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Howe, T.E., Shea, B., Dawson, L.J., Downie, F., Murray, A., Ross, C., Harbour, R.T., Caldwell, L.M. and Creed, G. (2011) Exercise for preventing and treating osteoporosis in postmenopausal women. The Cochrane Database of Systematic Reviews, CD000333.

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• TITLE: Widening the perspectives of fracture prevention in osteoporosis by identifying subgroups based upon psychological aspects and health behaviour

  AUTHORS: Helene V. Hjalmarson, Göran Jutengren, Margareta Möller

  KEYWORDS: Fracture Prevention; Health Behaviour; Sense of Coherence; Activity-Specific Balance Confidence; Cluster Analysis

  JOURNAL NAME: Health, Vol.5 No.7B, July 16, 2013

  ABSTRACT: The potential importance of psychological aspects in relation to risk factors for fractures and preventing unhealth behaviour has rarely been investigated in the field of osteoporosis. This study explores some psychological aspects and health behaviour of people detected to have osteoporosis at the time of a forearm fracture. Moreover, it aims at revealing subgroups within this population with clinical relevance for managing secondary prevention actions. Data collection was based on questionnaires and physical tests. Eighty-five individual were analysed. The results confirm earlier research on a similar population having relatively good self-reported health behaviour. The individuals reported high quality of life, high amount of physical activity and low alcohol intake. A majority reported good osteoporosis knowledge, a high sense of coherence (mean = 74) and high activity-specific balance confidence (mean = 81). Furthermore, hierarchical cluster analysis indicated a typology of two subgroups where 75% matched a health-resilient group while 25% matched a health-vulnerable group. The vulnerable group had a significantly lower sense of coherence SOC (p = 0.02) and activity-specific balance confidence, ABC (p = 0.001). This pattern was confirmed from behavioural aspects but only regarding one traditional risk factor namely the history of fractures. The health-vulnerable group achieved a significantly weaker physical profile, less reported time spent outdoors and lower quality of life. The differences found between the subgroups indicate that this typology, as a complement to models based upon relative risk like FRAX, can be relevant for widening perspectives in future research and clinical practice of fracture prevention in osteoporosis.