The Effect of Group Training or Spinal Orthosis on Quality of Life and Potential Plasma Markers of Pain in Older Women With Osteoporosis. A Randomized Controlled Trial

Elin Uzunel; Ann-Charlotte Grahn Kronhed; Christina Kaijser Alin; Aisha Siddiqah Ahmed; Per Wändell; Helena Salminen

doi:10.1016/j.arrct.2023.100297

The Effect of Group Training or Spinal Orthosis on Quality of Life and Potential Plasma Markers of Pain in Older Women With Osteoporosis. A Randomized Controlled Trial

Arch Rehabil Res Clin Transl. 2023 Sep 11;5(4):100297. doi: 10.1016/j.arrct.2023.100297. eCollection 2023 Dec.

Authors

Elin Uzunel^{1

2}, Ann-Charlotte Grahn Kronhed³, Christina Kaijser Alin¹, Aisha Siddiqah Ahmed⁴, Per Wändell¹, Helena Salminen^{1

2}

Affiliations

¹ Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
² Academic Primary Health Care Centre, Stockholm, Sweden.
³ Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
⁴ Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Abstract

Objective: Primary purpose was to examine the effects of exercise and use of a spinal orthosis on quality of life (QoL). Secondary, to explore the effects of above-mentioned interventions on plasma levels of potential markers of pain: substance P (SP), calcitonin gene-related peptide (CGRP), and interleukin-6 (IL-6).

Design: Randomized controlled trial.

Setting: Community-dwelling women in Stockholm.

Participants: A total of 113 women aged 60-93 years suffering from back pain and self-reported osteoporosis (n=113).

Interventions: The randomized controlled trial was 3-armed: participation in an equipment exercise group, treatment with an activating spinal orthosis or controls. The intervention time was 6 months.

Main outcome measures: QoL (QUALEFFO-41 and SF-36), plasma levels of SP, CGRP, and IL-6 measured at baseline and after 6 months in all 3 arms.

Results: No improvement of QoL was found. Comparing change in mobility (QUALEFFO-41), the effect in least squares means was lower in the spinal orthosis group compared with controls. In the exercise group, the role emotional score (SF-36) deteriorated during the intervention. Effect size varied between 0.02 and 0.6. There was no change in the levels of CGRP or SP, while IL-6 levels were lower at 6 months in the spinal orthosis group compared with the other groups. At least 1 previous vertebral fracture was verified by X-ray in 46 women.

Conclusion: The interventions showed none or negative effect on QoL, which was unexpected. The modest effect size may prompt a cautious interpretation. We found a lowering of IL-6 levels in the spinal orthosis group, but more studies are needed.

Keywords: Biomarkers; Osteoporosis; Pain; Quality of life; Rehabilitation; Women.