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Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Effect of exercises with weight vests and a patient education programme for women with osteopenia and a healed wrist fracture: a randomized, controlled trial of the OsteoACTIVE programme

Authors: K. A. Hakestad, M. K. Torstveit, L. Nordsletten, M. A. Risberg

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

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Abstract

Background

Exercise programmes have shown to be important for the prevention of fractures in patients with established osteoporosis. However, few studies have evaluated the effect of such programmes for women with low bone mineral density (BMD) (osteoporosis or osteopenia) who have already suffered a fracture. Studies have indicated that exercise programmes concentrating on muscular strength and dynamic balance have a positive effect on significant risk factors for falls such as quadriceps strength and balance. The aim of the present study was to assess the effect of a 6-month exercise programme and a patient education component (OsteoACTIVE) on quadriceps strength, BMD, dynamic balance, walking capacity, physical activity level and quality of life in postmenopausal women with osteopenia and a previous wrist fracture.

Methods

Eighty postmenopausal women with low BMD and a healed wrist fracture were randomized to OsteoACTIVE (n = 42) (age 65.5, range 51.2–79.2 years) or patient education only (control group) (n = 38) (age 63.9, range 52.7–86.8 years). Follow-up was conducted after 6 months (end of intervention) and 1 year. Outcome measures included quadriceps strength, BMD, dynamic balance, walking capacity, physical activity level and quality of life.

Results

Thirty-five participants (83 %) completed the OsteoACTIVE programme. Mean adherence to OsteoACTIVE was 87 % (range 48–100 %). Twenty-five participants (72 %) met the a priori goal of 80 % adherence to the program. No adverse events were reported. There were no significant differences between the two groups over the 1-year follow-up for any of the outcome measures.

Conclusion

The OsteoACTIVE rehabilitation programme revealed no significant effect on quadriceps strength, BMD, dynamic balance, walking capacity or self-reported functional outcomes over the 1-year follow-up.

