Bone Mineral Density, Osteoporotic and Osteopenic Postmenopausal in Women - Research Paper Example

Running Head: Bone mineral density (BMD) in postmenopausal women in comparison to osteoporotic and osteopenic postmenopausal women. Critical Appraisal Name Institution Date Introduction. Bone density is a term which refers to the ratio of weight to the area of the bones. This is a very important concept since it gives a clear picture of what effects can for example certain drugs have on a person, the effects of menopause, reasons as to why there has been reduced physical activity on a certain person and many other answers to other medical conditions which might have been noted in a person. Osteopenia is a condition where the bone mineral density is low than the normal state. Osteoporosis is a condition which occurs when there is imbalances in bone formation and reabsorption. Summary. A study was carried out by different entities to show whether exercise would increase bone mineral density in postmenopausal women with reduced bone mineral density in comparison to osteoporotic and osteopenic postmenopausal women without exercise. The study was conducted through various methods. Women volunteers were taken for the study including media advertisements for the same. Some of the women were also followed up in their respective homes. One on one and call interviews were conducted to get the medical details of all the volunteers to ensure that no woman had other complications which would interfere with the end results (Chuin, 2009).Through the interviews they were able to capture the required age group only since only women who had reached menopause were eligible for the experiment that is 43 years and above (Prince, 1991). Most of the following age group has reached their menopause. Media articles to advertise on the same excluded women below the age of 43 to apply for the same. Women with any kind of chronic diseases, taking steroid hormones and anticonvulsant drugs or smokers were eliminated from the study. With all the eligible women volunteers qualified their bone density was measured. Some has low bone density and others had osteoporosis imbalances. Others had osteopenia condition and therefore were considered for the same study.The type of volunteers were women who are heading to their late ages. Such volunteers need much attention, follow up and further reminding them of what is expected. Extensive follow up for the women with low bone density exerciseswas done to ensure they all performed as required by qualified physiotherapists. Others being send to facilities with well-equipped equipment’s for practice. The exercises mostly targeted the hip bone strength, muscle strength and the balance (Bolton, 2011). The bone density test was repeated every three months to check whether there were any changes on the same.A randomised controlled trial where calcium supplements were given to some of the women so that there can be improvement in the increase of the bone mineral density. All these was carried out in an average of five to six years to get the real data of all the changes that will show up during that period. Strength and balance measurements were carried out too to record the changes. Oestrogen medication was also administered to a different group of people (Pernambuco, 2013). The mediation was administered to the individuals at least ten weeks in each twelve weeks of the study. The qualified physiotherapist would take them through an intense supervised exercise while they do the other simple exercises on their own. The women did not begin the study with the same prognosis since after the test results it showed that some had very low levels of bone density, others were normal while others had osteoporosis conditions. These is a reason for the different types of medications administered to the different personalities. All the volunteers were randomised according to the different results and grouped according to the same (De Matos, 2009). Exercise time differed for each of the conditions and treatment for every woman was confidential. After being randomly grouped they were analyzed such that the women had to be medicated according to their distal bone density (Mosti, 2013). Most having most density stratum and the rest having a low one. The same information was private such that the pharmacist was the only person aware of that data (Prince, 1991).All the other involved individuals were not aware of the groupings making it easy for them to keep the patients credentials private. All the groups were treated equally and the follow ups were successfully completed. Critique. The sampling techniques used are good for the study since they have given us a good population definition of where the sample is drawn from. There is an ethical issue that if you are a smoker you cannot be able to participate in the study. The body of literature reaches the Hills causality criteria. For example, the combination of exercise with continuous replacement of the hormone estrogen and progesterone hormones leading to the maintenance of bone mass (Bravo, 1996). Calcium supplementation leading to maintenance of the same too. The trial experiment is rigorously designed and has yielded results which are closer to the truth. The trial are of better quality and are valid. All the research done has yielded similar results. These is a methodological quality qualifier since the same from the results can be applicable to a population and my patients. The research findings are applicable to other findings since meta-analysis has been well applied in the research. They have thoroughly examined valid studies on the same topic and tallied the results through