Objectives: To investigate whether a 12-week home-based programme of trunk-strengthening exercise could benefit spinal mobility, function and quality of life for osteoporotic and osteopenic postmenopausal women without fracture.
Designs: Randomized controlled clinical trial.
Setting: Department of Physical Therapy in National Taiwan University Hospital.
Subjects: Twenty-eight postmenopausal women (mean age 60.39=9.3 years) diagnosed with osteoporosis or osteopenia without fracture history were recruited for this study. Subjects were randomly assigned into exercise or control groups, each consisting of 14 subjects.
Interventions: The 12-week exercise programme included strengthening routines for the trunk extensor and flexor muscles. The subjects performed three sets of 10 repetitions for each of the exercises, with programmes carried out three times per day at home.
Main outcome measurements: Muscular strength, spinal range of motion (ROM) and motion velocity, Oswestry Disability Questionnaire (ODQ) and quality of life (QOL) were measured before the start and after completion of the exercise programme.
Results: Statistically significant improvements were demonstrated in spinal ROM and motion velocity in the sagittal and frontal planes for the exercise group (pB=0.05). Further, the strength of the trunk flexors and extensors increased after exercise training (pB=0.05). ODQ measure was significantly reduced in the exercise group (pB=0.05), while the controls showed no significant change. Subjects in the exercise group showed better satisfaction in some domains of the Short-Form-36 Health Survey quality of life questionnaire (pB=0.05).
Conclusions: This 12-week home-based trunk-strengthening exercise programme could improve trunk mobility and strength, and enhance QOL in osteoporotic and osteopenic postmenopausal women without vertebral fracture. Future study should recruit more cases or more severe subjects to verify the results.
Get full access to this article
View all access options for this article.
References
1.
1 Anonymous. Osteoporosis prevention, diagnosis and therapy. JAMA2001; 285: 785–95.
2.
2 Chien MY, Wu YT, Hsu AT, Yang RS, Lai JS. Efficacy of 24-week aerobic exercise program for osteopenic postmenopausal women. Calcif Tissue Int2000; 67: 443–48.
3.
3 Tsai KS, Chieng PU, Yang RS, Lee T. Prevalence of vertebral fractures in Chinese men and women in urban Taiwanese communities. Calcif Tissue Int1996; 59: 249–53.
4.
4 Melton LJ III. Perspectives: how many women have osteoporosis now?J Bone Miner Res1995; 10: 175–77.
5.
5 Kerr D, Morton A, Dick I, Deeg DJ, Lips P. Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res1996; 11: 218–25.
6.
6 Mazzeo RS, Cavanagh P, Evans WJ et al. American College of Sports Medicine position stand on exercise and physical activity for older adults. Med Sci Sports Exerc1998; 30: 992–1008.
7.
7 Gillespie LD, Gillespie WJ, Robertson MC et al. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev2001; 3: CD000340-CD000340.
8.
8 Tan J, Cubukcu S, Sepici V. Relationship between bone mineral density of the proximal femur and strength of hip muscles in postmenopausal women. Am J Phys Med Rehabil1998; 77: 477–82.
9.
9 Sinaki M, McPhee MC, Hodgson SF, Merritt JM, Offord KP. Relationship between bone mineral density of spine and strength of back extensors in healthy postmenopausal women. Mayo Clin Proc1986; 61: 116–22.
10.
10 Dornemann TM, McMurray RG, Benner JB, Anderson JJ. Effects of high-intensity resistance exercise on bone mineral density and muscle strength of 40–50-year-old women. J Sports Med Phys Fitness1997; 37: 246–51.
11.
11 Mitchell SL, Grant S, Aitchison T. Physiological effects of exercise on post-menopausal osteoporotic women. Physiotherapy1998; 84: 157–63.
12.
12 Nichols JF, Nelson KP, Peterson KK et al. Bone mineral density responses to high-intensity strength training in active older women. J Aging Phys Activity1995; 3:26–38.
13.
13 Pruitt LA, Taaffe DR, Marcus R. Effects of a one-year high-intensity versus low-intensity resistance training program on bone mineral density in older women. J Bone Miner Res1995; 10: 1788–95.
14.
14 Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJ Jr. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med1988; 108: 824–28.
15.
15 Tsauo JY, Chien MY, Yang RS. Spinal performance and functional impairment in postmenopausal women with osteoporosis and osteopenia without vertebral fracture. Osteoporosis Int2002; 13: 456–60.
