OSTEOPOROSIS AND DISABILITY IN LIFE-CARE COMMUNITY WOMEN

以前对女性骨质疏松症的研究主要集中在以下策略上 减少骨质流失或增加骨量。然而，很少有人注意到这一点 致力于解决女性多发性脊椎骨折的问题 有严重的疼痛、畸形和残疾。尽管减损 由脊椎骨折引起的不能完全纠正，它是 有可能通过有针对性的干预来改善这类残疾。 生活护理社区是这种干预的理想环境 因为在这些地区骨质疏松和脊椎骨折的患病率 设置很高，因为住在那里的妇女很容易进入 为了一次干预。我们建议对180名老年女性进行干预 有两个或两个以上的脊椎压缩骨折。六大生命关怀 北卡罗来纳州的社区已经同意允许我们从 并利用他们的设施进行这项干预。 在干预开始之前，所有受试者都将在 三个领域：生理、功能和心理社会。我们 已经设计并测试了为做到这一点而采取的措施的可靠性。一半的人 每个家庭的受访者都将参与以骨质疏松症为重点的 干预包括两个部分：物理治疗部分，包括 专门为解决肌肉骨骼问题而设计的练习 由脊柱骨折引起的，以及将关注的社会工作部分 关于教授应对技巧、保持自尊和减少压力 和精神症状。其他女性将接受安慰剂治疗 干预也有这两个组成部分，但不是定向的 骨质疏松症的问题。在安慰剂干预完成后， 这项研究的所有女性都将有机会 参与骨质疏松症干预的同时进行第一次干预 小组将练习自我维护技能。将重复采取措施 每隔三个月。我们的具体目标是提高产品质量 受访者在身体、功能和生活方面的生活 通过干预的心理社会表现，然后有那些 通过持续的个人锻炼和持续使用保持改善 积极的应对策略。这种干预应该很容易转化为 以一种低成本的方式帮助那些遭受痛苦的女性， 局限性，以及通常由脊柱引起的心理社会障碍 骨质疏松合并脊椎压缩骨折。

Previous studies of osteoporosis in women have focused on strategies to reduce bone loss or increase bone mass. Yet scant attention has been devoted to the problem of women with multiple vertebral fractures who have substantial pain, deformity, and disability. Although impairments caused by vertebral fractures cannot be completely corrected, it is possible to improve such disabilities with a targeted intervention. Life-care communities are an ideal setting for such an intervention because the prevalence of osteoporosis and vertebral fractures in these settings is high, and because women living there would have easy access to an intervention. We propose an intervention for 180 older women who have two or more vertebral compression fractures. Six life-care communities in North Carolina have agreed to permit us to recruit from their populations and to use their facilities for this intervention. Prior to the start of the intervention, all subjects will be assessed in three domains: the physical, the functional, and the psychosocial. We have designed and tested the reliability of measures to do this. Half of the respondents in each home will participate in the osteoporosis-focused intervention with two components: a physical therapy component with exercises designed specifically to address the musculoskeletal problems caused by spinal fractures, and a social work component that will focus on teaching coping skills, maintaining self-esteem, and minimizing stress and psychiatric symptoms. The other women will participate in a placebo intervention that also has these two components but which is not directed at osteoporotic problems. After the placebo intervention is complete, all women in that arm of the study will be offered the opportunity to participate in the osteoporosis intervention while the first intervention group will practice self-maintenance skills. Measures will be repeated at three-month intervals. Our specific aims are to improve quality of life of respondents in the areas of physical, functional, and psychosocial performance through the intervention and then to have those improvements maintained by continued individual exercise and ongoing use of positive coping strategies. This intervention should easily translate into a low-cost way of helping women who suffer from the pain, functional limitations, and psychosocial impairments that often result from spinal osteoporosis with vertebral compression fractures.