Skip to main content
Top
Published in: Osteoporosis International 8/2016

01-08-2016 | Original Article

Effect of twelve-month physical exercise program on patients with osteoporotic vertebral fractures: a randomized, controlled trial

Authors: L. Evstigneeva, O. Lesnyak, I. E. M. Bultink, W. F. Lems, E. Kozhemyakina, E. Negodaeva, G. Guselnikova, A. Belkin

Published in: Osteoporosis International | Issue 8/2016

Login to get access

Abstract

Summary

We performed a randomized clinical trial to evaluate the effect of a 12-month physical exercise program on quality of life, balance, and functional mobility in postmenopausal women with osteoporotic vertebral fractures. All three outcomes improved in the intervention group and were better than in the controls.

Introduction

Th aim of this study was to evaluate the effectiveness of a structured physical exercise intervention on quality of life, functional mobility, and balance in patients with osteoporotic vertebral fractures and back pain.

Methods

Seventy-eight postmenopausal women with vertebral fractures were randomized into an exercise group (n = 40) and a control group (n = 38). The mean age was 69.2 ± 7.7 years. All women had at least one osteoporotic vertebral fracture and suffered from chronic back pain. Patients with a history of vertebral and non-vertebral fracture within the past 6 months were excluded. The 40-min exercise program was conducted twice weekly for 1 year. Participants in the control group were instructed to continue their usual daily activities. Participants were assessed at baseline and at 12 months using the Quality of Life Questionnaire (QUALEFFO-41). Balance was measured with the Balance Master® System NeuroCom® and functional mobility was measured with the “timed up and go” test and “sit-to-stand” test.

Results

Total QUALEFFO-41 score after 12 months was significantly better in the exercise group (44.2 ± 7.5) compared to the control group (56.6 ± 9.4), p < 0.0001. Quality of life improved in domains: “Pain”, “Physical function: Jobs around the house”, “Physical function: Mobility”, “Social function”, “General health perception” in the exercise group as compared to the control group. After 12 months, balance as assessed by “Tandem Walk and Sway” became significantly better in the exercise group as compared to the control group (p = 0.02). A significant improvement in the “timed up and go” test (p = 0.02) and the “sit-to-stand” test (p = 0.01) was shown in the exercise group compared to the control group.

