Effect Of Community-based Program Based On Exercise On Improving Bone Health And Fall Risk Of Menopausal Women In Suburb

Objective: To develop a community-based program mainly including exercises and to examine its effectiveness on improving the bone density, muscle power of lower limbs and the equilibrium function of suburban menopausal women on the basis of knowing their relative knowledge of osteoporosis, self-efficacy, diet and exercises.Method: This research project is carried on by two stages.The First Stage: On the principle of convenience sampling, the baseline survey was conducted on 246 menopausal women from the suburbs of Shanghai who met the inclusion criteria with the main instruments of General Status Questionnaire, Osteoporosis-related knowledge Questionnaire, Osteoporosis-related Self-efficacy Scale and Diet and Exercises Scale.The Second Stage:60 menopausal women from the first stage who met the inclusion criteria were divided randomly into experimental group and control group according to the regions. Differences of the two groups on age, sex, educational level, marital status, child-bearing age, weight and height had no statistically significance (p>0.05)..The experimental group participated in the community-based program mainly based on the exercises while the control group received the routine nursing care. The main interventions included lectures, distribution of "Brochure of Daily Diet and Life for Osteoporosis Patients" and "Brochure of Tumbling-Preventing Exercises and Gymnastics ", individual guide (telephone consultation), group exercises and experience exchange symposiums. The relative knowledge of osteoporosis, self-efficacy and behaviors of both groups were measured respectively before and 2 and 6 months after the intervention and changes were evaluated. Meanwhile, the bone density, muscle power of lower limb and equilibrium function of both groups were measured by the professionals with the relative instruments before and 6 months after the intervention to evaluate the effect of intervention.Results:The First Stage:①The suburban menopausal women's knowledge of osteoporosis was humble, barely with the pass rate of 14.6%, which from low to high were for exercises, diet, medicines and simple diseases.②Those menopausal women who were older, lack of education or not in marriage had obviously less knowledge than those younger, better-educated or in marriage(p<0.05). By multiple regression analysis, the age, educational level and marriage were included in knowledge regression equation (F=422.69, p<0.001).③The suburban menopausal women's average score on the project regarding to the self-efficacy of osteoporosis was not high generally.④The suburban menopausal women's behaviors regarding to osteoporosis was relatively low. The average score on diet was obviously lower than that on exercises (t=21.95, P<0.001).⑤The suburban menopausal women's behaviors regarding to osteoporosis correlated positively with their relative knowledge and level of self-efficacy(r=0.28～0.37, P<0.01). By multiple regression analysis, knowledge and self-efficacy were predictors of the behavior.The Second Stage:①By repetitive measure analysis of variance, the level of knowledge, self-efficacy and behavioral status existed the interaction effect between time factor and group factor (p<0.001). By multivariate analysis, there were no significant differences of the level of knowledge, self-efficacy and behavioral status between experimental group and control group (p>0.05), but the levels of experimental group was obviously higher than that of control group after 2 months and 6 months (p<0.01～0.001).②Except for the Peak Torque at 120°, each muscle power index of experimental group significantly increased after 6 months'intervention (p<0.05-0.001), while no significant change occurred to control group after 6 months (p>0.05).③Each index of the equilibrium function of experimental group had no significant decrease after the intervention, while the close-eye locus length and sway power of control group increased after 6 months (p<0.05).④The bone density of lumber vertebrae and thigh bone of experimental group had no significant change after 6 months'intervention (p>0.05), while the bone density of L3 vertebral and femoral neck of control group significantly decreased (p<0.05).Conclusion:The knowledge of osteoporosis, relative self-efficacy and behaviors of suburban menopausal women are not ideal. The community-based program mainly based on the exercises can not only improve suburban menopausal women's knowledge of osteoporosis, self-efficacy and behaviors, but also strengthen the muscle power of lower limbs, stabilize the equilibrium function, help to prevent and defer bone loss, maintain the bone health and reduce the risk of falls.