Congress Abstracts 2006

27

PREVENTION OF FALLS AND OSTEOPOROTIC FRACTURES IN POSTMENOPAUSAL BREAST CANCER SURVIVORS. Nancy Waltman, PhD, APRN, University of Nebraska College of Nursing, Lincoln, NE; Gloria Gross, RN, PhD, University of Nebraska College of Nursing, Scottsbluff, NE; Ada Lindsey, RN, PhD, FAAN, Retired, AL; Carol Ott, RN, PhD, OCN^®, University of Nebraska College of Nursing, Kearney, NE; and Janice Twiss, PhD, APRN, and Kris Berg, EdD, University of Nebraska at Omaha, Omaha, NE.

Significance and Background: Major consequences of osteoporosis are fractures caused by low bone mineral density (BMD) and by falls. Breast cancer survivors (BCS) are at risk for osteoporosis because cancer treatments can cause early-onset menopause and early bone loss (low BMD). To prevent fractures in BCS, interventions need to address prevention of falls as well as improvement in BMD.

Purpose: This study compared effectiveness of a two treatment group intervention (G1, G2) in preventing falls and fractures in 174 postmenopausal BCS.

Methods and Analysis: Postmenopausal women with history of stage 0, I, or II breast cancer and with low BMD were randomly assigned to one of two treatment groups (G1 or G2). Both groups received risedronate, calcium, and vitamin D for 24 months. G1 subjects also participated in strength/weight training exercises (SWTE). Outcomes at 6 and/or 12 month intervals included muscle strength (Biodex), dynamic balance (backward tandem walk), falls, fractures, and BMD, and differences between groups were analyzed using ANCOVA.

Theoretical Framework: Facilitative strategies based on Bandura's (1997) Self-Efficacy Theory promoted adherence to intervention components in both G1 and G2 groups.

Findings and Implications: Findings are reported for first 12 months in an ongoing 24 month intervention, and BMD results are not included. Mean age of G1 (SWTE) group women (n = 81) was 58.7 (+7.4) years compared to 58.5 (+7.6) years in G2 group (n = 93). Mean time since menopause or HRT for G1 group was 6.8 (+6.5) years compared to 7.8 (+7.6) years in G2 group. Women in the G1 group had significantly improved balance [F (2,171) = 2.38, p = .007] and muscle strength for hip flexion [F (2,171) = 3.08, p= .04]. Differences in knee flexion [F (2,171) = 2.38, p = .09] and knee extension [F (2,171) = 2.34, p=.09] approached significance. Twenty-six of 81 G1 subjects reported a total of 40 falls and 32 of 93 G2 subjects reported 58 falls. Twenty percent of G2 subjects had multiple falls compared to less than 7% of G1 subjects (p =.01). G1 subjects had one fracture (right wrist) and G2 subjects had two fractures (left ankle and patella). Implications will be discussed at the presentation.