Conclusions

This is the first 12 month-randomized clinical trial of exercise in osteoporotic women with a vertebral fracture that demonstrates improvement of three key outcome measures: quality of life, functional mobility, and balance.
Literature
1.
go back to reference WHO (2003) WHO Scientific Group on the Prevention and Management of Osteoporosis. Prevention and management of osteoporosis: report of WHO scientific group. WHO Technical Report Series 2003: Vol. 921 WHO (2003) WHO Scientific Group on the Prevention and Management of Osteoporosis. Prevention and management of osteoporosis: report of WHO scientific group. WHO Technical Report Series 2003: Vol. 921
2.
go back to reference Mikhailov E, Benevolenskaya LI, Mylov NM (1997) Incidence of vertebral fractures in population sample of individuals aged 50 years and older. Bull Traumatol Orthop NN Priorov 3:20–27, in Russian Mikhailov E, Benevolenskaya LI, Mylov NM (1997) Incidence of vertebral fractures in population sample of individuals aged 50 years and older. Bull Traumatol Orthop NN Priorov 3:20–27, in Russian
3.
go back to reference Evstigneeva LP, Lesnyak OM, Piven AI (2001) Epidemiology of osteoporotic vertebral fractures according to X-ray and morphometric analysis among population sample of citizens of Ekaterinburg aged 50 years and older. Osteoporos Osteopathy 2:2–6 (in Russian) Evstigneeva LP, Lesnyak OM, Piven AI (2001) Epidemiology of osteoporotic vertebral fractures according to X-ray and morphometric analysis among population sample of citizens of Ekaterinburg aged 50 years and older. Osteoporos Osteopathy 2:2–6 (in Russian)
4.
go back to reference Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRefPubMed Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRefPubMed
5.
go back to reference Haczynski J, Jakimiuk A (2001) Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit 7:1108–1117PubMed Haczynski J, Jakimiuk A (2001) Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit 7:1108–1117PubMed
7.
go back to reference Body JJ, Bergmann P, Boonen S et al (2010) Evidence-based guidelines for the pharmacological treatment of postmenopausal osteoporosis: a consensus document by the Belgian Bone Club. Osteoporos Int 21:1657–1680CrossRefPubMedPubMedCentral Body JJ, Bergmann P, Boonen S et al (2010) Evidence-based guidelines for the pharmacological treatment of postmenopausal osteoporosis: a consensus document by the Belgian Bone Club. Osteoporos Int 21:1657–1680CrossRefPubMedPubMedCentral
8.
go back to reference MacLean C, Newberry S, Maglione M et al (2008) Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med 148:197–213CrossRefPubMed MacLean C, Newberry S, Maglione M et al (2008) Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med 148:197–213CrossRefPubMed
9.
go back to reference Liu-Ambrose TY, Khan KM, Eng JJ, Lord SR, Lentle B, McKay HA (2005) Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass. Osteoporos Int 16:1321–1329CrossRefPubMed Liu-Ambrose TY, Khan KM, Eng JJ, Lord SR, Lentle B, McKay HA (2005) Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass. Osteoporos Int 16:1321–1329CrossRefPubMed
10.
go back to reference Burr J, Shephard R, Cornish S, Vatanparast H, Chilibeck P (2012) Arthritis, osteoporosis, and low back pain: evidence-based clinical risk assessment for physical activity and exercise clearance. Can Fam Physician 58(1):59–62PubMedPubMedCentral Burr J, Shephard R, Cornish S, Vatanparast H, Chilibeck P (2012) Arthritis, osteoporosis, and low back pain: evidence-based clinical risk assessment for physical activity and exercise clearance. Can Fam Physician 58(1):59–62PubMedPubMedCentral
11.
go back to reference Sinaki M (2012) Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention. PMR 4(11):882–888CrossRef Sinaki M (2012) Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention. PMR 4(11):882–888CrossRef
12.
go back to reference Bonaiuti D, Arioli G, Diana G, Franchignoni F, Giustini A, Monticone M, Negrini S, Maini M (2005) SIMFER rehabilitation treatment guidelines in postmenopausal and senile osteoporosis. Eura Medicophys 41(4):315–337PubMed Bonaiuti D, Arioli G, Diana G, Franchignoni F, Giustini A, Monticone M, Negrini S, Maini M (2005) SIMFER rehabilitation treatment guidelines in postmenopausal and senile osteoporosis. Eura Medicophys 41(4):315–337PubMed
13.
go back to reference Bennell KL, Matthews B, Greig A, Briggs A, Kelly A, Sherburn M, Larsen J, Wark J (2010) Effects of an exercise and manual therapy program on physical impairments, function and quality of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord 11:36CrossRefPubMedPubMedCentral Bennell KL, Matthews B, Greig A, Briggs A, Kelly A, Sherburn M, Larsen J, Wark J (2010) Effects of an exercise and manual therapy program on physical impairments, function and quality of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord 11:36CrossRefPubMedPubMedCentral
14.
