Effects of a rehabilitation treatment including kinesitherapyand hydrokinesitherapy in a spa centre: arandomized controlled trial in patients with postmenopausalosteoporosis

Introduction. Recent studies have shown that women with postmenopausal osteoporosis present postural modifications associated with changes in balance, leading to increased risk of falling. The aim of rehabilitation in these patients is to reduce fall risk and prevent fall complications. The objective of this study was to evaluate the impact on posture and balance of an association of kinesitherapy and hydrokinesitherapy in a spa centre, in females with postmenopausal osteoporosis. Materials and methods. A group of 65 subjects with postmenopausal osteoporosis (mean age 63.1 years; T-score < -2.5 measured by the Dexa technique), were randomized into 2 groups: an experimental group (EG) with 32 subjects (mean age, 62.9±2.1) and a control group (CG) with 33 subjects (mean age 63.9 ±1.5). The EG underwent rehabilitation treatment including kinesitherapy and hydrokinesitherapy in a spa centre, while the CG received no rehabilitation treatment. At baseline and after 12 months all subjects were evaluated with a compass-needle pocket goniometer (IncliMed®) for spinal mobility and a force platform balance, with eyes both open and shut. Results. At baseline assessment no significant differences were found between the two groups. At final assessment, after treatment, the women in the EG presented a significant improvement in balance compared to those in the CG. In particular, analysis with the force platform balance yielded a statistically significant decrease (p<0.050) in sway path, sway area and A-P sway values with eyes shut, in addition to a non-statistically significant decrease in the same parameters with eyes open. Assessment of the vertebral column showed postural alignment at the level of the thoracic kyphosis, with changes in partial values and an improvement in vertebral column mobility in the sagittal plane. Conclusion. This study suggests that our rehabilitation programme can alter postural state, improve spinal mobility, reduce balance instability and consequently decrease the risk of falling.