Authors (including presenting author) :
Liu BKP(1), Wong SMS(1), Wong GHS(1), Chao CYL(1), Chan ACM(1)
Affiliation :
(1)Physiotherapy Department, Queen Elizabeth Hospital
Introduction :
Osteoporosis is a progressive skeletal disease which leads to a reduction in the strength and mass of the bones. This leads to increased bone fragility and susceptibility to fracture. Bone reacts actively to increased loading and force and therefore exercise plays an important management strategy for maintaining or improving bone health and strength. Tai chi is a safe and effective form of exercise recommended for people with osteoporosis. It is gentle and works in a pain free joint range that strengthens muscles and improves body awareness and balance. Progressive resistance exercise stimulates bone cell activities by exerting a pulling force during muscular contraction through the tendon anchored on the bone. It is in believe that a combination of these two forms of exercise may yield a better health benefits.
Objectives :
To evaluate the efficacy of combining the modified tai chi chuan with theraband progressive resistance exercise on improving the balance control and muscle strength in people with osteoporosis.
Methodology :
Ninety-eight older adults, aged 64±5.5 years old, diagnosed with osteoporosis and attended the Osteoporosis Clinic at the Diabetic and Endocrine Centre in the Queen Elizabeth Hospital were invited to participate in the exercise program. The averaged DEXA T-score at the spine and hip was -1.9 and -2.2 respectively. All participants attended an exercise class in group of ten to twelve led by experienced physiotherapists. The exercise class composed of 4 forms of modified tai chi chuan exercise in conjunction with theraband progressive resistance exercise. Participants learned and practiced the exercise together. Postural advice and exercise that should be avoided were emphasized in the training. Participants were subsequently asked to self-practice the exercises, 30 minutes a day, 3 times a week regularly at home. An educational booklet with photos illustration on the taught exercise and exercise logbook for compliance checking were given. Outcome measures included muscle strength, balance performances and confidences, and quality of life measures. It was evaluated before training and at subsequent 6 months follow-up.
Result & Outcome :
At 6 months follow-up, the total handgrip strength was statistically significantly improved from 34.2±10.4 to 36.9±10.9 kgf (p=0.005), 30s sit to stand test improved from 11.4±5.1 to 13.1±5.7 times (p≤0.001), Timed up and Go test reduced from 11.5±4.0 to 10.2±4.1 seconds (p=0.005) and Berg Balance Scale Score improved from 49.66±7.7 to 50.7±5.8 (p=0.049). 82% of participants reported a successful development of regular exercise habit after attending the exercise class. Our results did not demonstrate statistical significant differences in the Activity-specific Balance Confidence score and the osteoporosis-specific quality-of-life questionnaire QUALEFFO31. Our findings showed that the combination of modified tai chi chuan with theraband progressive resistance exercise was effective on improving the balance control and muscle strength in older adults at risk of osteoporotic fragility fracture. Long-term strategies are required to promote the compliance of developing a regular exercise habit to combat osteoporosis and its associated complications.