Trial registration

NCT01357278 at ClinicalTrials.gov (date of registration2010-04-21).
Literature
1.
go back to reference WHO Scientific group. Prevention and managment of osteoporosis: report of WHO scientific group. 2003. Report No.: WHO Technical Report Series 2003: Vol. 921. WHO Scientific group. Prevention and managment of osteoporosis: report of WHO scientific group. 2003. Report No.: WHO Technical Report Series 2003: Vol. 921.
2.
go back to reference Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994;4(6):368–81.CrossRefPubMed Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994;4(6):368–81.CrossRefPubMed
3.
go back to reference Osnes EK, Lofthus CM, Meyer HE, Falch JA, Nordsletten L, Cappelen IF, et al. Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int. 2004;15:567–74.CrossRefPubMed Osnes EK, Lofthus CM, Meyer HE, Falch JA, Nordsletten L, Cappelen IF, et al. Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int. 2004;15:567–74.CrossRefPubMed
4.
go back to reference Pasco JA, Sanders KM, Hoekstra FM, Henry MJ, Nicholson GC, Kotowicz MA. The human cost of fracture. Osteoporos Int. 2005;16:2046–52.CrossRefPubMed Pasco JA, Sanders KM, Hoekstra FM, Henry MJ, Nicholson GC, Kotowicz MA. The human cost of fracture. Osteoporos Int. 2005;16:2046–52.CrossRefPubMed
5.
go back to reference Klotzbuecher CM, Ross PD, Landsman PB, Abbott III TA, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721–39.CrossRefPubMed Klotzbuecher CM, Ross PD, Landsman PB, Abbott III TA, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721–39.CrossRefPubMed
6.
go back to reference Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int. 2001;12:989–95.CrossRefPubMed Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int. 2001;12:989–95.CrossRefPubMed
7.
go back to reference Pfeifer M, Sinaki M, Geusens P, Boonen S, Preisinger E, Minne HW. Musculoskeletal rehabilitation in osteoporosis: a review. J Bone Miner Res. 2004;19(8):1208–14.CrossRefPubMed Pfeifer M, Sinaki M, Geusens P, Boonen S, Preisinger E, Minne HW. Musculoskeletal rehabilitation in osteoporosis: a review. J Bone Miner Res. 2004;19(8):1208–14.CrossRefPubMed
8.
go back to reference Kahn K, McKay H, Kannus R, Bailey D, Wark J, Bennel K. Physical Activity and Bone Health. USA: Human Kinetics; 2001. Kahn K, McKay H, Kannus R, Bailey D, Wark J, Bennel K. Physical Activity and Bone Health. USA: Human Kinetics; 2001.
9.
go back to reference 9 Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011;CD000333. doi: 10.1002/14651858.CD000333.pub2. 9 Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011;CD000333. doi: 10.​1002/​14651858.​CD000333.​pub2.
10.
11.
go back to reference de Kam D, Smulders E, Weerdesteyn V, Smits-Engelsman BC. Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials. Osteoporos Int. 2009;20:2111–25.CrossRefPubMed de Kam D, Smulders E, Weerdesteyn V, Smits-Engelsman BC. Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials. Osteoporos Int. 2009;20:2111–25.CrossRefPubMed
12.
go back to reference Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2003;4:CD000340.PubMed Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2003;4:CD000340.PubMed
13.
go back to reference Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;9(11):CD004963. Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;9(11):CD004963.
14.
go back to reference Li WC, Chen YC, Yang RS, Tsauo JY. Effects of exercise programmes on quality of life in osteoporotic and osteopenic postmenopausal women: a systematic review and meta-analysis. Clin Rehabil. 2009;23(10):888–96.CrossRefPubMed Li WC, Chen YC, Yang RS, Tsauo JY. Effects of exercise programmes on quality of life in osteoporotic and osteopenic postmenopausal women: a systematic review and meta-analysis. Clin Rehabil. 2009;23(10):888–96.CrossRefPubMed
15.
go back to reference Liu CJ, Latham N. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev. 2009;8(3):CD002759. Liu CJ, Latham N. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev. 2009;8(3):CD002759.
16.
go back to reference Peterson MD, Rhea MR, Sen A, Gordon PM. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev. 2010;9(3):226–37.PubMedCentralCrossRefPubMed Peterson MD, Rhea MR, Sen A, Gordon PM. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev. 2010;9(3):226–37.PubMedCentralCrossRefPubMed
17.
go back to reference Vuori IM. Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc. 2001;33(6):551–86.CrossRef Vuori IM. Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc. 2001;33(6):551–86.CrossRef
18.
go back to reference Shaw JM, Snow CM. Weighted vest exercise improves indices of fall risk in older women. J Gerontol A Biol Sci Med Sci. 1998;53(1):M53–8.CrossRefPubMed Shaw JM, Snow CM. Weighted vest exercise improves indices of fall risk in older women. J Gerontol A Biol Sci Med Sci. 1998;53(1):M53–8.CrossRefPubMed
19.
go back to reference Snow CM, Shaw JM, Winters KM, Witzke KA. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2000;55(9):M489–91.CrossRefPubMed Snow CM, Shaw JM, Winters KM, Witzke KA. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2000;55(9):M489–91.CrossRefPubMed
20.
go back to reference Puthoff ML, Darter B, Nielsen DH, Yack HJ. The effect of weighted vest walking on metabolic responses and ground reaction forces. Med Sci Sports Exerc. 2006;38(4):746–52.CrossRefPubMed Puthoff ML, Darter B, Nielsen DH, Yack HJ. The effect of weighted vest walking on metabolic responses and ground reaction forces. Med Sci Sports Exerc. 2006;38(4):746–52.CrossRefPubMed
