BackgroundExercise 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.MethodsEighty 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.ResultsThirty-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.ConclusionThe 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 registrationNCT01357278 at ClinicalTrials.gov (date of registration2010-04-21).

BackgroundFractures 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.MethodsEighteen 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.ResultsThe 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.ConclusionsThe 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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This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Hakestad, K. A., Torstveit, M. K., Nordsletten, L., Axelsson, Å. C., Risberg, M. A. (2015). Exercises including weight vests and a patient education program for women with osteopenia: a feasibility study of the OsteoACTIVE rehabilitation program. Journal of Orthopaedic and Sports Physical Therapy,45,[97][98][99][100][101][102][103][104][105] Dette er siste tekst-versjon av artikkelen, og den kan inneholde små forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på www.jospt.org: http://dx

Adequate nutrition is a basic human right, yet older adults are at high risk of malnutrition. Nutrition is not a part of most nursing curricula. Limited research has been done on digital case-based learning (CBL) in breakout rooms (digital groups); therefore, the aim was to develop and evaluate a preclinical digital CBL unit (3-h synchronously and with an asynchronously flipped classrooms approach) for prevention and treatment of malnutrition and to explore nursing students’ experiences and learning outcomes. Different scenarios for two fictive cases were created in which malnutrition-related challenges were included (such as terminal care) and embedded on the ThingLink platform. In an explorative mixed methods cross-sectional study design, students (n = 78) completed an online evaluation. The results revealed that students wanted more synchronous interaction with educators and less time alone in breakout rooms due to their peers being unprepared, passive and unfamiliar and not turning on their cameras or logging on too late. The learning outcome from quizzes and word clouds were high, but the added pedagogical value of ThingLink seemed low. This explorative study sheds light on central issues related to the use of technology in nurse education, resistance against student active methods and digital pedagogy.