ACTLIFE protocol for osteoporotic women: preliminary results at 6 months

INTRODUCTION: Osteoporosis (OP) is characterized by a reduced bone mass, that is accompanied by an increased risk of fracture with consequent pain, decreased physical, social, and functional capacity. Therefore, the impaired postural alignment and the reduced mobility and flexibility of the spine limit the use of the normal motor strategies, important features to reduce the risk of falling. The aim of the study is to evaluate the range of motion (ROM) and joint mobility before and after 22-weeks exercise protocol (ACTLIFE) for women with post-menopausal OP. METHODS: 21 sedentary women (63 ± 5 years) with primary post-menopausal OP were recruited by Center and Metabolic Skeleton Diseases at the Rizzoli Institute Orthopaedic in Bologna. Subjects with vertebral fracture were included. ACTLIFE protocol, aimed at improving joint mobility, muscle force, balance, motor coordination and endurance, was performed by the subjects twice a week for 22 weeks. The subjects were directly followed by the trainers, every 6 weeks the program was changed. The ROM of knee, hip and shoulder and the mobility of low back by sit and reach test were evaluated before and after the program. RESULTS: After 6 months of intervention, shoulders ROM significantly improved from 40.4±36 cm to 29.7±33 cm (p<0.05). Sit and reach test also changed from 0.81±8.5 cm to -2±9 cm (p<0.05). The hip and knee ROM showed no significant differences (hip from 103.5° ±6.2° to 104.5°±9.6°, knee from 125°±8.9° to 126°±7.5°). CONCLUSION: Shoulder joint may result often weak and not-well trained. This could explain how a specific training could induce significant improvement in ROM after 6 months. Several studies reported low back pain as one of main functional problems in OP subjects. Hence, several exercises of ACTLIFE protocol were focused on improving hamstring muscles flexibility, muscles core awareness, pelvis and lumbar spine mobility. This was reflected in great results on sit and reach test. Knee and hip ROM at the baseline were already high for all the cohort, thus no significant improvements could be found after 6 months of protocol. A further analysis after 12 months could be interesting to evaluated subjects’ progresses. In future, a wider experimental group is needed to better understand the role of physical activity programs on mobility and its relationship with OP disease.