go back to reference Bergland A, Thorsen H, Karesen R (2011) Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial. Osteoporos Int 22(6):1863–1871CrossRefPubMed Bergland A, Thorsen H, Karesen R (2011) Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial. Osteoporos Int 22(6):1863–1871CrossRefPubMed
15.
go back to reference Malmros B, Mortensen L, Jensen MB, Charles P (1998) Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int 8(3):215–221CrossRefPubMed Malmros B, Mortensen L, Jensen MB, Charles P (1998) Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int 8(3):215–221CrossRefPubMed
16.
go back to reference Yang L, He C, Lei Z, Xie W, Lan Q (2007) Effect of pain-free exercises on female osteoporosis patients with spinal compressive fracture. J Clin Rehab Tis Eng Res 11:9108–9111 Yang L, He C, Lei Z, Xie W, Lan Q (2007) Effect of pain-free exercises on female osteoporosis patients with spinal compressive fracture. J Clin Rehab Tis Eng Res 11:9108–9111
17.
go back to reference Bergstrom I, Bergstrom K, Kronhed A, Karlsson S, Brinck J (2011) Back extensor training increases muscle strength in postmenopausal women with osteoporosis, kyphosis and vertebral fractures. Adv Physiother 13(3):110–117CrossRef Bergstrom I, Bergstrom K, Kronhed A, Karlsson S, Brinck J (2011) Back extensor training increases muscle strength in postmenopausal women with osteoporosis, kyphosis and vertebral fractures. Adv Physiother 13(3):110–117CrossRef
18.
go back to reference Gold DT, Shipp KM, Pieper CF, Duncan PW, Martinez S, Lyles KW (2004) Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial. J Am Geriatr Soc 52(9):1471–1478CrossRefPubMed Gold DT, Shipp KM, Pieper CF, Duncan PW, Martinez S, Lyles KW (2004) Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial. J Am Geriatr Soc 52(9):1471–1478CrossRefPubMed
19.
go back to reference Papaioannou A, Adachi JD, Winegard K, Ferko N, Parkinson W, Cook RJ, Webber C, McCartney N (2003) Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int 14:677–682CrossRefPubMed Papaioannou A, Adachi JD, Winegard K, Ferko N, Parkinson W, Cook RJ, Webber C, McCartney N (2003) Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int 14:677–682CrossRefPubMed
20.
go back to reference Giangregorio LM, Macintyre NJ, Thabane L, Skidmore CJ, Papaioannou A (2013) Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev 1:CD008618PubMed Giangregorio LM, Macintyre NJ, Thabane L, Skidmore CJ, Papaioannou A (2013) Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev 1:CD008618PubMed
21.
go back to reference School of Health (2008) Osteoporosis. In: OМ L (ed) Guidelines for physicians. GEOTAR-Media, Russia, 64 p School of Health (2008) Osteoporosis. In: OМ L (ed) Guidelines for physicians. GEOTAR-Media, Russia, 64 p
22.
go back to reference Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O, Kanis JA, Kellingray S, Leplege A, Liberman UA, McCloskey E, Minne H, Reeve J, Reginster JY, Scholz M, Todd C, de Vernejoul MC, Wiklund I (1999) Quality of life in patients with vertebral fractures: validation of quality of life questionnaire of the European foundation for osteoporosis (QUALEFFO). Osteoporos Int 10(2):150–160CrossRefPubMed Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O, Kanis JA, Kellingray S, Leplege A, Liberman UA, McCloskey E, Minne H, Reeve J, Reginster JY, Scholz M, Todd C, de Vernejoul MC, Wiklund I (1999) Quality of life in patients with vertebral fractures: validation of quality of life questionnaire of the European foundation for osteoporosis (QUALEFFO). Osteoporos Int 10(2):150–160CrossRefPubMed
23.
go back to reference Di Fabio RP (1995) Sensitivity and specificity of platform posturography for identifying patients with vestibular dysfunction. Phys Ther 75(4):290–305PubMed Di Fabio RP (1995) Sensitivity and specificity of platform posturography for identifying patients with vestibular dysfunction. Phys Ther 75(4):290–305PubMed
24.
go back to reference Usachev VI, Dotsenko VI, Kononov AF, Artemov VG (2009) New methodology for the stabilometric diagnosis of equilibrium dysfunction. Vestn Otorinolaringol 3:19–22PubMed Usachev VI, Dotsenko VI, Kononov AF, Artemov VG (2009) New methodology for the stabilometric diagnosis of equilibrium dysfunction. Vestn Otorinolaringol 3:19–22PubMed
25.
go back to reference Nelson SR, Di Fabio RP, Anderson JH (1995) Vestibular and sensory interaction deficits assessed by dynamic platform posturography in patients with multiple sclerosis. Ann Otol Rhinol Laryngol 104(1):62–68CrossRefPubMed Nelson SR, Di Fabio RP, Anderson JH (1995) Vestibular and sensory interaction deficits assessed by dynamic platform posturography in patients with multiple sclerosis. Ann Otol Rhinol Laryngol 104(1):62–68CrossRefPubMed
26.
go back to reference Di Nardo W, Ghirlanda G, Cercone S, Pitocco D, Soponara C, Cosenza A, Paludetti G, Di Leo MA, Galli I (1999) The use of dynamic posturography to detect neurosensorial disorder in IDDM without clinical neuropathy. J Diabetes Complicat 13(2):79–85CrossRefPubMed Di Nardo W, Ghirlanda G, Cercone S, Pitocco D, Soponara C, Cosenza A, Paludetti G, Di Leo MA, Galli I (1999) The use of dynamic posturography to detect neurosensorial disorder in IDDM without clinical neuropathy. J Diabetes Complicat 13(2):79–85CrossRefPubMed
