Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures

Abstract

This randomized controlled trial was designed to investigate the effect of a 6-month home-based exercise program versus control (usual activities) on quality of life for postmenopausal women with osteoporosis who had at least one vertebral fracture. Twelve-month assessments of outcomes were completed to determine if women would continue exercising with minimal supervision and if benefit could be sustained. The home exercise program followed a "lifestyle exercise" approach where participants completed exercises 60 min per day, 3 days a week and could complete exercises in small periods of time throughout the day. Exercise activities included stretching, strength training and aerobics (i.e. walking). Participants were assessed at baseline, 6 months, and 12 months using the Osteoporosis Quality of Life Questionnaire (OQLQ), the Sickness Impact Profile (SIP), a balance test, and the Timed Up And Go test. Bone mineral density was assessed at baseline and 12 months for both the lumbar spine and femoral neck. Quality of life (OQLQ) improved over 6 months in the exercise group compared to the control group in the domains of symptoms (P=0.003), emotion (P=0.01) and leisure (P=0.03). Results from the balance test indicated a greater effect in the exercise group over 12 months (P<0.05). There were no significant differences between groups in measures of Timed Up and Go, SIP at 6 and 12 months, and femoral neck and lumbar spine bone mineral density at 12 months. Home-based exercise with minimal supervision improves quality of life in elderly women with vertebral fractures. Future research is needed to determine if home exercise programs reduce falls and fall-related injuries in the elderly.

Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture

“…A subsequent randomized controlled trial of unilateral training 7 days a week (where non-trained leg was used as the control) in adult males reported a significant effect of exercise on femoral neck BMD, but no statistically significant effect on lumbar spine BMD or total hip, which is consistent with the results of the metaanalysis [41]. There has been only one trial examining the effects of exercise on BMD in women with vertebral fractures; no significant between-group difference was reported, but there were sources of bias (e.g., subgroup analysis from larger trial, co-intervention with osteoporosis medication, high or unclear risk on other items) that may have affected the ability to detect an exercise effect [42]. The panel rated the overall quality of evidence supporting a positive effect of exercise on BMD as low for individuals with osteoporosis and very low for individuals with vertebral fractures.…”

“…Pooled analyses of two trials [45,46] revealed a small but significant between groups difference in favor of exercise for Timed Up and Go test performance. Yet, these findings should be viewed with caution given that two other trials not included in the pooled analysis did not find significant between-group differences, suggesting inconsistency in the reported effects [42,43]. Walking speed was reported in one trial; there was a small but significant effect in favor of exercise [46].…”

Effects of remote feedback in home-based physical activity interventions for older adults: A systematic review

“…Adherence was addressed in 22 studies [7,10,11,20,21,[23][24][25][27][28][29]31,32,35,37,41,[43][44][45][46][47][48]. Details on adherence are shown in Table 2.…”

Effects of a physical therapy program on quality of life among community-dwelling elderly women: randomized-controlled trial

“…In the Environment domain, it was observed two Different studies have already presented some improvement to quality of life after physical training programs. It was observed, for example, significant improvement to quality of life after a balance training program among elderly people with risk of falls (23); after a home training program among elderly women with vertebral fractures (24); and, after a water-based resistance and balance training among women with fibromyalgia (25).…”