PURPOSE This study evaluated a multifaceted intervention for osteoarthritis symptoms. METHODS A cluster randomized controlled trial was conducted with a convenience sample of 90 patients aged between 45 and 82 years, who were recruited from three Community Health Posts (CHPs). The CHPs were randomized into two experimental groups (E1 and E2) and one control group (C). The intervention included health education and counseling combined with exercise classes based on the Interaction Model of Client Health Behavior. Trained community health nurse practitioners led the intervention. Stretching exercise (E1) and walking (E2) combined with muscle strengthening exercise were provided. The instruments included the Patient Activation Measure (PAM), Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), Stanford Health Assessment Questionnaire Disability Scale (HAQDS), and Center for Epidemiologic Studies Depression Scale (CES-D). The HAQDS was measured using an ordinal scale, and Likert scales were used for the other instruments. Chi-square test and analysis of covariance were used; P values  .05) except for joint pain and patient activation (P < .05). At post-test, the changes in the mean scores were significant for joint pain and stiffness, and physical functioning. E2 with walking exercise showed better improvements in joint pain and physical functioning than the other groups (P < .01). CONCLUSIONS Eight sessions of multifaceted intervention improved the osteoarthritis symptoms. Follow-up studies will be needed to determine the intermediate and long-term effects of the multifaceted intervention.

Evaluation of the Interaction Model of Client Health Behavior-based multifaceted intervention on patient activation and osteoarthritis symptoms.

Effects of 12 Weeks Aerobic Exercise on Health-related Physical Fitness and Bone Density in Elderly

[Purpose] This study was designed to investigate the effects of lactose-free milk intake and whole-body vibration exercises on bone density in elderly female nursing home residents who had difficulty exercising outdoors and had not consumed milk. [Subjects and Methods] Twenty seven elderly women aged 70 or older from 3 nursing homes located in Incheon, Korea participated in the study. The experimental group (n=13) carried out whole-body vibration exercises and drank lactose-free milk, while the control group (n=14) continued to live their ordinary nursing home lives. Weight, BMI, T-scores, and Z-scores were compared between the experimental and control groups after 12 weeks. [Results] The comparison of changes in weight and BMI in the control group before and after the 12-week experiment found no statistically significant differences. However, bone mineral density was significantly different, with the T-score significantly decreasing from -2.99 to -3.48 and the Z-score decreasing from -1.87 to -2.58. The other comparisons of physical changes in the control group before and after the 12-week experiment found no statistical significance. [Conclusion] The results indicate that regular consumption of lactose-free milk and performing whole-body vibration exercises can delay the progression of bone density loss in older adults in nursing homes; adequate exercise and calcium intake could eventually help prevent fractures.

https://www.jstage.jst.go.jp/article/jpts/29/7/29_jpts-2017-096/_pdf

The effects of milk intake and whole-body vibration exercise on bone mineral density in elderly women in nursing homes.

TThe effects of swimming, bicycle exercise, or combined exercise on body composition and bone density in old women

The purpose of this study is to investigate the effects of indoor and outdoor exercise environments on bone mineral density and body composition in old women. A total of 26 old women were randomly divided into two groups: an indoor exercise group (IE, n=13) and an outdoor exercise group (OE, n=13). The exercise groups performed moderate exercise (HR max 50~70%; RPE 11-15) three times a week for 60 minutes over 20 weeks. After exercise training, bone mineral density was significantly improved in the OE group as compared with the IE group. Body fat mass was significantly decreased in the IE group. Weight, lean body mass, and body fat mass were significantly decreased in the OE group. Body mass index was significantly decreased in the outdoor exercise group as compared to the IE group. Our findings show that a 20-week program of outdoor exercise training improves bone mineral density and body composition in old women. As mentioned above, it has been found that engaging in an outdoor exercise program for 20 weeks has a positive effect on bone mineral density and body composition in old women. In conclusion, engaging in the outdoor exercise program, including aerobic and resistance exercises, for 20 weeks improved bone mineral density and inhibited bone loss in old women and had a positive influence on vitamin D levels, thereby potentially lowering the risk of osteoporosis.

http://koreascience.or.kr:80/article/JAKO201225150623038.pdf

Jeong-Ok Yang

Papers

Effects of Indoor and Outdoor Exercise Environments on Bone Mineral Density and Body Composition in Old Women