16.
16 Lips P, Cooper C, Agnusdei D et al. Quality of life as outcome in the treatment of osteoporosis: The development of a questionnaire for quality of life by the European Foundation for Osteoporosis. Osteoporosis Int1997; 7:36 –38.
17.
17 Lips P, Cooper C, Agnusdei D et al. Quality of life in patients with vertebral fractures: validation of the quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporosis Int1999; 10: 150–60.
18.
18 Oleksik A, Lips P, Dawson A et al. Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res2000; 15: 1384–92.
19.
19 Tsai KS, Cheng WC, Chen CK et al. Effect of bone area on spinal density in Chinese men and women in Taiwan. Bone1997; 21: 547–51.
20.
20 Kemmler W, Engelke K, Lauber D, Weineck J, Hensen J, Kalender WA. Exercise effects on fitness and bone mineral density in elderly postmenopausal women: 1-year EFOPS results. Med Sci Sports Exerc2002; 34: 2115–23.
21.
21 Gronblad M, Hupli M, Wennerstrand P et al. Intercorrelation and test–retest reliability of the Pain Disability Index (PDI) and the Oswestry Disability Questionnaire (ODQ) and their correlation with pain intensity in low back pain patients. Clin J Pain1993; 9: 189–95.
22.
22 Ware JE, Snow KK, Kosinski MA, Gandek B. SF-36 Health survey manual and interpretation guide. Boston, MA: The Health Institute. 1993.
23.
23 Brazier JE, Harper R, Johns NMB et al. Validating the SF-36 health survey questionnaire: new outcome measures for primary care. BMJ1992; 305: 160–64.
24.
24 Langrana NA, Lee CK, Alexander H. Quantitative assessment of back strength using isokinetic testing. Spine1984; 9: 287–90.
25.
25 Marras WS, Fathallah FA, Miller RJ, Davis SW, Mirka GA. Accuracy of a three-dimensional lumbar motion monitor for recording dynamic trunk motion characteristics. Intern J Indus Ergonomics1992; 9:75 –87.
26.
26 Sashika H, Matsuba Y, Watanabe Y. Home program of physical therapy: effect on disabilities of patients with total hip replacement. Arch Phys Med Rehabil1996; 77: 273–77.
27.
27 Larsen J. Osteoporosis. In: Sapsford R, Bullock-Saxton J, Markwell S eds. Women's health –a textbook for physiotherapists. Philadelphia: WB Saunders Co., 1998: 434 –35.
28.
28 Sinaki M, Grubbs NC. Back strengthening exercises: quantitative evaluation of their efficacy for women aged 40 to 65 years. Arch Phys Med Rehabil1989; 70:16–20.
29.
29 Riggs BL, Melton III LJ. Osteoporosis: etiology, diagnosis, and management. Philadelphia: Lippincott-Raven, 1988.
30.
30 Marras WS, Wongsam PE. Flexibility and velocity of the normal and impaired lumbar spine. Arch Phys Med Rehabil1986; 67: 213–17.
31.
31 Adachi JD, Ioannidis G, Berger C et al. The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporosis Int2001; 12: 903–908.
32.
32 Cook DJ, Guyatt GH, Adachi JD et al. Development and validation of the Mini-Osteoporosis Quality of Life Questionnaire (OQLQ) in osteoporotic women with back pain due to vertebral fractures. Osteoporosis Quality of Life Study Group. Osteoporosis Int1999; 10: 207–13.
33.
33 Guyatt GH, Eagle DJ, Sackett B et al. Measuring quality of life in the frail elderly. J Clin Epidemiol1993; 46: 1433–44.
34.
34 Lydick E, Zimmerman SI, Yawn B et al. Development and validation of a discriminative quality of life questionnaire for osteoporosis (The OPTQoL). J Bone Miner Res1997; 12: 456–63.
35.
35 ACSM position stand on osteoporosis and exercise. Med Sci Sports Exerc1995; 27:i–vii.
36.
36 Kerschan K, Alacamlioglu Y, Kollmitzer J et al. Functional impact of unvarying exercise program in women after menopause. Am J Phys Med Rehabil1998; 77: 326–32.
37.
37 Lau EMC, Woo J, Leung PC, Swaminthan R, Leung D. The effects of calcium supplementation and exercise on bone density in elderly Chinese women. Osteoporosis Int1992; 2: 168–73.
