) completed the trial. Mean exercise adherence was 55% and mean attendance for the three osteoporosis educational sessions ranged from 63-82%. After 12 and 18 months, there were no significant effects of the Osteo-cise program on HRQoL, osteoporosis knowledge or health beliefs relative to controls. Per protocol analyses (≥ 66% exercise adherence; n = 41) revealed a significant net benefit in EQ-5D-3L utility for the Osteo-cise group relative to controls after 12 months ( P = 0.024) and 18 months ( P = 0.029) and a significant net improvement in osteoporosis knowledge scores at 18 months ( P = 0.014). Conclusion This study supports the importance of adherence to exercise regimes, as adherence to the Osteo-cise: Strong Bones for Life program was associated with improvements in HRQoL and osteoporosis knowledge in older adults at increased risk for falls and fractures. Trial registration number: ACTRN12609000100291. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-023-06693-y.

Benefits of a family-based care transition program for older adults after hip fracture surgery

“…In a separate study, the results indicated that continuity of care after discharge could enhance postoperative QoL in elderly individuals with HF [ 12 ]. Although the results of the present study indicated that the FBCTP was effective in improving the HRQoL of older adults after HFS, different outcomes were observed in another study in which an 18-month community-based exercise, osteoporosis education, and behavior change program failed to improve the HRQoL of older adults at risk of fracture [ 31 ]. One of the potential explanations for the observed differences in outcomes is the continuation of the program through telephone consultations and home visits, which have been shown to improve HRQoL within 8 weeks.…”