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， 致力于多处脊椎骨折的妇女问题， 有严重的疼痛畸形和残疾 虽然损伤 脊椎骨折引起的骨折不能完全纠正， 通过有针对性的干预措施来改善这种残疾。 生活护理社区是进行这种干预的理想场所 因为这些人中骨质疏松症和椎骨骨折的患病率 环境很高，而且因为居住在那里的女性可以很容易地进入 进行干预 我们建议对180名老年妇女进行干预， 有两处或多处脊椎压缩性骨折。 六个生活护理 北卡罗来纳州的社区已经同意允许我们从 并利用其设施进行干预。 在开始干预之前，所有受试者将在 三个领域：身体，功能和心理社会。 我们 设计并测试了这些措施的可靠性。 半年 每个家庭的受访者将参加以家庭为重点的 两个部分的干预：物理治疗部分， 专门针对肌肉骨骼问题设计的练习 脊柱骨折造成的，以及社会工作的组成部分，将重点放在 教授应对技巧，保持自尊，减少压力 和精神症状 其他的妇女将参加安慰剂 干预也有这两个组成部分，但不直接 在非理性的问题上。 在安慰剂干预完成后， 该研究中的所有女性都将有机会 参与骨质疏松干预，而第一次干预 小组将练习自我维护技能。 将重复采取措施 每三个月一次 我们的具体目标是提高 受访者在身体、功能和心理方面的生活 心理社会表现通过干预，然后有那些 通过持续的个人锻炼和持续使用来保持改善 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疼痛的女性， 限制和心理社会障碍，往往导致脊柱 骨质疏松伴椎体压缩性骨折

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.