Original Research Article
Year: 2019 | Month: August | Volume: 9 | Issue: 8 | Pages: 1-9
The Efficacy of a Structured Exercise Program versus Zoledronic Acid in Persons with Primary Osteoporosis: A Prospective, Randomized Controlled Trial
Dr Abhimanyu Vasudeva1, Ms Srishti Nanda2, Dr Samantak Sahu3, Dr Osama Neyaz1, Dr Arun Choudhary1, Dr Raunak Kumar1, Prof. Shiv Lal Yadav4
1Senior Resident, 3Junior Resident, 4Professor,
Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi
2Doctoral Candidate, Department of Physiology, All India Institute of Medical Sciences, New Delhi
Corresponding Author: Shiv Lal Yadav
ABSTRACT
Background: Osteoporosis is an age-related decline in bone health wherein treatment with bisphosphonates, such as zoledronic acid, remains a popular choice. Recently, exercise has emerged as a non-pharmacological alternative; however, the extent of its efficacy remains unclear.
Research question: Is a structured exercise program as efficacious as zoledronic acid in improving bone mineral density, reducing pain and improving quality of life in persons with primary osteoporosis?
Methods: Diagnosed cases of primary osteoporosis from consecutive patients visiting OPD of PM&R were recruited for a prospective, randomized controlled trial in a tertiary hospital. Participants were randomly allocated to receive one year of exercise, or, a single infusion of zoledronic acid. Primary outcome of the study was bone mineral density (BMD). The principal investigator, outcome assessor and statistical analyzer were masked to the allocations; intervention administrators were masked to the outcome measures. Data was analyzed using intention-to-treat with multiple imputations.
Results: Two hundred patients of osteoporosis were recruited between April 2018 and May 2019. Statistically significant(p<0.05) differences were found for BMD between the groups at the 12 months follow-up in favor of zoledronic acid except for the wrist site. Symptoms of mild whole body pain and impaired quality of life were reported at baseline. On comparing the two groups, statistical significance was found in favor of zoledronic acid at both the 6 months and the 12 months follow-up for both the parameters.
Conclusion: Exercise is not as efficacious as a Zoledronic acid infusion in persons with primary osteoporosis.
Trial registration: CTRI/2018/03/012837
Key words: Osteoporosis, Bone Mineral Density, Exercise, Zoledronic acid, Randomized controlled trial