A WEIGHT-BEARING, WATER-BASED EXERCISE PROGRAM FOR OSTEOPENIC WOMEN -ITS IMPACT ON BONE, FUNCTIONAL FITNESS, AND WELL-BEING

Objective: To evaluate the effects of a weight-bearing, waterbased, ex ercise program designed for women with low bone mass. Design: A test-r etest cross-sectional, prospective study. Setting: Community-dwelling women from a Canadian city. Participants: Seventy-seven postmenopausal women, 50 to 70 years of age, with spinal or femoral bone density bel ow the fracture threshold. Intervention: Subjects exercised in a pool with waist-high water for 60 minutes, 3 days a week, over a 12-month p eriod. Forty minutes of each session were devoted to successive jumps and muscular exercises designed to promote bone accretion, strength, a nd endurance. Main Outcome Measures: Spinal and femoral bone mineral d ensity (BMD) measured by dual-energy X-ray absorptiometry, functional fitness (flexibility, coordination, agility, strength/endurance, and c ardiorespiratory endurance) assessed with the American Alliance for He alth, Physical Education, Recreation and Dance battery, and psychologi cal states evaluated with Dupuy's General Well-Being Schedule. Results : Spinal BMD decreased significantly (p < .001), whereas there was no change in femoral neck BMD (p = .90). Four of the parameters chosen to assess functional fitness, namely, flexibility, agility, strength/end urance, and cardiorespiratory endurance, were affected positively by t he exercise program (all p values < .001). Psychological well-being al so improved significantly after participation in the exercise program (p < .001). Conclusion: The intervention was successful in improving t he functional fitness and psychological well-being of the participants , despite a lack of effect on the skeletal system. Future studies are needed to identify water exercises that are safe yet exert enough stre ss on the bones to initiate a bone response. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physic al Medicine and Rehabilitation.