Abstract
BackgroundOsteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition.Methods/designThe Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed.DiscussionThe findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture.Trial registrationAustralian New Zealand Clinical Trials Registry reference ACTRN12609000100291
Highlights
Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease
This paper describes the methods of the Osteo-cise: Strong Bones for Life trial; an 18-month communitybased randomised controlled trial designed to evaluate the effectiveness and feasibility of an evidence-based, multi-modal exercise, osteoporosis education and behavioural change program for improving bone health, muscle power and function in community-dwelling older adults at increased risk for falls and fracture
The long-term goal is that the Osteocise: Strong Bones for Life program will serve as a model for future osteoporosis and falls prevention programs that can be implemented within the community with the aim of reducing fracture incidence and related risk factors for fracture, and reduce osteoporosisrelated health care costs and morbidity
Summary
Osteoporosis and associated fractures are a growing public health concern globally, but current practice is largely aimed at secondary prevention after fractures have occurred, rather than primary prevention at the community level [2]. The Osteo-cise: Strong Bones for Life project is unique in that it is designed as an evidence-based ‘research to practise' trial to evaluate the feasibility and effectiveness of a multifaceted community-based exercise, osteoporosis education/awareness and behavioural change program for improving musculoskeletal health and function in older adults at increased risk of osteoporosis, falls and fractures. JG, CAB and RMD wrote the manuscript and PRE, KMS, CAN and KH reviewed draft versions.
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