21.
go back to reference Bergstrom I, Landgren B, Brinck J, Freyschuss B. Physical training preserves bone mineral density in postmenopausal women with forearm fractures and low bone mineral density. Osteoporos Int. 2008;19(2):177–83.CrossRefPubMed Bergstrom I, Landgren B, Brinck J, Freyschuss B. Physical training preserves bone mineral density in postmenopausal women with forearm fractures and low bone mineral density. Osteoporos Int. 2008;19(2):177–83.CrossRefPubMed
22.
go back to reference Carter ND, Khan KM, McKay HA, Petit MA, Waterman C, Heinonen A, et al. Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ. 2002;167(9):997–1004.PubMedCentralPubMed Carter ND, Khan KM, McKay HA, Petit MA, Waterman C, Heinonen A, et al. Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ. 2002;167(9):997–1004.PubMedCentralPubMed
23.
go back to reference Malmros B, Mortensen L, Jensen MB, Charles P. Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int. 1998;8(9):215–21.CrossRefPubMed Malmros B, Mortensen L, Jensen MB, Charles P. Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int. 1998;8(9):215–21.CrossRefPubMed
24.
go back to reference Carter ND, Khan KM, Mallinson A, Janssen PA, Heinonen A, Petit MA, et al. Knee extension strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. Gerontology. 2002;48(6):360–8.CrossRefPubMed Carter ND, Khan KM, Mallinson A, Janssen PA, Heinonen A, Petit MA, et al. Knee extension strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. Gerontology. 2002;48(6):360–8.CrossRefPubMed
25.
go back to reference Hakestad KA, Torstveit MK, Nordsletten L, Axelsson AC, Risberg MA. Exercises including weight vests and a patient education program for women with osteopenia: a feasibility study of the OsteoACTIVE rehabilitation program. J Orthop Sports Phys Ther. 2015;10(1–36):97.CrossRef Hakestad KA, Torstveit MK, Nordsletten L, Axelsson AC, Risberg MA. Exercises including weight vests and a patient education program for women with osteopenia: a feasibility study of the OsteoACTIVE rehabilitation program. J Orthop Sports Phys Ther. 2015;10(1–36):97.CrossRef
26.
go back to reference Gold DT, Silverman SL. Osteoporosis self-management: choices for better bone health. South Med J. 2004;97(6):551–4.CrossRefPubMed Gold DT, Silverman SL. Osteoporosis self-management: choices for better bone health. South Med J. 2004;97(6):551–4.CrossRefPubMed
27.
go back to reference Eitzen I, Hakestad KA, Risberg MA. Inter- and intrarater reliability of isokinetic thigh muscle strength tests in postmenopausal women with osteopenia. Arch Phys Med Rehabil. 2012;93(3):420–7.CrossRefPubMed Eitzen I, Hakestad KA, Risberg MA. Inter- and intrarater reliability of isokinetic thigh muscle strength tests in postmenopausal women with osteopenia. Arch Phys Med Rehabil. 2012;93(3):420–7.CrossRefPubMed
28.
go back to reference Lodder MC, Lems WF, Ader HJ, Marthinsen AE, van Coeverden SC, Lips P, et al. Reproducibility of bone mineral density measurement in daily practice. Ann Rheum Dis. 2004;63(3):285–9.PubMedCentralCrossRefPubMed Lodder MC, Lems WF, Ader HJ, Marthinsen AE, van Coeverden SC, Lips P, et al. Reproducibility of bone mineral density measurement in daily practice. Ann Rheum Dis. 2004;63(3):285–9.PubMedCentralCrossRefPubMed
29.
go back to reference Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults. Arch Phys Med Rehabil. 2002;83(110003–9993 (Print)):1566–71.CrossRefPubMed Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults. Arch Phys Med Rehabil. 2002;83(110003–9993 (Print)):1566–71.CrossRefPubMed
30.
go back to reference Enright PL. The six-minute walk test. Respir Care. 2003;100(4):783–5. Enright PL. The six-minute walk test. Respir Care. 2003;100(4):783–5.
31.
go back to reference WIse RA, Brown CD. Minimal clinically important differences in the six-minute walk test and the incremental shuttle walking test. COPD. 2005;2(1):125–9.CrossRefPubMed WIse RA, Brown CD. Minimal clinically important differences in the six-minute walk test and the incremental shuttle walking test. COPD. 2005;2(1):125–9.CrossRefPubMed
32.
33.
go back to reference Ries AL. Minimally clinically important difference for the UCSD Shortness of Breath Questionnaire, Borg Scale, and Visual Analog Scale. COPD. 2005;2(1):105–10.CrossRefPubMed Ries AL. Minimally clinically important difference for the UCSD Shortness of Breath Questionnaire, Borg Scale, and Visual Analog Scale. COPD. 2005;2(1):105–10.CrossRefPubMed
34.
go back to reference Dinger MK, Oman RF, Taylor EL, Vesely SK, Able J. Stability and convergent validity of the Physical Activity Scale for the Elderly (PASE). J Sports Med Phys Fitness. 2004;44(2):186–92.PubMed Dinger MK, Oman RF, Taylor EL, Vesely SK, Able J. Stability and convergent validity of the Physical Activity Scale for the Elderly (PASE). J Sports Med Phys Fitness. 2004;44(2):186–92.PubMed
35.
go back to reference Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46(2):153–62.CrossRefPubMed Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46(2):153–62.CrossRefPubMed
36.
go back to reference Loland N. Reliability of the physical activity scale for the elderly (PASE). Eur J Sport Sci. 2002;2(5):1–12.CrossRef Loland N. Reliability of the physical activity scale for the elderly (PASE). Eur J Sport Sci. 2002;2(5):1–12.CrossRef
37.
