New research from Canada and Australia shows that finding the right model of exercise for vertebral fracture patients is tough…particularly at the recruitment stage.
The study, “Build better bones with exercise (B3E pilot trial): results of a feasibility study of a multicenter randomized controlled trial of 12 months of home exercise in older women with vertebral fracture,” appears in the November 2018 edition of Osteoporosis International.
Co-author Lora Giangregorio, Ph.D., Schlegel Research Chair in Mobility and Aging at the University of Waterloo in Ontario, Canada, explained the study to OTW“People with osteoporotic vertebral fractures are often fearful of fracturing again and can have pain or other issues related to their fracture. There is very little evidence related to the safety and efficacy of exercise in this population. In fact, they are often told, ‘Don’t bend. Don’t lift.’ This is a disincentive to physical activity participation.”
The authors wrote, “One hundred forty-one participants were recruited; an average of 20 per site, though most sites took longer than anticipated. Retention and adherence met the criteria for success: 92% of participants completed the study; average adherence was 66%. The intervention group did not differ significantly in the number of falls or fragility fractures compared to the control group. There were 18 serious adverse events in the intervention group and 12 in the control group.”
Dr. Giangregorio told OTW: “We learned that it is difficult to recruit individuals with vertebral fractures for an exercise study. People either didn’t want to exercise or being in a study, or they really wanted to exercise and didn’t want to risk being randomized to control. We have some interesting results forthcoming regarding the effects of the intervention on physical function and other outcomes—stay tuned. Future studies should consider alternative research designs, like comparative efficacy.”
“I am not sure a few physiotherapist visits to advise on home exercise is the right model of exercise delivery for this population to support long-term adherence and effectiveness. We might consider a model comparable to cardiac rehab, with graduation to a home program or community program that is fee for service. Further, I think we need to innovate in the design of clinical trials of exercise in the rehabilitation realm.”
“Many individuals with vertebral fractures want an exercise program and will stick with it. Don’t be afraid to recommend it and help them find resources to support physical activity or exercise participation. We developed resources (e.g., free downloadable videos, one page summaries for doctors and nurses to give out, booklet) with Osteoporosis Canada.”
Thanks