Effect of Two Different Exercise Programs on Physical Fitness of Women with Postmenopausal Osteoporosis*

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1 World Applied Sciences Journal 23 (8): , 2013 ISSN IDOSI Publications, 2013 DOI: /idosi.wasj Effect of Two Different Exercise Programs on Physical Fitness of Women with Postmenopausal Osteoporosis* Ramiz Arabaci and Mine Topsaç Department of Physical Education and Sport, Faculty of Education, Uludag University, Bursa, Turkey Submitted: May 21, 2013; Accepted: Jul 3, 2013; Published: Jul 22, 2013 Abstract: The aim of this study was to investigate the effect of different two twelve-week exercise programs which include strength and balance co-ordination to physical fitness capacity of elderly women with postmenopausal osteoporosis. 24 women between the ages of who suffer from osteoporosis and are treated with the support of medicines and have not menstruated for several years (menostasis) participated in this research. Subjects divided into two equal groups. Strength exercises program were applied to the first group (n=12, X age= 59.5±5.9 year) and balance co-ordination exercises program were applied to the second group (n=12, X age= 60.5±4.5 year). For each of group, before (pre-test) and after (post-test) the exercise program subjects anthropometric components such as height, weight, BMI, body fat %, waist and hip circumference, waist/hip ratio were determined and senior fitness tests (chair stand test, arm curl, 6 min walk, 2 min step tests, chair sit & reach, back scratch and 8 Foot Up and Go) were performed. Pre-test and post-test results were compared with Paired-Samples T Test. In conclusion, strength and balance co-ordination exercise programs that were applied to the year-old women with postmenopausal osteoporosis improve the physical fitness capacities. It is suggested that elderly women suffering from osteoporosis should apply at least 60-minute strength and/or balance co-ordination exercise programs in a week for more healthy and quality life. Thus, they will decrease the risk of falling down by improving strength, durability, flexibility and balance features and prevent to being fractures. Key words: Osteoporosis Physical activity Menostasis Strength Co-ordination Balance INTRODUCTION exercise plays an important role on the fight against osteoporosis in the elders, there is very little evidence Osteoporosis is a systemic skeletal disease which about this. Exercise is a broad concept. In this concept, ends with decreased bone mass, deterioration of physical activities which has wide spectrum, starting with micro-structure on bone tissue and increase in fragility very simple movements such as walking and complex [1, 2]. This skeletal disease is more common in women movements with the high-intensity in sports competitions than in men [3]. At least thirty per cent of women over the take part in. Increasing exercise has a positive effect on age of fifty in the world suffer from osteoporosis [4, 5]. many factors about health [8]. It is unknown that while The incidence of osteoporosis is increasing. The best osteoporosis is being treated and prevented, which treatment strategies were being tried to create with exercise (its type, frequency, intensity etc.) will provide communication between organizations. Morbidity and benefit [9, 10]. Although physical activity and exercise are mortality are common in old persons, especially in among important factors which provide to protect and patients with osteoporosis and it includes high medical increase the bone weight, type of exercise has more expenses [6]. Exercise has an important role among the important role. Every type of exercise does not provide to treatment and/or preventive strategies [7]. Although it the same effect. In recently studies have been emphasized depends on variables such as gender, race, diet, exercise that while strength exercises generally have an important and hormones; maximal weight of bone is generally effect on bone weight and bone density, swimming has reached in adulthood at first. In spite of the fact that not an important effect. Moreover it is important that *This study was presented in 13. National Sports Physician Congress, Bursa / TURKEY, December, Corresponding Author: Ramiz Arabaci, Department of Physical Education and Sport, Faculty of Education, Uludag University, Bursa, Turkey Cell: , Fax:

