Treatment of postmenopausal osteoporosis: a literature-based algorithm for use in the public health care system

Irrational use of alendronate sodium by the elderly

Introduction: The effectiveness and safety of alendronate sodium are dependent on patient adherence to very specific guidelines regarding use. This study aims to estimate the rational use of alendronate sodium in the elderly. Methods: This is a cross-sectional study carried out with a structured questionnaire containing form of use and occurrence of adverse events related to alendronate sodium. The patients were recruited in their own homes. Rational use was considered as being the participants who: a) took the tablet in the morning; b) were fasting; c) waited at least 30 minutes before eating; d) ingested with a full glass of water; e) ingested the whole tablet; f) and remained in the orthostatic position for at least 30 minutes after use. Additionally, the odds ratio (OR) was used to analyze the association between the irrational use of alendronate sodium and the independent variables. Results and Discussion: Of the 248 participants in the study, most of the participants administered the medication in the morning (95.2%), with fasting (89.1%), waited at least 30 minutes to eat the first meal of the day (87.9%), and were in the orthostatic position until the time of the first meal (78.6%), but less than half ingested the tablet with a full glass of water (43.6%). Rational use of the medication was observed in only 30.7% of the participants. Regarding possible adverse events, 13.3% of the participants reported some event. Among the most prevalent were dry cough (6.5%), stomach pain (5.2%) and some throat discomfort (4.8%). The irrational use of this medication is associated with age and education level. Conclusion: The prevalence of irrational use of alendronate sodium in the elderly is high, and this use is associated with patients’ sociodemographic factors.

A single whole body vibration session influences quadriceps muscle strength, functional mobility and balance of elderly with osteopenia and/or osteoporosis? Pragmatic clinical trial

BACKGROUND

The purpose of this study verify the immediate effect of whole body vibration (WBV) on quadriceps muscle strength, functional mobility and balance in elderly patients with Osteopenia and/or Osteoporosis.

METHODS

This was a randomized pragmatic clinical trial with 34 elderly (32 women) randomly assigned to two groups: the experimental group (EG; n = 17) who underwent low-frequency (16 Hz) WBV and the control group (CG; n = 17) who performed the walk. Outcome measures were: quadriceps muscle strength measured by a maximal repetition test (1RM); functional mobility assessed by the Timed Up and Go (TUG) test and balance assessed by the Berg Balance Scale (BBS).

RESULTS

In within-group interaction, a significant increase was observed in quadriceps muscle strength (EG:p = 0.047) and balance (EG: p = 0,012; CG: p = 0,007). In between-groups interaction, a significant difference was not observed. There was an increase in the muscular strength of the EG and in the balance in both groups.

CONCLUSION

An WBV training session was able to alter the muscular strength of the LQ and the balance of the elderly with Osteopenia and/or Osteoporosis. It is suggested, however, that future studies involving larger sample number and/or populations should be developed to analyze the short-term effects of WBV.