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Efficacy of a self-management program for osteoporotic subjects
Alp A, Kanat E, Yurtkuran M
American Journal of Physical Medicine & Rehabilitation 2007 Aug;86(8):633-408
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study is based on whether the self-management program choices For Better Bone Health is effective to promote behavioral strategies for improving bone health, life quality, pain perception, physical function, and balance in osteoporotic subjects. DESIGN: In this single-blind, randomized controlled study, a total of 50 sedentary women with postmenopausal and idiopathic osteoporosis were selected from the outpatients of Ataturk Balneotherapy and Rehabilitation Center according to their physical activity level and T scores of dual-energy x-ray absorptiometry as the inclusion criteria. Fifty sedentary women with BMD T scores of -2.5 or lower were randomized into two groups (self-management group: group 1; and control group: group 2) and enrolled in a 6-mo study. Participants attended self-management class once a week for 5 wks. Evaluations were done at baseline, at the end of the fifth week, and at the sixth month. Pain-intensity evaluation by visual analogue scale (VAS), life-quality assessments by SF-36, balance testing by Sensitized Romberg Test (SRT), and functional assessment by Timed Sit to Stand test (TSS) and a simple questionnaire were the outcome measures. RESULTS: When the groups were compared by change scores and percentages of change, improvements observed in pain intensity by VAS (p < 0.001), SF-36 Physical Function (p < 0.001), SF-36 Physical Role Limitations (p < 0.001), SF-36 Social Function (p < 0.001), SF-36 Mental Health (p < 0.001), SF-36 Vitality (p < 0.01), SF-36 Pain (p < 0.001), SF-36 General Health Perceptions (p < 0.05), SF-36 Emotional Role Limitations (p < 0.01), SRT eyes open (p < 0.001), SRT eyes closed (p < 0.001), and TSS (p < 0.001) were determined to be superior in group 1 at the end of the sixth month. Seventy-four percent of patients in group 1 engaged in regular physical activities, and 92% of them declared that they understood the purpose and benefits of medications and dietary calcium intake. Fifty-seven percent of them formed personal plans for preventing traumas, whereas 8% of the subjects in group 2 experienced new falls but no fractures. CONCLUSION: It is determined that the self-management class led to improvements in functional, balance, and life-quality outcomes and to reductions in pain perception.

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