statistical methodology which enabled the report of the results like they are of a large study. The research process followed has been clearly documented and the research method is logical since the research problems are clearly stated. For example, we are told that long-term evidence from randomized trials of the effectiveness of exercise in preventing disability and fall-related fractures in elderly people has been lacking (Korpelainen, 2010). Considering the fact that the analysis was carried out covering the age of above forty three years old, it’s grounded in data that the researcher was not influenced by bias because such a trial could only deal with women who have already reached their menopause.The women below that age group could not have qualified for the research since they were not going in line with the case study. The treatment effect was precise since positive results were gotten from the study. For the physical therapy practice, measuring of outcomes is the most important component. The result showed that exercise stimulates bone synthesis in postmenopausal women but decreases bone resorption in postmenopausal women with osteoporosis (Roghani, 2013). I can be able to apply the same treatment to my patients who are suffering from osteoporosis. This can be done by diving them into groups of weight vest, control and aerobic keeping in mind that exercise while wearing a weighted vest is better for improving balance (Basat,2013). The health of osteopenic women can be increased beyond the normal initial levels for well-being and functional fitness (Kemmler, 2014).Ensuring that thepostmenopausalwomen with osteopenia are not under bone enhancing medication.All the patients’ important outcomes were considered since we get to know from the results that even the women who had undertaken home based training had a long term effect on gait and balance (Korpelainen, 2010). Conclusion Further research is recommend to strengthen this field of study so that it can be clear on what should be done to postmenopausal women with osteoporosis. This is because when such women undergo through this exercises, bone resorption decreases. Studies and research should be conducted on what other ways can be used instead of administering calcium drugs to the ages of forty three years and above especially the patients who have low serum calcitriol levels. Exercise alone is ineffective while in preventing bone loss (Prince, 1991). Therefore, more research needs to be emphasized on this area. This is because our case study is about showing whether exercise would increase bone mineral density in postmenopausal women with reduced bone mineral density in comparison to osteoporotic and osteopenic postmenopausal women without exercise. Therefore, more studies and researches should be carried out to emphasize on this area. In case a patient is undertaking bone enhancing medication, that should be researched on to know how such a patient should undertake exercise as one of the therapies. References 1. Basat, H., Esmaeilzadeh, S., Eskiyurt, N. (2013). The effects of strengthening and high-impact exercises on bone metabolism and quality of life in postmenopausal women: A randomized controlled trial. Journal of Back and Muskuloskeletal Rehabilitation, 26(4), 427-435. 2. Bolton, K., Egerton, T., Wark, J., Wee, E., Matthews, B., Kelly, A…. (2011). Effects of exercise on bone density and falls risk factors in postmenopausal women with osteopenia: A randomised controlled trial. Journal of Science and Medicine in Sport, 15(2), 102-109. 3. Bravo, G., Gauthier, P., Roy, P.-M., Payette, H., Gaulin, P., Harvey, M., Peloquin, L.….. (1996). Impact of a 12-Month Exercise Program on the Physical and Psychological Health of Osteopenic Women.Journal- American Geriatrics Society, 44 (7), 756-762. 4. Chuin, A., Labonté, M., Tessier, D., Khalil, A., Bobeuf, F., Doyon, C. Y., Rieth, N., (2009). Effect of antioxidants combined to resistance training on BMD in elderly women: a pilot study.International Osteoporosis Foundation, 20(7), 1253-1258. 5. De Matos, O., Da Silva, L., Oliveira, J., Branco, C. (2009).Effect of specific exercise training on bone mineral density in women with postmenopausal osteopenia or osteoporosis.Gynecological Endocrinology, 25(9), 616-620. 6. Kemmler, W., Von Stengel, S., Bebenek, M., Hentschke, C., Kalendar, W. (2012). Exercise and fractures in postmenopausal women: 12-year results of erlangen fitness and osteoporosis prevention study. Osteoporosis International, 23(4), 1267-1276 7. Korpelainen, R., Kiukaanniemi, S., Nieminen, P., Heikkinen, J., Vaananen, K., Korpelainen, J. (2010). Long-term outcomes of exercise a randomized trial in older women with osteopenia. Archives of Internal Medicine.170(17). 8. Mosti, M. P., Kaehler, N., Stunes, A. K., Hoff, J., &Syversen, U. (2013). Maximal strength training in postmenopausal women with osteoporosis or osteopenia. National Strength & Conditioning Association, 27(10), 2879-86. 9. Pernambuco, C., Borba-Pinheriro, C., Vale, R., Monterio, P., Dantas, E. (2013). Functional autonomy, bone mineral density and serum osteocalcin levels in older female participants of an aquatic exercise program. Archives of Gerontology and Geriatrics, 56(3), 466-471. 10. Prince, R., Smith, M., Dick, I., Price, R., Webb, P., Henderson, K., Harris, M. (1991). Prevention of postmenopausal osteoporosis.The New England Journal of Medicine, 325. 11. Roghani, T., Torkaman, G., Movasseghe, S., Hedayati, M., Goosheh, B., &Bayat, N. (2013). Effects of short-term aerobic exercise with and without external loading on bone metabolism and balance in postmenopausal women with osteoporosis. Rheumatology International, 33(2) 291-298. Read More