Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial

J Am Geriatr Soc. 2004 Sep;52(9):1471-8. doi: 10.1111/j.1532-5415.2004.52409.x.


Objectives: To assess whether group exercise and coping classes reduce physical and psychological impairments and functional disability in older women with prevalent vertebral fractures (VFs).

Design: Randomized, controlled trial (modified cross-over) with site as unit of assignment; testing at baseline and 3, 6, 9, and 12 months.

Setting: Nine North Carolina retirement communities.

Participants: One hundred eighty-five postmenopausal Caucasian women (mean age 81), each with at least one VFs.

Intervention: The intervention group had 6 months of exercise (3 meetings weekly, 45 minutes each) and coping classes (2 meetings weekly, 45 minutes each) in Phase 1, followed by 6 months of self-maintenance. The control group had 6 months of health education control intervention (1 meeting weekly, 45 minutes) in Phase 1, followed by the intervention described above.

Measurements: Change in trunk extension strength, change in pain with activities, and change in psychological symptoms.

Results: Between-group differences in the change in trunk extension strength (10.68 foot pounds, P<.001) and psychological symptoms (-0.08, P=.011) were significant for Phase 1. Changes in pain with activities did not differ between groups (-0.03, P=.64); there was no change in the pain endpoint. In Phase 2, controls showed significant changes in trunk strength (15.02 foot pounds, P<.001) and psychological symptoms (-0.11, P=.006) from baseline. Change in pain with activities was not significant (-0.03, P=.70). During self-maintenance, the intervention group did not worsen in psychological symptoms, but improved trunk extension strength was not maintained.

Conclusion: Weak trunk extension strength and psychological symptoms associated with VFs can be improved in older women using group treatment, and psychological improvements are retained for at least 6 months.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Aged
  • Aged, 80 and over
  • Cross-Over Studies
  • Exercise Therapy / organization & administration*
  • Female
  • Geriatric Assessment
  • Humans
  • Longitudinal Studies
  • Mental Health*
  • Muscle Weakness / diagnosis
  • Muscle Weakness / etiology
  • Muscle Weakness / prevention & control*
  • North Carolina
  • Osteoporosis, Postmenopausal / complications
  • Pain / etiology
  • Pain / prevention & control
  • Patient Education as Topic / organization & administration*
  • Self-Help Groups / organization & administration*
  • Spinal Fractures / complications
  • Spinal Fractures / physiopathology
  • Spinal Fractures / psychology
  • Spinal Fractures / rehabilitation*
  • Thorax
  • Treatment Outcome