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Postmenopausal women with osteopenia and a healed wrist fracture have reduced physical function and quality of life compared to a matched, healthy control group with no fracture.

Hakestad KA, Nordsletten L, Torstveit MK, Risberg MA - BMC Womens Health (2014)

Bottom Line: The patients had 17.6% lower quadriceps strength at 60°/sec (p = 0.025) at left limb and 18.5% at 180°/sec (p = 0.016) at right limb, and 21% lower at 180°/sec (p = 0.010) at left limb compared to the controls.Impaired performance for the patients was found with 2.4 seconds (p = 0.002) on the FSST, 74 metres (p < 0.001) on the 6MWT, and 1.4 points (p = 0.003) on the BS compared to the controls.The patients scored lower on the sub-scales on the SF-36 role limitations-physical (p = 0.014), bodily pain (p = 0.025) and vitality (p = 0.015) compared to the controls.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, Norwegian Research Center for Active Rehabilitation (NAR), Oslo University Hospital, Trondheimsveien 235, 0514 Oslo, Norway. k.a.hakestad@medisin.uio.no.

ABSTRACT

Background: Fractures lead to reduced physical function and quality of life (QOL), but little is known about postmenopausal women with osteopenia and a healed wrist fracture. The purpose was to evaluate physical function in terms of quadriceps strength, dynamic balance, physical capacity and QOL in postmenopausal women with osteopenia and a healed wrist fracture compared to a matched, healthy control group with no previous fracture.

Methods: Eighteen postmenopausal women with osteopenia (patients) (mean age 59.1 years, range 54 - 65) and a healed wrist fracture were matched to 18 healthy control subjects on age (mean age 58.5 years, range 51 - 65), height, weight and body mass index (BMI). We measured quadriceps strength at 60°/sec and at 180°/sec with Biodex 6000, dynamic balance with the Four Square Step Test (FSST), physical capacity with the six-minute walk test (6MWT) followed by the Borg's scale (BS), and QOL with the Short Form 36 (SF-36), bone mineral density (BMD) with dual x-ray absorptiometry (DXA) and physical activity level with the Physical Activity Scale for the Elderly.

Results: The patients had 17.6% lower quadriceps strength at 60°/sec (p = 0.025) at left limb and 18.5% at 180°/sec (p = 0.016) at right limb, and 21% lower at 180°/sec (p = 0.010) at left limb compared to the controls. Impaired performance for the patients was found with 2.4 seconds (p = 0.002) on the FSST, 74 metres (p < 0.001) on the 6MWT, and 1.4 points (p = 0.003) on the BS compared to the controls. The patients scored lower on the sub-scales on the SF-36 role limitations-physical (p = 0.014), bodily pain (p = 0.025) and vitality (p = 0.015) compared to the controls.

Conclusions: The patients with osteopenia and a healed wrist fracture scored significantly lower on quadriceps strength, dynamic balance, physical capacity and QOL compared to the matched controls. Greater focus should be put on this patient group in terms of rehabilitation and early prevention of subsequent fractures.

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Flow-chart of the inclusion of the subjects.
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Figure 1: Flow-chart of the inclusion of the subjects.

Mentions: The matching procedure was as follows: we recruited the healthy controls from the local area by healthcare professionals and through patients’ friends. They were matched on age (±5 years), height, weight and body mass index (BMI) among the 80 included subjects in the on-going randomized, controlled, single-blinded study (RCT) (reference number http://www.clinicaltrials.gov NCT01357278) carried out at Oslo University Hospital, Norway who were most similar to the controls on the selected criteria. In total 36 patients in the RCT matched the 18 selected controls. To have a 1:1 relationship we divided the 36 into 18 pairs, and the demographic characteristics of both members of the pair were then averaged to derive a single value for the pair to which controls were then matched.The main aim of the RCT was to evaluate the effect of an active rehabilitation programme using weight vests on risk factors for falling (quadriceps strength, balance) and quality of life in women with osteopenia and a healed wrist fracture. The intervention consisted of a six-month active rehabilitation programme with a one-year follow-up (Figure 1).