2 exercise was done which parts of body. For instance, if The aim of this study was to investigate the effect of exercise is basically done with the lower extremity; femur, different two 12 week exercise programs which include neck and lumbar spine may increase the bone density. strength and balance co-ordination to physical fitness It is suggested to the patients suffering from osteoporosis capacity of elderly women with postmenopausal that they should prefer dynamic exercises instead of static osteoporosis. ones and they should be applied exercises that increase their functional capacities [physical fitness] MATERIALS AND METHODS minutes workouts which improve to long-term flexibility, muscle strength and balance co-ordination are suggested Subjects: 24 women between the ages of who suffer especially for the elders [9]. In addition to this, strength from osteoporosis and are treated with the support of [11] and balance co-ordination exercises are recommended medicines in Physical Medicine and Rehabilitation to prevent the fractures which are often seen on elderly Department in Medical Faculty of Uludag University and patients suffering from osteoporosis and become have not menstruated for several years (menostasis) depending on falling down as a result of disturbances of participated in this research. All subjects have been balance [12, 13]. married and retired. They have 1000 $ average monthly Physical fitness components such as strength, income. Subjects divided into two equal groups and balance, co-ordination, flexibility, agility and endurance subject were chosen at random. Subjects have not are lower on elderly patients suffering from osteoporosis physical and/or mental condition which prevented to than their peers depending on in-activeness. These participate in intervention. Strength exercises were applied physical fitness components may be improved with to the first group (n=12, X age= 59.5±5.9 year) and balance exercise programs. However, there has not been done co-ordination exercises were applied to the second group much work that is well-designed up to present. (n=12, X = 60.5±4.5 year). Subjects were informed about age Fig. 1: Experimental Procedure 1062

3 Table 1: Exercise programs applied to the subjects. Strength Exercise Programs Balance Co-ordination Exercise Programs 1. Quadriceps isometric exercise 1. Reciprocal lower extremity movement (10 repetition, eyes closed) 2. Strengthening exercise upper extremity muscles (5-10 repetition) 2. Bridging (10 repetition) 3. Strengthening exercise abdominal muscles, back extensors (5 repetition) 3. Sitting down and standing up on a high chair (5 repetition). 4. Progressive resistive exercises lower extremity muscles In second week, sitting down and standing up on a low chair Quadriceps 4. Reciprocal foot movements 4.2. Hamstring 5. Modified Phomberg Exercises (standing in balance with closed-eyes 4.3. Gluteus Maximus during 20 seconds.) (on rough floor, on soft floor.) 4.4. Glutesus Medius 6. Standing in balance on one foot during 30 seconds (for two extremity) 4.5.Cooling- down exercises (eyes are open, eyes are closed) 7. Exercise with balance board 8. Bending to the forward, back and two sides on one extremity while eyes are open. 9. Walking / stopping on heel and tiptoe. 10. Walking / stopping in tandem position 11. Smooth floor / hurdle walking 12. Mini squat exercise 13. Cooling-down exercises application procedure before study. All subjects attended to the research as volunteers and they were informed about experimental method. Declaration of Helsinki was read by the subjects and they were informed about ethical principles [14]. post-test rates of every experimental group were compared with Paired-Samples T Test. P< 0.05 value was accepted as significance level. RESULTS Applied Exercise Program: 12-week (three day in a week: Dates that were gotten from study are shown on Monday, Wednesday, Friday), 60 minute exercise program Table 2 and Table 3. was applied to the subjects. Same warm-up program were It is shown on Table 2 that pre-test and post-test applied to the two groups; 5-10 minutes free exercises, height 66.6 ± 10.4 kg and 63.5 ± 11.3kg, BMI 27.3 ± 4.8 stretching exercises hamstring stretching, gluteus 2 2 kg/m and 26.1 ± 5.3 kg/m (p>0.05), BMR ± 501 kj maximus and hip flexor stretching, triceps surae and 5370 ± kj (p<0.05), body fat % 23.6 ± 7.9 and stretching, paraspinal stretching. Exercise