A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis

Abstract

Purpose: Despite the decreased gravitational loading that is experienced in an aquatic environment, little research has been conducted on this exercise medium for women with osteoporosis (OP). Aquatic exercise (AE) may improve function and balance, thus ultimately decreasing fall risk and the potential for hip fractures in this high-risk population. Method: A total of 68 women with OP, aged 60 years or older, were recruited into a randomized clinical trial evaluating the impact of AE, land exercise (LE), and no exercise (NE) on balance, functional mobility, and quality of life (QOL). Results: Only one balance measure (backward tandem walk) significantly improved with AE compared to LE, but this did not translate into a greater improvement in self-report function. There were no significant differences between the exercise interventions and NE, except for in ratings of global change, where participants in the AE group were three times more likely to report improvement than those in the NE group. Conclusion: There were no differences in balance, function, or QOL in women with OP who followed an AE or LE programme compared to those in an NE control group. However, the significant differences in backward tandem walk between the AE and LE groups and self-reported global change between the AE and NE groups warrant further investigation. Significant improvements in balance and global change suggest that AE is a viable alternative for older women with OP who have difficulty exercising on land.

Effect of Resistance Exercises on Function in Older Adults with Osteoporosis or Osteopenia: A Systematic Review

“…The control group in each study consisted of aged matched participants in similar numbers to the intervention group. The control groups in four studies were instructed not to perform any additional activities that were not performed before the study 6,[32][33][34] ; the control group in the remaining study performed stretching (sham exercise) for the duration of the study but no additional activities. 35 PEDro scores for the studies ranged between 5 and 7 (see Table 2); agreement between reviewers on study quality was 93% (k ¼ 0.82; 95% CI, 0.63-0.92).…”

“…23 An interesting finding is the notably larger effect size (1.74) in the study by Chien and colleagues 6 relative to the effect sizes found for the other four studies, which ranged from 0.08 to 0.46. [32][33][34][35] Based on our observations, frequency of and compliance with the exercise programme may have a more positive effect in older adults with osteoporosis than exercises that either target specific muscle groups or are a more generalized exercise programme. Future studies should examine the frequency, time, and duration of exercises rather than focusing on the exercise protocols alone.…”

“…The results suggest that interventions using resistance training can have a beneficial impact on the domains of physical function and ADL in older adults with osteoporosis or osteopenia. Four studies [32][33][34][35] found a trivial to small effect, one other study 6 showed a large effect. Variation in effect may be due to multiple characteristics of the study, including exercise protocol and compliance rate.…”

“…Three of the included articles targeted resistance exercises 2-3 Â/week, ranging from 50 to 60 minutes in duration for each session, with direct supervision by a physical therapist or other instructor. 32,34,35 Effect sizes for the resistance intervention in these studies range from trivial to small. Participants in the study by Chien and colleagues 6 performed home-based resistance exercises focusing on the abdomen, low back, and hip without direct supervision.…”

“…A study by Jette 23 includes ADL within the definition of physical function, making it difficult to differentiate between the two terms and, thus, to determine whether 32 Chien et al 6 Hongo et al 33 Grahn Kronhed et al 34 Liu-Ambrose et al 35 1 the effects were influenced by the specific outcome measure used. 23 An interesting finding is the notably larger effect size (1.74) in the study by Chien and colleagues 6 relative to the effect sizes found for the other four studies, which ranged from 0.08 to 0.46.…”