Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Au JYT(1), Chak NNT(1), Leung HC(2), Chan JSP(1), Leung KKL(1), Yeung EMP(2), Yu TKK(2)
Affiliation :
Physiotherapy Department (2) Department of Rehabilitation, Kowloon Hospital
Introduction :
Elderly people with osteo-sarcopenia present with bone and muscle fragility. Characterised by comparatively low physical function, it poses formidable healthcare challenges including falls and fractures. Formulating a sustainable exercise-nutritional program to improve bone and muscle health is imperative.
Objectives :
(1)To unveil the natural decline in physical function and balance ability, and (2)to determine modifiable outcomes through a 12-week hybrid exercise-nutritional intervention.
Methodology :
A randomised controlled trial was conducted to assess the effect of a 12-week exercise program consisting of resistance, aerobic, balance and flexibility training plus nutritional support on elderly people with osteo-sarcopenia. Participants were diagnosed with osteo-sarcopenia by the doctor of Osteoporosis Clinic and randomly assigned to either intervention group or waitlist-control group which received intervention after a three-month observation period. (1)Patient’s demographic characteristics, (2)handgrip strength, (3)physical function, and (4)sensory organisation test(Balance Master) for balance ability were retrieved. Intention-to-treat analysis was used for missing data.
Result & Outcome :
Twelve patients aged 78.8±5.1 years old were recruited. Initial and post-three-month-observation data from waitlist-control group(n=5) were analysed to evaluate the disease’s natural progression. Pre-intervention and post-intervention data from patients who completed 12-week intervention(n=12) were compared to assess the program’s effect. One control group patient dropped out during intervention period due to COVID-19 infection. No baseline between-group differences were detected in all parameters(p>0.05). Surprisingly, waitlist-control group experienced significant natural deterioration in equilibrium score of condition-1 under sensory organisation test(93.20±3.70initial >90.73±4.37 post-three-month-observation,p=0.009). In particular, when compared the change scores of intervention to waitlist-control group, patients received intervention showed significantly more improvement in handgrip strength(+2.33±2.15vs-1.00±2.83kg,p=0.018), 5 times sit-to-stand test(-6.91±8.23vs+5.87±13.38seconds,p=0.028) and equilibrium score of condition-1(+0.67±2.3vs-2.47±1.17,p=0.012). Conclusively, our study revealed a rapid decline in general postural control ability among elderly individuals with osteo-sarcopenia within a three-month observation window period of control group. Not only does this affirm that they are vulnerable to fall, but it also alarms us to treat patients timely regarding its rapid disease progression. Most importantly, among all physical assessment tools, sensory organisation test seems to be the most sensitive to picking up the sign of physical decline, which can potentially be used for risk stratification at an early stage. Our exercise program is proven to be effective in improving limbs muscle strength and general balance control ability.
