Objective: To determine whether a 6-month digital health intervention increased participation in physical activities recommended for fracture prevention over 12 months in postmenopausal women with osteoporosis.
Material and Methods: Fifty women (mean±SD age 64.3±6.1 years) were randomised to a 6-month exercise and education program (3 sessions/week) delivered via Amazon Alexa Echo Show digital voice assistant (DVA), or monthly emails (control). The Bone-specific Physical Activity Questionnaire (BPAQ) assessed participation in physical activities and generated current BPAQ scores, representing osteogenic potential of 12-month physical activity.
Results: At baseline, mean±SD 2.3±1.5 different physical activity types were reported in the previous 12 months. Forty-three women completed follow-up (23 DVA; 20 control) with activity types increasing for DVA compared with control (1.2±1.5 vs 0.3±1.26; P=0.044). At baseline, 44% of control participants and 28% of DVA participants reported participating in resistance training; this increased at 12 months non-significantly (P=0.375) to 55% for control and significantly (P=0.020) to 61% for DVA. Zero participants reported balance or impact training at baseline; this increased significantly at 12 months for balance training to 10% for control and 30% for DVA, and for impact training to 5% for control and 35% for DVA (all P<0.001; significantly greater increase in impact training for DVA compared with control: P=0.017). BPAQ scores increased by 1.76±2.81 (P=0.007) for DVA and by 0.60±1.64 (P=0.116) for control at 12 months, but these changes did not differ between groups (P=0.306).
Conclusions: Participation in activities recommended for fracture prevention improved during this 12-month study of postmenopausal women with osteoporosis, with increases in balance and impact training observed in both groups, increases in resistance training and BPAQ scores observed for DVA only, and significantly more DVA than control participants performing impact training. Further trials are required to determine whether digital health interventions can support long-term adherence to these activities.