Telerehabilitation Versus Traditional Balance Training in Women With Osteoporosis.

Official title

Comparison of Telerehabilitation and Traditional Balance Training in Post Menopausal Women With Osteoporosis.

Overview

Osteoporosis is a silent disease that leads to fractures, postural deformities, and impaired balance, especially in postmenopausal women. In Pakistan, prevalence is high, with 39% of women reported as severely osteoporotic. Postmenopausal women with osteoporosis and balance issues face increased fall risk due to poor bone density, weakened muscles especially in the lower limb band altered posture .Balance and strength training reduce fall risk, but access to in-person rehabilitation is limited. Telerehabilitation provides remote delivery of structured exercise programs and has shown positive outcomes in balance and bone health. Few studies, however, have compared telerehabilitation with conventional training across all balance domains. The goal of this randomized controlled trial is to compare the effect of Telerehabilitation and Traditional Balance Training in Post Menopausal Women with osteoporosis. Participants will be randomly assigned to one of the two groups, and both will receive an identical standardized balance training program . The results of this clinical trial will help evaluate how telerehabilitation can improve the balance of postmenopausal women with osteoporosis and improve health outcomes.

Detailed description

Osteoporosis often remains undetected until fractures occur, typically involving the hip, wrist, or spine, and may also cause back pain, height loss, and kyphosis. Postmenopausal women face increased fall risk due to reduced bone density, weakened lower limb muscles, and altered posture. Many also develop fear of falling, which restricts activity and accelerates muscle weakness.

Globally, osteoporosis affects about 23.1% of women and 11.7% of men, with fragility fractures being a major cause of disability. In Pakistan, hospital-based findings show a high proportion of postmenopausal women as severely osteoporotic, with a strong link to fall-related injuries.

Exercise interventions, including balance, resistance, and weight-bearing training, are known to improve bone strength, postural control, and confidence by stimulating bone remodelling and enhancing musculoskeletal performance. Telerehabilitation, delivered via video conferencing, provides remote access to such programs and has demonstrated improvements in stability, weight-shifting, and functional balance.

However, most studies assess limited outcomes using tools like TUG or BBS, without addressing static, dynamic, anticipatory, and reactive balance together. Evidence largely comes from high-income countries, while data from resource-limited settings like Pakistan remain scarce. This trial seeks to evaluate telerehabilitation compared to traditional training across comprehensive balance domains in postmenopausal women with osteoporosis.

Interventions

• Other Telerehabilitation group
  The telerehabilitation group participated in balance training sessions delivered through secure virtual platforms such as WhatsApp video calls. Participants completed 3 sessions per week, each lasting 45-60 minutes, over a total of 6 weeks (18 sessions). The program target static, dynamic, anticipatory, and reactive balance. participants will use households items.session began with warm-up exercises such as gentle marching, arm circles, and hamstring stretches, followed by balance training targe
• Other Traditional balance training group
  Same as telerehabilitation group but it will concluded in a clinical setting.

Primary outcome measures

• Change in Berg Balance Scale score [Time frame: Baseline and 6 weeks]

Secondary outcome measures (4)

• Change in Time up and Go test score [Time frame: Baseline and 6 weeks]
• Functional reach test [Time frame: Baseline and 6 weeks]
• Change in Push and release test score [Time frame: Baseline and 6 weeks]
• Change in Single leg stance test score [Time frame: Baseline and 6 weeks]

Eligibility criteria

Inclusion criteria

• • Women diagnosed with osteopenia and osteoporosis at hip and lumbar spine through DEXA

• Age 50-70 years
• Have mobile phones and can communicate in video call
• Have Balance score (21-44) on berg balance scale
• A caregiver must be available to assist the participant during Tele sessions.

Exclusion criteria

• • Women with severe mobility impairments.

• Women with cognitive conditions affecting participation.
• Women with lower limb joint injury or surgery

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Riphah International Hospital — Islamabad

Publications

• Li S, Li Y, Liang Q, Yang WJ, Zi R, Wu X, Du C, Jiang Y. Effects of tele-exercise rehabilitation intervention on women at high risk of osteoporotic fractures: study protocol for a randomised controlled trial. BMJ Open. 2022 Nov 7;12(11):e064328. doi: 10.1136/bmjopen-2022-064328. PMID 36344002
• Rezaei MK, Torkaman G, Bahrami F, Bayat N. The effect of six week virtual reality training on the improvement of functional balance in women with type-I osteoporosis: A preliminary study. Sport Sci Health. 2023;19(1):185-194. doi: 10.1007/s11332-022-01018-8. Epub 2022 Nov 15. PMID 36408530
• Wei F, Hu Z, He R, Wang Y. Effects of balance training on balance and fall efficacy in patients with Osteoporosis: A systematic review and meta-analysis with trial sequential analysis. J Rehabil Med. 2023 May 17;55:jrm00390. doi: 10.2340/jrm.v55.4529. PMID 37194565

Identifiers

NCT: NCT07148479 · Mehak bibi

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