AIM: To explore the effect of exercise therapy on the improvements of bone mineral density and low back pain in pulmonary tuberculosis patients with osteoporosis. METHODS: Seventy-two patients with infiltrative pulmonary tuberculosis patients with osteoporosis, who were treated in Yuhong District Tuberculosis Dispensary from January 2002 and December 2004, were randomly divided into exercise group (n = 36) and control group (n = 36). The main manifestations of the patients were low lack pain, and osteoporosis in thoracic spine and lumbar spine and vertebral deformation shown by x-ray from frontal and lateral positions. All the patients received drug therapy of anti-tuberculosis and calcium supplement, besides those in the exercise group received walking intervention of aerobic endurance exercise, the velocity was 80 to 100 pace per minute, the walking distance was 1.0 to 5.0 km, 15 to 20 minutes for each time and gradually increased after 2 to 4 weeks to the maximal time of 60 minutes, the frequency was 3 times a week. The aware exercise intensity ranged 12 to 13 exercise equivalent, the training lasted for 6 months. Evaluation of curative effects: (1) The lumbar bone mineral densities of anteroposterior position were detected before and after treatment with dual energy x-ray absorptiometry (the golden diagnostic standard of osteoporosis was bone mineral density < 25% of the normal value arid above; the x-ray characteristics of osteoporosis was divided into 4 grades according to the form of bone trabecula; Primary period: total bone mineral density was decreased, bone trabecula was thin; grade I: transverse bone trabecula was reduced, vertical bone trabecula was obvious; grade II: transverse bone trabecula was further reduced, vertical bone trabecula became wider; grade III: transverse bone trabecula almost disappeared, vertical bone trabecula was also not obvious). (2) Scoring standards for low back pain; pain was lasting and obvious as 1.5 points; pain was sometimes mild and sometimes severe as 1.0 point; feeling pain or slight pain after tiredness as 0.5 point; no pain as 0 point; All the patients in both groups were assessed before and after treatment respectively. (3) According to the degree of low back pain and osteoporosis and bone mineral density, the curative effect in the exercise group was evaluated after exercise; The evaluation standards of curative effects; disappearance of symptoms (low back pain disappeared completely; spinal x-ray showed normal to changes of grade I, or no abnormality of bone mineral density), turn better (the symptom of low back pain almost disappeared, but spinal x-ray showed no changes of grade II and above, or bone mineral density turned from moderate and severe to normal or mild), invalid (no changes in low back pain, spinal x-ray and determination of bone mineral density). The t test was used for the analysis of the intergroup significant difference. RESULTS: All the 72 cases were involved in the analysis of results without deletion. (1) The lumbar bone mineral density in the exercise group after treatment was significantly higher than that in the control group (0.87 +/- 0.16, 0.68 +/- 0.15 g/cm2, t = 5.198, p < 0.05); the symptom of low back pain in the exercise group after treatment was obviously ameliorated as compared with that in the control group (0.565 +/- 0.15, 0.395 +/- 0.11, t = 5.484, p < 0.05); compared with before treatment, the lumbar bone mineral density after treatment was markedly increased, and the symptom of low back pain was significantly ameliorated in the exercise group. (2) After 6-month training in the exercise group, the symptom disappeared in 11% (4/36) of the patients, turned better in 36% (13/36), and invalid in 53% (19/36), the total effective rate was 47% (17/36). CONCLUSION: Aerobic exercise therapy can not only relieve bone loss and increase bone mineral density, but also ameliorate the symptom of low back pain in the patients, it can effectively improve the clinical symptoms in pulmonary tuberculosis patients with osteoporosis.

Full text (sometimes free) may be available at these link(s):      help

• PDF locator
• publisher