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Osteologie 2014; 23(02): 123-132
DOI: 10.1055/s-0037-1620039
Original and review articles
Schattauer GmbH

New aspects of physical therapy for osteoporosis

A randomized clinical trial[*] Neue Aspekte der physikalischen Therapie der OsteoporoseEine randomisierte klinische Untersuchung
G. Schröder
1   Klinikum Südstadt Rostock, Department Internal Med, Rostock
,
A. Knauerhase
2   Department Internal Med, University of Rostock, Rostock
,
G. Kundt
3   University of Rostock, School of Medicine, Institute of Biostatistics and Informatics in Medicine and Ageing Research, Rostock
,
H.-C. Schober
1   Klinikum Südstadt Rostock, Department Internal Med, Rostock
› Author Affiliations
Further Information

Publication History

received: 05 May 2013

accepted after revision: 12 May 2014

Publication Date:
02 January 2018 (online)

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Summary

Fractures due to osteoporosis are among the leading causes of functional limitation, chronic pain, and greater morbidity in advanced age. Apart from bone, risk factors for osteoporotic fractures include non-osseous causes such as falls or reduced neuromuscular capacity. Muscle and coordination exercises enhance the patient’s abilities in daily life and prevent falls. In view of recent conclusions drawn from competitive sports, which stress the significance of muscles of the trunk with regard to reducing back pain and optimizing posture, we used sling exercises to determine whether they benefit patients with osteoporosis and are more useful than traditional physiotherapy. A stable ceiling construction was installed for sling exercise; slings were suspended from this construction. Fifty patients were randomized into two groups. Group A received traditional physiotherapy while group B was given sling exercises, in each case twice a week for a period of three months. The exercises were similar in the two groups. Both performed chair-rising exercises and pelvic lift in supine position; the sling exercise group used the slings for this purpose. The results of treatment (pre-post) were analyzed in terms of pain levels, mobility, trunk strength, and the shape of the back. For the latter we used the spine scanner Diers®Formetric 4D to measure the spine surface of the patients with low radiation. After a further three months with no specific exercise treatment, we re-tested the patients to establish the long-term effects of the two types of exercises. Forty-four patients (88 %) completed the study. Patients were assigned to small groups for the exercises (a maximum of 5 patients each), and thus received individual attention and motivation. Positive training effects were achieved in both groups. Significantly better results in regard of improved mobility (8.2 ± 1.9 vs. 6.7 ± 1.4; p = 0.005) and pain at rest (3.1 ± 1.7 vs. 1.9 ± 1.4; p = 0.011) were registered in the sling exercise group. A comparison of the baseline values for these parameters to those reported at follow-up, without specific stabilization or strengthening exercises, it was found that the effect lasted for a minimum period of 3 months (p < 0.001). The results of the investigation confirm the known positive effects of physical therapy with regard to back pain in patients with osteoporosis. Simultaneously, sling exercise proved to be a treatment alternative that improves trunk strength and posture as well as provides greater mobility, thus improving quality of life in patients with osteoporosis.

Zusammenfassung

Die klinische Manifestation der Osteoporose ist die Fraktur. Sie zählt im Alter zu den Hauptursachen für funktionelle Einschränkungen, chronische Schmerzen und erhöhte Morbidität. Die Frakturrisiken sind einerseits ossär begründet, andererseits u. a. auf Stürze und eine verminderte neuromuskuläre Kapazität zurückzuführen. Muskuläres- und Koordinationstraining können helfen, die Leistungsfähigkeit im Alltag zu verbessern, Schmerzen zu lindern und zur Sturzprophy -laxe beizutragen. Vor dem Hintergrund neuer Erkenntnisse aus dem Leistungssport, die auf die Bedeutung der Rumpfmuskeln hinsichtlich vertebraler Schmerzreduktion und Haltungsoptimierung hinweisen, wählten wir das Schlingentraining, um zu untersuchen, ob auch Osteoporosepatienten davon profi -ti eren und welche Vorteile gegenüber traditioneller Physiotherapie bestehen. In beiden Gruppen konnten positive Trainingseffekte erzielt werden, wobei sich signifikant bessere Resultate hinsichtlich Ruheschmerz (3,1 ± 1,7 vs. 1,9 ± 1,4; p = 0,011) und Mobilität (8,2 ± 1,9 vs. 6,7 ± 1,4; p = 0,005) in der Schlingentrainingsgruppe fanden. Die Studienergebnisse werden als spezifische Anpassungen an die Trainingstherapie interpretiert.

Keywords

Osteoporosis - fall risk reduction - trunk strength - sling exercise therapy

Schlüsselwörter

Osteoporose - Sturzrisikoreduktion - Rumpfkraft - Schlingentraining

* This overview is a fusion of two previously published articles. Refer to “Effects of physical therapy on quality of life in osteoporosis patients – a randomized clinical trial” (Health Qual Life Outcomes 2012; 10: 101) and “Trunk stabilization with sling in osteoporosis patients – a randomized clinical trial” (Eur Rev Aging Phys Act 2013 DOI 10.1007/s11556–013–0128–6).