Positive effects of exercise on falls and fracture risk in osteopenic women

Abstract

Summary: Exercise may affect osteopenic women at risk of falls and fractures. A workstation approach to exercise was evaluated in a randomised study of 98 women. The intervention group improved in measures of balance, strength and bone density. This study supports a preventative exercise approach that aims to reduce risk factors for fractures and falls, in women already at risk, through balance training and weight-bearing activity. Introduction: The objective of this study was to determine the effects of a workstation balance training and weight-bearing exercise program on balance, strength and bone mineral density (BMD) in osteopenic women. A single-blinded randomised controlled trial (RCT) was undertaken for 20 weeks with measurements at baseline and completion. Materials and methods: Ninety-eight (98) community-dwelling osteopenic women aged 41-78 years were recruited through the North Brisbane electoral roll. Subjects were randomised via computer-generated random numbers lists into either a control (receiving no intervention), or exercise group (two one-hour exercise sessions per week for 20 weeks with a trained physiotherapist). Assessments at baseline and post-intervention included balance testing (five measures), strength testing (quadriceps, hip adductors / abductors / external rotators and trunk extensors), and DXA scans (proximal femur and lumbar spine). Baseline assessment showed no significant differences between groups for all demographics and measures except for subjects taking osteoporosis medication. The percentage differences between pre- and post-intervention measurements were examined for group effect by ANOVA using an intention-to-treat protocol. Results: Ninety-eight women (mean age 62.01 years, SD 8.9 years) enrolled in the study. The mean number of classes attended for the 42 participants in the exercise group who completed the program was 28.2 of a possible 40 classes (71%). At the completion of the trial the intervention group showed markedly significant better performances in balance (unilateral and bilateral stance sway measures, lateral reach, timed up and go and step test) (p<0.05) with strong positive training effects reflecting improvements of between 10% to 71%. Similarly there were gains in strength of the hip muscles (abductors, adductors, and external rotators), quadriceps and trunk extensors with training effects between 9% and 23%. Conclusions: Specific workstation exercises can significantly improve balance and strength in osteopenic women. This type of training may also positively influence bone density although further study is required with intervention over a longer period. A preventative exercise program may reduce the risk of falls and fractures in osteopenic women already at risk. © 2007 International Osteoporosis Foundation and National Osteoporosis Foundation.