programs which 20.9 ± 9.3 (p<0.05), waist circumference of 90.8 ±13.3 cm were applied to the two groups were indicated in Table 1. and 86.8 ± 9.9 cm (p<0.05), hip circumference of strength ± 12.8 cm and 107 ± 12.4 cm (p<0.05), waist/hip Experimental Procedure: Before the exercise program, circumference 0.83±0.06 and 0.81±0.05 (p>0.05) experimental subjects height and body compositions respectively is determined of strength group (SG). Pre-test were determined by using bioimpedance method and post-test, height 59.4 ±10.3 kg and 59.1 ± 9.8 kg (Tanita BC-418MA, Tanita Europe B.V. Hoogoorddreef 2 2 (p>0.05), BMI 24.2 ±4 kg/m and 23.9 ± 3.6 kg/m, BMR 56E1101 BE Amsterdam, Holland). After that, senior 5354 ± kj and 5200 ± kj (p<0.05), body fat % fitness tests were applied. In these tests, Chair Stand Test 20.1 ± 4.5 and 18.7 ± 5.1 (p<0.05), waist circumference is used for measuring lower extremity strength, Arm Curl 82.8 ± 8 cm and 80.5 ±6.8 cm (p<0.05), hip circumference Test is used for measuring strength, 6 min Walk and 2 min ± 6.8 cm and 101.1± 5.4 cm (p<0.05), waist/hip ratio Step Tests are used for measuring aerobic strengthen, 0.83 ± 0.06 and 0.81 ± 0.05 (p>0.05) respectively is 8 Foot up and Go is used for measuring skills [15]. determined balance co-ordination group. Same tests were applied again after 12-week exercise It is shown on Table 3 that pre-test and post-test program (Figure 1). Datas that were taken before chair stand 13.9 ± 3.4 no of stands and 17 ± 5.4 no of application (pre-test) compared with datas that were taken stands, arm curl 23 ± 4.8 no of rep and 26.8 ± 5.7 no of rep after application (post test). (p<0.05), 6 min walk 500.5±87.1m and 530 ±78.3 m (p<0.05), 2 min step test 76.9 ±14.7 no of steps and 97.8 ±28 no of Statistical Analysis: Data evaluation was done with steps (p<0.05), chair sit & reach 1.2±6.9 cm and 2.3 ±6.3 cm packaged software SPSS 17 for Windows. Pre-test and (p>0.05), back scratch -8.3 ± 9.4 cm and -4.9 ±7.1 cm 1063

4 Table 2: Descriptive and anthropometric features of subjects before and after exercise (Mean±SD) Strength (SG) Balance Co-ordination (BCG) Variable Pre-test Post -test Pre-test Post -test Height (cm) 161± ± ± ±4.8 Weight (kg) 66.6± ± ± ±9.8 2) BMI (kg/m 27.3± ± ±4 23.9±3.6 BMR (kj) ± ±439.5* 5354± ±318.6* Body Fat (%) 23.6± ±9.3* 20.1± ±5.1 Waist Circumference (cm) 90.8± ±9.9* 82.8±8 80.5±6.8* Hip Circumference (cm) 109.6± ±12.4* 103.8± ±5.4* Waist/Hip Ratio 0.83± ± ± ±0.06 BMI: Body Mass Index SG: Strength Group BMR: Basal Metabolic Rate BCG: Balance Co-ordination Group * : p<0.05: There is statistically significant difference. Table 3: Senior fitness test score of subjects before and after exercise program (Mean±SS) Strength Group (SG) Balance Coordination Group (BCG) Variable Pre-test Post -test Pre-test Post -test Chair Stand (no of stands) 13.9±3.4 17±5.4* 15.6± ±3.3 Arm Curl (no of rep) 23± ±5.7* 22± ±5.5 6 min Walk (m) 500.5± ±78.3* 495± ± min Step Test (no of steps) 76.9± ±28* 110.8± ±31.2 Chair Sit & Reach (cm) 1.2± ± ± ±3.6* Back Scratch (cm) -8.3± ±7.1* -3.96± ±3.4 8 Foot Up and Go (sec) 6.1± ± ± ±1.3* * : There is statistically significant difference (p<0.05) (p<0.05), 8 foot up and go 6.1 ±1.2 sec and 5.7 ±1.2 sec strength and balance co-ordination exercises on physical (p>0.05) respectively is determined of strength group. fitness of menopausal women who suffer from Pre-test and post-test chair stand 15.6 ±4.3 no of number osteoporosis. Hypothesis of this research is determined and 16.1 ±3.3 no of number (p>0.05), arm curl 22 ±3.9 no of so; the effects of two applied exercise methods on rep and 25.5 ± 5.5 no of rep (p>0.05), 6 min walk 495 ±34.6 physical fitnesses of experimental subjects are positive; m and ± 35.7 m (p>0.05), 2 min step test ± 23.9 but strength exercises are more effective in accordance no of step and ± 31.2 no of step (p>0.05), chair sit with balance co-ordination exercises. When variances on and reach 0.67 ±7.1 cm and 2.8 ±3.6 cm (p<0.05), back anthropometric features of experimental subjects who are scratch ± 4.1 cm and -1.2 ± 3.4 cm (p>0.05), 8 foot up in control and balance co-ordination group were analyzed, and go 7.2 ± 1.9 sec and 5.6 ±1.3 sec (p<0.05) respectively we determined that average height, BMI, %fat, waist and is determined of balance co-ordination group. hip circumference decreased after 12-week exercise program. However, it can be