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， 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 设置是高的，因为生活在那里的妇女将很容易获得 进行干预我们建议对216名老年妇女进行干预， 至少有一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 他们的设施进行干预。开始前 干预，所有受试者将在三个领域进行评估： 身体上的功能上的心理上的我们有设计， 测试了这些措施的可靠性。一半的受访者 将参加以艾滋病为重点的干预活动， 有两个组成部分：一个物理治疗部分， 专为解决肌肉骨骼问题而设计， 脊柱骨折，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，尽量减少压力 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，但没有 针对非军事化的问题。安慰剂干预后， 完成后，该研究中的所有女性都将获得 有机会参与骨质疏松症干预， 第一个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 提高答复者在身体、 功能和心理社会表现，通过干预， 然后让这些改善继续由个人维持， 练习和持续使用积极的应对策略。这 干预措施应充分转化为帮助妇女低成本方式 他们遭受着生理和心理上的功能限制 脊髓损伤可能导致的损伤和独立性丧失 骨质疏松伴椎体压缩

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.