DISABILITY AND OSTEOPOROSIS 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216名老年女性进行干预 至少有一处脊椎压缩骨折。六大生命关怀 北卡罗来纳州的社区已经同意允许我们从 他们为这次干预准备的设施。在开始之前 干预措施，所有受试者将在三个领域进行评估： 生理的、功能的和心理的。我们有设计和 测试了为做到这一点所采取措施的可靠性。一半的受访者 在每个家庭都将参加以骨质疏松为重点的干预 包括两个部分：物理治疗部分和锻炼 专为解决由以下原因引起的肌肉骨骼问题而设计 脊椎骨折，以及一个社会工作部门，将专注于 教授应对技巧，保持自尊，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，但没有 针对骨质疏松症问题。在安慰剂干预之后 完成后，这项研究中的所有女性都将获得 有机会参与骨质疏松症干预 第一干预组将练习自我维护技能。措施 将每隔三个月重复一次。我们的具体目标是 提高受访者在以下方面的生活质量： 功能和心理社会表现，通过干预和 然后让持续不断的个人保持这些改进 锻炼和持续使用积极的应对策略。这 干预应该很好地转化为一种低成本的帮助妇女的方式 世卫组织--遭受心理和生理上的功能限制 脊柱可能导致的损伤和独立性丧失 伴有脊椎受压的骨质疏松。

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 216 older women who have at least one vertebral compression fracture. Six life-care communities in North Carolina have agreed to permit us to recruit from 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 design 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 translate well into a low-cost way of helping women who-suffer from the functional limitations, psychosocial and physical impairments, and loss of independence that can result from spinal osteoporosis with vertebral compression.