said that differences between DISCUSSION two measurements are more in control group. When differences on physical fitness features of Many of studies that investigate effects of exercise experimental subjects who participated in research were which is used on treatment of osteoporosis were done. analyzed after 12-week exercise, it is confirmed that Results from these studies show that resistance and changes happened in a positive way in strength and strength exercises have an important role on treatment balance co-ordination groups. However, while statistically and prevention of osteoporosis. There are lots of significant difference happens in a positive way on upper researches which show that balance and co-ordination and lower extremity strength, aerobic resistance and upper exercises are beneficial in addition to resistance exercises extremity flexibility in strength group [p<0.05]; in balance [16-20]. We do not know about researches that research co-ordination group, statistically significant difference effects of strength and balance co-ordination exercises on happens in just dynamic balance and lower extremity physical fitness of women who suffer from osteoporosis. flexibility. Results that were gotten from our research Aim of our study was to investigate the effect of 12-week support the hypothesis that we mentioned above. 1064

5 Rogers et al., (2001) determined thanks to their tissue. Moreover falling down and fractures depending on research that training programs, which include balance falling down can be prevented by improving balance and exercises and applied to elders suffering from co-ordination. Both balance and co-ordination features osteoporosis, are more developer than training programs, can be improved by applying exercise programs which which include aerobic, strength or flexibility exercises, in include strength and balance co-ordination exercises to terms of balance [21]. Although it is a complex subject to the women suffering from osteoporosis. As a result, they designate the effect of different types of exercises, it is live a high-quality life. emphasized on lots of researches that balance exercises decrease the risk of falling down [22, 23]. Some researches REFERENCES which analyze the effect of exercise that is about decreasing the falling down on elders show that physical 1. Howe, T.E., B. Shea, L.J. Dawson, F. Downie, activity decreases the falling down %40 [24]. A. Murray, C. Ross, R.T. Harbour, L.M. Caldwell and This research has some limitations. Firstly; just G. Greed, Exercise for Preventing and Treating volunteer women took part in this research as Osteoporosis in Postmenopausal Women. Cochrane experimental subjects. Secondly, it can be generally said Database Systematic Review, 6(7): CD pub2. that functional capacities of experimental subjects were 2. NIH Consensus Development Panel on Osteoporosis good at the beginning of exercise programs. Finally, just Prevention, D. A., Osteoporosis prevention, two different types of exercises were controlled. Type of diagnosis and therapy. The Journal of The American exercise which improve the functional capacity in a best Medical Assoc, 285(6): way can be determined by taking different exercise 3. ACSM, American College of Sports Medicine programs such as durability and swimming to the position stand. Osteoporosis and exercise. Medicine experimental procedure. Moreover we can recommend that and Science in Sports and Exercise, 27(4): 1-7. exercise programs should be applied for a longer time. 4. Delaney, M.F. and M.S. LeBoff, Metabolic Bone Disease. In: S. Ruddy, E.D. Harris and C.B. CONCLUSION Sledge, Kelly's Textbook of Rheumatology. Philadelphia: WB Saunders Company. Consequently, strength and balance co-ordination 5. Kleereekoper, M. and L.V. Avioli, Evaluation exercise programs that were applied to the year-old and Treatment of Postmenapausal Osteoporosis. women with postmenopausal osteoporosis improve the En: Primer on the Metabolic Bone Diseases and physical fitness capacities. It is suggested that elderly Disorders of Mineral Metabolism. M. Favus et al. women suffering from osteoporosis should apply at least Lippincott Raven Publishers. Philadelphia. 