Effectiveness of Physiotherapeutic Group Education in Improving Quality of Life, Physical Performance and Back Extensor Muscle Strength among Postmenopausal Women with Osteoporosis

Abstract

Introduction: Menopause associated symptoms may interrupt daily activities and wellbeing among postmenopausal women. Decline in muscle strength and bone mineral density may lead to bone fragility, increase osteoporotic fracture risk, decrease functional performance and quality of life (QOL) among postmenopausal women. The aim of this study was to investigate the effectiveness of 8-weeks physiotherapeutic education (an education session and home-based exercise) on back extensor muscle (BEM) strength, physical performance, balance and QOL in postmenopausal women. Methods: A single blinded, two-arm pilot randomize clinical trial consisting of 30 postmenopausal women with mean age of 68.90 (SD = 8.44) years were randomly assigned to the experimental (n=15) and control (n=15) groups. Experimental group received a group education and performed 8-weeks of home-based exercises. Participants in experimental group recorded exercises performed in their exercise diaries and a physiotherapist monitored their progress through phone calls every two weeks. Control group maintained their daily routine. Assessments were performed at baseline and after eight weeks of intervention for quality of life (QOL), physical performance, BEM strength, handgrip muscle strength and balance using Euro-EQ5D Questionnaire, Short Physical Performance Battery (SPPB) test, prone trunk extension test with a load cell, hand-held dynamometer and Activities-specific Balance Confidence (ABC) scale, respectively. Results: The adherence of exercise in experimental group was 86.67%. Mixed model ANOVA analysis showed that there was an interaction effect for BEM strength (p < 0.01). Specifically, the self-perceived health status (EQVAS), EQ5D health Utility index, SPPB and ABC scale had more improvements from pre to post test (all p < 0.05) among experimental compared to control group. Conclusion: Physiotherapeutic education (a group education combined with 8-weeks of therapeutic home-based exercises) provides an effective means to improve BEM strength and physical performance in postmenopausal women.