impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis

Osteoporosis is a major public health problem affecting the elderly population, particularly women. The objective of the study was to evaluate the effects of adding weight-bearing exercise as opposed to nonweight-bearing programs to the medical treatment of bone mineral density [BMD] and health-related quality of life [HRQoL] of elderly patients with osteoporosis. Participating in the study were 40 elderly osteoporotic patients [27 females and 13 males], with ages ranging from 60 to 67 years, who were receiving medical treatment for osteoporosis. They were assigned randomly into two groups: Group-I: Twenty patients practiced weight-bearing exercises. Group-II: Twenty patients did nonweight-bearing exercises. All patients trained for 45-60 min/session, two sessions/week for 6 months. BMD of the lumbar spine, right neck of femur, and right distal radial head of all patients were measured by dual-energy X-ray absorptiometry before and after both treatment programs. In addition, the QoL was measured by means of the HRQoL "ECOS-16" questionnaire. T-tests proved that mean values of BMD of the lumbar spine, right neck of femur and right distal radial head were significantly increased in both groups with greater improvement in the weight-bearing group. The QoL was significantly improved in both groups, but the difference between them was not significant. Addition of weight-bearing exercise program to medical treatment increases BMD more than nonweight-bearing exercise in elderly subjects with osteoporosis. Furthermore, both weight-bearing and nonweight-bearing exercise programs significantly improved the QoL of patients with osteoporosis

effect of different laser intensities on elderly with knee osteoarthritis

The purpose of this study was to determine the effect of two different intensities of low-level laser therapy [LLLT] on reducing pain severity, improving the quality of life through increasing functional ability, and the active knee flexion range of motion in elderly patients with knee osteoarthritis. Thirty patients [male and female] aged between 60 and 70 years and diagnosed as chronic knee osteoarthritis participated in this study. Patients were assigned randomly into two groups: the first [group A] 15 [4 male and 11 female] patients with a mean age of 64.3 [ +/- 6.3] years treated with a laser dose of 3 J/cm[2] over 5 points around the knee. The second group [group B] 15 [6 male and 9 female] patients with a mean age of 60.5 [ +/- 8.7] years treated with a laser dose of 6 J/cm[2] on the same 5 points around the knee. Both groups received an exercise program consisted of stretching for the quadriceps and calf muscles in addition to strengthening exercises in form of straight leg raising and quadriceps setting exercise. The treatment lasted for 12 sessions, 3 sessions per week "each other day". Patients were assessed before and after treatment by Visual Analogue Scale [for pain] WOMAC index, and universal goniometer [for quality of life]. Statistical analysis revealed that there was a significant improvement in pain intensity, functional ability, and range of active knee flexion in both treatment groups after treatment, with no significant difference between both treatment groups. Low-level laser therapy is effective in the treatment of a elderly patients with knee osteoarthritis regarding the dose of 3 J/cm[2]. or 6 J/cm[2]. At the same time it is safe and applicable for elderly subjects

Efficacy of muscle energy technique in treatment of chronic mechanical low back pain

This study was conducted to compare the effect of muscle energy technique versus combined spinal flexion-extension exercises on reduction of pain severity, functional disability; and increasing the range of motion of trunk flexion, extension, right, and left bending in mechanical low back pain patients. Forty male and female patients diagnosed as chronic mechanical low back pain participated in this study. Patients were divided randomly into two groups, the first group [Group A] consisted of 11 male and 9 female patients with a mean age 33 [ +/- 1.58] years treated with the combined spinal flexion-extension exercises program, the second group [Group B] consisted of 9 male and 11 female patients with a mean age 30.20 [ +/- 1.57] years treated with the muscle energy technique. Both groups were treated for 12 sessions, 3 sessions per week [each other day]. Patients were assessed before and after treatment by visual analouge scale, Oswestry disability index, and tape measurements. Both groups had significantly less low back pain severity and less functional disability after treatment. The improvement of pain and function in the muscle energy technique group was more than the combined spinal flexion-extension group. The combined spinal flexion-extension exercise were more effective in increasing lumbar flexion and extension motions than the muscle energy technique. There was no significant difference between groups regarding increasing the right and left trunk bending motions. The muscle energy technique is more effective than the combined spinal flexion-extension exercises in reducing low back pain severity and functional disability and is recommended to be used for patients with chronic mechanical low back pain. Spinal flexion-extension exercises are recommended to be used when increasing lumbar flexion and extension motions is an additional goal of treatment

Role of aerobic training program on pain, function, and aerobic fitness in chronic low back pain patients

The purpose of this study was to investigate the efficacy of three different exercise programs [back program, aerobic program and back in addition to aerobic program] on pain severity, functional disability, and aerobic fitness [maximal oxygen consumption, maximal oxygen consumption per kilogram, expiratory volume and breathing frequency] in patients with chronic mechanical low back pain. Sixty [26 male and 34female] adult patients were included in this study. Their age ranged from 25 to 45 years with mean age of [35. 7 +/- 6.1] with a history of chronic mechanical low back pain [suffering from low back pain for more three months at least]. Patients were divided randomly into three equal groups: each group included twenty patients. Group-a: participated in back exercise program three times per week for two months. Group-b: practiced conditioning exercise program three times per week for thirty to forty minutes for two months. Group-c: practiced back exercises plus conditioning exercises program three times per week for thirty to forty minutes for two months. Pain intensity was assessed by visual analog scale. The functional status of the patients was assessed by Oswestry Low back pain disability questionnaire. Aerobic fitness was evaluated by ErgoSpirometry-system [ZAN] before and after the three treatment programs. Paird t-test statistical analysis revealed there were significant improvements in pain, functional disability scale in all groups, while aerobic fitness improved in group II, and III only. The AN OVA and LSD revealed that there were significant differences among three groups where the third group was the best group regarding pain intensity and aerobic fitness. From this study it was concluded that aerobic exercises has an important role in the treatment of patients with chronic low back pain and should be included in management of those patients