60-minute strength and/or balance co-ordination exercise 6. Sinaki, M., R.H. Brey, C.A. Hughes, D.R. Larson and programs in a week for more healthy and quality life. K. Kaufman, Balance Disorder and Increased Thus, they will decrease the risk of falling down by Risk of Falls in Osteoporosis and Kyphosis: improving strength, durability, flexibility and balance significance of Kyphotic Posture and Muscle features and prevent to being fractures. Strength. Osteoporos International, 16(8): Nooritajer, M., The Effect of Education on ACKNOWLEDGEMENTS Physical Activity Style and Body Mass Index on Employed Women in Iran University of Medical The authors would like to thank of all of the females Sciences. World Applied Sciences Journal, who participated in present study. We wanted to say our 9(6): satisfaction for the support of Department of Physical 8. El-Kader, M.A. and M.A. Gari, Physical Therapy and Rehabilitation, Faculty of Medicine, Uludag Training Combined with Dietary Measures and University. Acupuncture in The Treatment of Adult Obesity. A Comparison of Two Protocols. World Applied Practical Applications: Exercise programs which were Sciences Journal, 7(4): applied to elderly women suffering from osteoporosis and 9. Bergmann, P., J.J. Body, S. Boonen, Y. Boutsen, include three-day, 60-minute per a day strength and J.P. Devogelaer, S. Goemaere, J. Kaufman, J.Y. balance co-ordination exercises improve physical fitness Reginster and S. Rozenberg, Loading and and functional capacities. This type of exercises slows Skeletal Development and Maintenance. Journal of down to osteolysis by increasing the resistance of bone Osteoporosis, 2011(ID ):

6 10. Turner, C.H. and A.G. Robling, Exercises for 18. Bleicher, K., R.G. Cumming, V. Naganathan, Improving Bone Strength. Britisch Journal of Sport J.M. Seibel, P.N. Sambrook, M.F. Blyth, D.G. Le Medicine, 39(40): Couteur, J.D. Handelsman, H.M. Creasey and 11. Warburton, D.E., N. Gledhill and A. Quinney, L. Waite, Lifestyle Factors, Medications and The Effects of Changes in Musculoskeletal Fitness Disease Influence Bone Mineral Density In Older on Health. Canadian Journal of Applied Physiology, Men: Findings From The Champ Study. Osteoporos 26(2): International, 22(9): Carter, N.D., K.M. Khan, M.A. Petit, A. Heinonen, 19. Nikander, R., H. Sievanen, A. Heinonen, M.D. Robin, C. Waterman, M.G. Donaldson, P.A. Janssen, K. Uusi- Rasi and P. Kannus, Targeted Exercise A. Mallinson, L. Riddell, K. Kruse, J.C. Prior, Against Osteoporosis: A Systematic Review and L. Flicker and H.A. McKay, Results of a 10 week Meta-Analysis for Optimising Bone Strength Community Based Strength and Balance Training Throughout Life. BMC Medicine, 8: 47. Programme to Reduce Fall Risk Factors: A 20. Levine, J.P., Identification, Piagnosis and Randomised Controlled Trial in year Old Prevention of Osteoporosis. American Journal of Women with Osteoporosis. Britisch Journal of Sport Managemment Care, 17(suppl 6): Medicine, 35(5): Rogers, M.E., J.E. Fernandez and R.M. Bohlken, Abbasi, A., H. Sadeghi, H.B. Tabrizi, K. Bagheri, Training to Reduce Postural Sway and Increase A. Chazemizad and A.K. Asl, Effect of Whole Functional Reach In the Elderly. Journal of Body Vibration, Aquatic Balance and Combined Occupational Rejabilitation, 11(4): Training on Neuromuscular Performance, Balance and 22. Chang, J.T., S.C. Morton, L.Z. Rubenstein, Walking Ability in Male Elderly Able-Bodied W.A. Mojica, M. Maglione, M.J. Suttorp, E.A. Roth Individual. World Applied Sciences Journal, and P.G. Shekelle, Interventions for the 15(1): Prevention of Falls in Older Adults:Systematic 14. World Medical Association Declaration of Review and Metaanalysis of Randomised Clinical Helsinki, Ethical Principles for Medical Research Trials. British Medical Journal, 328(7441): Involving Human Subjects. JAMA, 284(23): Skelton, D.A., Effects of Physical Activity on Postural Stability. Age Ageing, 30(Suppl. 4): Jones, C.J. and R.E. Rikli, Measuring Functional 24. Brnett, A., B. Smith, S.R. Lord, M. Williams and Fitness of Older Adults. The Journal on Active A. Baumand, Community-Based Group Exercise Aging, 1(2): Improves Balance and Reduces Falls in At-Risk Older 16. Bailey, C.A., S. Kukuljan and R.M. Daly, People: A Randomised Contolled Trial. Age Ageing, Effects of Lifetime Loading History on Cortical Bone 32(4): Density and its Distribution in Middle-Aged and Older Men. Bone, 47(3): Bemben, D.A. and M.G. Bemben, Dose-Response Effect of 40 Weeks of Resistance Training on Bone Mineral Density in Older Adults. Osteoporos International, 22(1):

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