go back to reference Ware Jr JE, The SCD, MOS. 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed Ware Jr JE, The SCD, MOS. 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed
38.
go back to reference McHorney CA, Ware Jr JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40–66.CrossRefPubMed McHorney CA, Ware Jr JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40–66.CrossRefPubMed
39.
go back to reference Hays RD, Woolley JM. The concept of clinically meaningful difference in health-related quality-of-life research. How meaningful is it? Pharmacoeconomics. 2000;18(5):419–23.CrossRefPubMed Hays RD, Woolley JM. The concept of clinically meaningful difference in health-related quality-of-life research. How meaningful is it? Pharmacoeconomics. 2000;18(5):419–23.CrossRefPubMed
40.
go back to reference Risberg MA. Evaluation of knee function after anterior cruciate ligament reconstruction. Oslo: Surgical Clinic, Ullevaal Hospital, University of Oslo; 1999. Risberg MA. Evaluation of knee function after anterior cruciate ligament reconstruction. Oslo: Surgical Clinic, Ullevaal Hospital, University of Oslo; 1999.
42.
go back to reference Bonaiuti D, Arioli GF, Diana G, Franchignoni F, Giustini A, Monticone M, et al. SIMFER Rehabilitation treatment guidelines in postmenopausal and senile osteoporosis. Eura Medicophys. 2005;41(4):315–37.PubMed Bonaiuti D, Arioli GF, Diana G, Franchignoni F, Giustini A, Monticone M, et al. SIMFER Rehabilitation treatment guidelines in postmenopausal and senile osteoporosis. Eura Medicophys. 2005;41(4):315–37.PubMed
43.
go back to reference Sayers SP. High-speed power training: a novel approach to resistance training in older men and women. A brief review and pilot study. J Strength Cond Res. 2007;21(2):518–26.PubMed Sayers SP. High-speed power training: a novel approach to resistance training in older men and women. A brief review and pilot study. J Strength Cond Res. 2007;21(2):518–26.PubMed
44.
go back to reference Pereira MA, Kriska AM, Day RD, Cauley JA, LaPorte RE, Kuller LH. A randomized walking trial in postmenopausal women: effects on physical activity and health 10 years later. Arch Intern Med. 1998;158:1695–701.CrossRefPubMed Pereira MA, Kriska AM, Day RD, Cauley JA, LaPorte RE, Kuller LH. A randomized walking trial in postmenopausal women: effects on physical activity and health 10 years later. Arch Intern Med. 1998;158:1695–701.CrossRefPubMed
45.
go back to reference Guadalupe-Grau AF, Fuentes TF, Guerra BF, Calbet JA. Exercise and bone mass in adults. Sports Med. 2009;39(6):439–68.CrossRefPubMed Guadalupe-Grau AF, Fuentes TF, Guerra BF, Calbet JA. Exercise and bone mass in adults. Sports Med. 2009;39(6):439–68.CrossRefPubMed
46.
go back to reference Kelley GA, Kelley KS, Tran ZV. Resistance training and bone mineral density in women: a meta-analysis of controlled trials. Am J Phys Med Rehabil. 2001;80(1):65–77.CrossRefPubMed Kelley GA, Kelley KS, Tran ZV. Resistance training and bone mineral density in women: a meta-analysis of controlled trials. Am J Phys Med Rehabil. 2001;80(1):65–77.CrossRefPubMed
47.
go back to reference Gianoudis J, Bailey CA, Ebeling PR, Nowson CA, Sanders KM, Hill KF, et al. Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. J Bone Miner Res. 2014;29(1):182–91.CrossRefPubMed Gianoudis J, Bailey CA, Ebeling PR, Nowson CA, Sanders KM, Hill KF, et al. Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. J Bone Miner Res. 2014;29(1):182–91.CrossRefPubMed
48.
go back to reference Whitney SL, Marchetti GF, Morris LO, Sparto PJ. The reliability and validity of the four square step test for people with balance deficits secondary to a vestibular disorder. Arch Phys Med Rehabil. 2007;88(1):99–104.CrossRefPubMed Whitney SL, Marchetti GF, Morris LO, Sparto PJ. The reliability and validity of the four square step test for people with balance deficits secondary to a vestibular disorder. Arch Phys Med Rehabil. 2007;88(1):99–104.CrossRefPubMed
49.
go back to reference ATS statement: guidelines for the six-minute walk test. Am J Respiratory Clin Care Med. 2002;166(1):111–7. ATS statement: guidelines for the six-minute walk test. Am J Respiratory Clin Care Med. 2002;166(1):111–7.
50.
go back to reference Loge JH, Kaasa S. Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scand J Soc Med. 1998;26(4):250–8.PubMed Loge JH, Kaasa S. Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scand J Soc Med. 1998;26(4):250–8.PubMed
51.
go back to reference Gold DT, McClung B. Approaches to patient education: emphasizing the long-term value of compliance and persistence. Am J Med. 2006;119(4 Suppl 1):S32–7.CrossRefPubMed Gold DT, McClung B. Approaches to patient education: emphasizing the long-term value of compliance and persistence. Am J Med. 2006;119(4 Suppl 1):S32–7.CrossRefPubMed
52.
go back to reference McCambridge J, Witton J, Elbourne D. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67(3):267–77.PubMedCentralCrossRefPubMed McCambridge J, Witton J, Elbourne D. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67(3):267–77.PubMedCentralCrossRefPubMed
Metadata
Title
Effect of exercises with weight vests and a patient education programme for women with osteopenia and a healed wrist fracture: a randomized, controlled trial of the OsteoACTIVE programme
Authors
K. A. Hakestad
M. K. Torstveit
L. Nordsletten
M. A. Risberg
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0811-z

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