27.
go back to reference Langlois F, Vu TT, Chassé K, Dupuis G, Kergoat MJ, Bherer L (2013) Benefits of physical exercise training on cognition and quality of life in frail older adults. J Gerontol B Psychol Sci Soc Sci 68(3):400–404CrossRefPubMed Langlois F, Vu TT, Chassé K, Dupuis G, Kergoat MJ, Bherer L (2013) Benefits of physical exercise training on cognition and quality of life in frail older adults. J Gerontol B Psychol Sci Soc Sci 68(3):400–404CrossRefPubMed
28.
go back to reference Smith AA, Summers GD, Baxendale A, Butterly RJ (1998) A randomized controlled trial of the effects of weight-bearing exercise and resistance training on risk factors for fracture in women with osteoporosis. In: Ring EFJ, Elvins DM, Bhalla AK (eds) Current research in osteoporosis and bone mineral measurement. British Institute of Radiology, London, p 128 Smith AA, Summers GD, Baxendale A, Butterly RJ (1998) A randomized controlled trial of the effects of weight-bearing exercise and resistance training on risk factors for fracture in women with osteoporosis. In: Ring EFJ, Elvins DM, Bhalla AK (eds) Current research in osteoporosis and bone mineral measurement. British Institute of Radiology, London, p 128
29.
go back to reference Bautmans I, Van Arken J, Van Mackelenberg M, Mets T (2010) Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med 42:129–135CrossRefPubMed Bautmans I, Van Arken J, Van Mackelenberg M, Mets T (2010) Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med 42:129–135CrossRefPubMed
30.
go back to reference Carter ND, Khan KM, McKay HA, Petit MA, Waterman C, Heinonen A, Janssen PA, Donaldson MG, Mallinson A, Riddell L, Kruse K, Prior JC, Flicker L (2002) Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ 167:997–1004PubMedPubMedCentral Carter ND, Khan KM, McKay HA, Petit MA, Waterman C, Heinonen A, Janssen PA, Donaldson MG, Mallinson A, Riddell L, Kruse K, Prior JC, Flicker L (2002) Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ 167:997–1004PubMedPubMedCentral
31.
go back to reference Madureira MM, Takayama L, Gallinaro AL, Caparbo VF, Costa RA, Pereira RMR (2007) Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial. Osteoporos Int 18:419–425CrossRefPubMed Madureira MM, Takayama L, Gallinaro AL, Caparbo VF, Costa RA, Pereira RMR (2007) Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial. Osteoporos Int 18:419–425CrossRefPubMed
32.
go back to reference Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C (2011) Exercise for improving balance in older people. Cochrane Database Syst Rev 11:CD004963PubMed Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C (2011) Exercise for improving balance in older people. Cochrane Database Syst Rev 11:CD004963PubMed
33.
go back to reference Barrett E, McCreesh K, Lewis J (2014) Reliability and validity of non-radiographic methods of thoracic kyphosis measurement: a systematic review. Man Ther 19(1):10–17CrossRefPubMed Barrett E, McCreesh K, Lewis J (2014) Reliability and validity of non-radiographic methods of thoracic kyphosis measurement: a systematic review. Man Ther 19(1):10–17CrossRefPubMed
34.
go back to reference Dusdal K, Grundmanis J, Luttin K, Ritchie P, Rompre C, Sidhu R, Harris SR (2011) Effects of therapeutic exercise for persons with osteoporotic vertebral fractures: a systematic review. Osteoporos Int 22(3):755–769CrossRefPubMed Dusdal K, Grundmanis J, Luttin K, Ritchie P, Rompre C, Sidhu R, Harris SR (2011) Effects of therapeutic exercise for persons with osteoporotic vertebral fractures: a systematic review. Osteoporos Int 22(3):755–769CrossRefPubMed
35.
go back to reference Kemmler W, Bebenek M, Kohl M, von Stengel S (2015) Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporos Int 26(10):2491–2499. doi:10.1007/s00198-015-3165-3 CrossRefPubMed Kemmler W, Bebenek M, Kohl M, von Stengel S (2015) Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporos Int 26(10):2491–2499. doi:10.​1007/​s00198-015-3165-3 CrossRefPubMed
36.
go back to reference Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10-year follow-up of postmenopausal women. Bone 30(6):836–841CrossRefPubMed Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10-year follow-up of postmenopausal women. Bone 30(6):836–841CrossRefPubMed
37.
go back to reference Sinaki M, Mikkelsen BA (1984) Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil 65:593–596PubMed Sinaki M, Mikkelsen BA (1984) Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil 65:593–596PubMed
Metadata
Title
Effect of twelve-month physical exercise program on patients with osteoporotic vertebral fractures: a randomized, controlled trial
Authors
L. Evstigneeva
O. Lesnyak
I. E. M. Bultink
W. F. Lems
E. Kozhemyakina
E. Negodaeva
G. Guselnikova
A. Belkin
Publication date
01-08-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 8/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3560-4

Other articles of this Issue 8/2016

Osteoporosis International 8/2016 Go to the issue