Postmenopausal women with osteopenia and a healed wrist fracture have reduced physical function and quality of life compared to a matched, healthy control group with no fracture.

Hakestad KA, Nordsletten L, Torstveit MK, Risberg MA - BMC Womens Health (2014)

Flow-chart of the inclusion of the subjects.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4127073&req=5

Figure 1: Flow-chart of the inclusion of the subjects.
Mentions: The matching procedure was as follows: we recruited the healthy controls from the local area by healthcare professionals and through patients’ friends. They were matched on age (±5 years), height, weight and body mass index (BMI) among the 80 included subjects in the on-going randomized, controlled, single-blinded study (RCT) (reference number http://www.clinicaltrials.gov NCT01357278) carried out at Oslo University Hospital, Norway who were most similar to the controls on the selected criteria. In total 36 patients in the RCT matched the 18 selected controls. To have a 1:1 relationship we divided the 36 into 18 pairs, and the demographic characteristics of both members of the pair were then averaged to derive a single value for the pair to which controls were then matched.The main aim of the RCT was to evaluate the effect of an active rehabilitation programme using weight vests on risk factors for falling (quadriceps strength, balance) and quality of life in women with osteopenia and a healed wrist fracture. The intervention consisted of a six-month active rehabilitation programme with a one-year follow-up (Figure 1).

Bottom Line: The patients had 17.6% lower quadriceps strength at 60°/sec (p = 0.025) at left limb and 18.5% at 180°/sec (p = 0.016) at right limb, and 21% lower at 180°/sec (p = 0.010) at left limb compared to the controls.Impaired performance for the patients was found with 2.4 seconds (p = 0.002) on the FSST, 74 metres (p < 0.001) on the 6MWT, and 1.4 points (p = 0.003) on the BS compared to the controls.The patients scored lower on the sub-scales on the SF-36 role limitations-physical (p = 0.014), bodily pain (p = 0.025) and vitality (p = 0.015) compared to the controls.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, Norwegian Research Center for Active Rehabilitation (NAR), Oslo University Hospital, Trondheimsveien 235, 0514 Oslo, Norway. k.a.hakestad@medisin.uio.no.

ABSTRACT

Background: Fractures lead to reduced physical function and quality of life (QOL), but little is known about postmenopausal women with osteopenia and a healed wrist fracture. The purpose was to evaluate physical function in terms of quadriceps strength, dynamic balance, physical capacity and QOL in postmenopausal women with osteopenia and a healed wrist fracture compared to a matched, healthy control group with no previous fracture.

Methods: Eighteen postmenopausal women with osteopenia (patients) (mean age 59.1 years, range 54 - 65) and a healed wrist fracture were matched to 18 healthy control subjects on age (mean age 58.5 years, range 51 - 65), height, weight and body mass index (BMI). We measured quadriceps strength at 60°/sec and at 180°/sec with Biodex 6000, dynamic balance with the Four Square Step Test (FSST), physical capacity with the six-minute walk test (6MWT) followed by the Borg's scale (BS), and QOL with the Short Form 36 (SF-36), bone mineral density (BMD) with dual x-ray absorptiometry (DXA) and physical activity level with the Physical Activity Scale for the Elderly.

Results: The patients had 17.6% lower quadriceps strength at 60°/sec (p = 0.025) at left limb and 18.5% at 180°/sec (p = 0.016) at right limb, and 21% lower at 180°/sec (p = 0.010) at left limb compared to the controls. Impaired performance for the patients was found with 2.4 seconds (p = 0.002) on the FSST, 74 metres (p < 0.001) on the 6MWT, and 1.4 points (p = 0.003) on the BS compared to the controls. The patients scored lower on the sub-scales on the SF-36 role limitations-physical (p = 0.014), bodily pain (p = 0.025) and vitality (p = 0.015) compared to the controls.

Conclusions: The patients with osteopenia and a healed wrist fracture scored significantly lower on quadriceps strength, dynamic balance, physical capacity and QOL compared to the matched controls. Greater focus should be put on this patient group in terms of rehabilitation and early prevention of subsequent fractures.

Show MeSH
Related in: MedlinePlus