Introduction: Osteoporosis is a silent disease but result in big health impact. Osteoporotic fractures especially hip or vertebral fractures cause substantial pain, severe disability and also associate with decreased life expectancy. Furthermore, it results in heavy burden to health care system. Elderly falls are an independent and important determinant of hip fractures. It is advocated that treatments for osteoporosis should include not only drug treatment but also advice on lifestyle, nutrition, exercise and other measures to reduce falls. This study evaluated whether a tailor-made client empowerment exercise program is effective in promoting bone health and prevent fall incidence in clients with osteopenia or osteoporosis.
Method: This was a retrospective study. Clients with osteoporosis or osteopenia plus³ 2 osteoporotic fracture risk factors were recruited into the program whereas those presented with secondary osteoporosis were excluded. Multi-disciplinary education was provided to enrich clients' knowledge on consequence and management of osteoporosis and falls, and at the meanwhile motivate them to adapt an active life style. Then, clients would go through 8 weeks of trice-a-week physiotherapist-lead training and practical sessions to empower their skill and knowledge on performing specific exercises such as postural and flexibility, balance, muscle strengthening, low impact weight bearing exercises and Tai Chi. In addition, whole body vibration therapy was provided to suitable clients. Berg balance scale, body mass index, tragus to wall test, grip strength, 30 seconds chair stand test, six minute walk test, exercise habit and fall frequency were assessed at baseline, post program, and one year follow up to evaluate the effectiveness of the program. DEXA was used to measured bone health at baseline and two years follow up. Data was analysis with paired t-test and chi square X2 using MedCalc Ver 15.6.1, p was set at ￡ 0.05.
Results: 26 female clients (age: 68.7 ± 9.0) was participating in the program. 19 of them were completed 1 year follow up and 5 were completed 2 year follow up. In summary: Berg balance scale, tragus to wall test, grip strength, 30 seconds chair stand test and 6 minute walk test were statistically significant improved (p < 0.05) from baseline to post treatment. The gains were able to maintain at 1 year follow up. Moreover, number of clients developing regular exercise habit was significantly increased (baseline:50%, one year follow up: 87%) and the fall rate seems to decrease( baseline: 15% and one year follow up:5%) . Concerning bone health, DEXA result of 5 clients who completed two years follow up showed that their bone density were well maintained.
Conclusion: A physiotherapist-leaded client empowerment exercise program is effective in modifying risk factors associated with fall & osteoporosis. It should be considered as part of the primary or secondary strategy in osteoporosis managemen
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