Exercise and Prevention of Hip Fractures
Condition: Bone Mineral Density; Strength; Balance; Osteoporosis; Fractures
MeSH terms: Osteoporosis; Fractures, Bone
Study type: Interventional

Summary: 
      The significance of this population-based study is in producing new information for planning
      interventions and rehabilitation programs for the elderly, planning education of health care
      personnel and planning national health education programs for different age groups.

      The study consists of an epidemiological cross-sectional study and a randomized controlled
      intervention study. The study population consisted of all the 1689 home-dwelling women born
      during 1924-1927 residing in Oulu, Northern Finland, who were asked to a screening visit
      including bone mineral density (BMD) measurement of the distal radius in 1997. 1222 women
      attended the clinic and were afterwards mailed a postal questionnaire focusing on lifelong
      risk factors for osteoporosis, e.g. the amount of physical activity at work and during
      leisure time, daily intake of calcium and use of alcohol and cigarettes. Those with BMD value
      more than 20% lower than the reference value, underwent a densitometry of the hip. All women
      with femoral neck BMD more than 20% below the reference value (n=160) were randomly selected
      to either exercise (n=84) or control (n=76) group. At baseline and after that annually during
      the 30-month intervention, balance, muscle strength, aerobic capacity, walking speed,
      cognitive functions and mood are measured from all the participants. Hip BMD will be measured
      annually. The exercise group participates in a supervised training program with weekly
      sessions from the beginning of October to the end of April. In addition to the supervised
      sessions the participants train daily at home. From April to October the exercises are
      performed purely at home. The training regimen consists of balance, strength and impact
      exercises. The intervention group keeps diary of their daily physical activity. The number
      and severity of falls are recorded from both the groups.

      The purpose of the study is:

        1. to identify factors accounting for low BMD in elderly home-dwelling women with severe
           osteopenia.

        2. to evaluate how supervised regular weight-bearing exercise program affects BMD in
           elderly home-dwelling women with severe osteopenia

        3. to evaluate how supervised regular balance and muscle training affects balance and
           muscle strength in elderly home-dwelling women with severe osteopenia.

           In addition the aim is to:

        4. study how regular supervised exercise affects the incidence and severity of falls, mood
           and cognitive functions in women with severe osteopenia.

      Hypothesis and research methods

      The main hypothesis is that long-term supervised, mainly home- based regular impact-type and
      balance and muscle exercises can improve balance and muscle strength of lower extremities and
      maintain bone mass in elderly women. We also hypothesize that the incidence of falls is lower
      in the exercise group than in the controls and that the falls are more injurious in the
      control group than in the intervention group during the follow-up period
    


Intervention name(s): Exercise
Intervention type(s): Behavioral
Intervention description(s): Supervised, mainly home-based balance, strength and jumping exercises
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Aging; Osteoporosis; Exercise; Population based; Randomized trial; Falls; Fractures