Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

STOP FRACTURE! Strength Training for Optimum Prevention of Fracture. Refocussing A Clinical paradigm That Underutilises Recognised Effective therapy:  A study protocol. (#348)

Belinda R Beck 1 2 , Jacqueline Center 3 , Lyn March 4 , Robyn Speerin 5 , Peter Wong 6 , Oliver Frank 7 , Julian Currie 1 , Claire Crossley 1 , Ann Robinson 8 , Craig Knox 9 , Carole David 10 , Martin Downes 1 , Ping Zhang 1 , Sally Dwyer 4 , Amy T Harding 1
  1. Griffith University, QLD, Australia
  2. The Bone Clinic, Brisbane, QLD, Australia
  3. Garvan Institute of Medical Research, Sydney, NSW, Australia
  4. Royal North Shore Hospital, Sydney, NSW, Australia
  5. University of Sydney, Sydney, NSW, Australia
  6. Westmead Hospital , Sydney, NSW, Australia
  7. University of Adelaide, Adelaide, South Australia, Australia
  8. Gold Coast Hospital and Health Services, Gold Coast, QLD, Australia
  9. Lismore Base Hospital, Lismore, NSW, Australia
  10. Consumer, Central Coast, NSW, Australia

Aims

Osteoporosis is insufficiently treated. While most forms of exercise do not increase bone mass, supervised high intensity resistance and impact training (HiRIT) is effective, but awareness and availability has been low.

The overarching goal of the STOP FRACTURE! study is to reduce the incidence of minimal trauma fracture (MTF) with HiRIT therapy. The specific project aims are to 1) enhance practitioner and patient awareness and patient pathways to HiRIT, and 2) assess the effectiveness of HiRIT referral in an existing model of care (MOC) to reduce MTF and improve secondary health, functional and economic outcomes.

Methods

STOP FRACTURE! is a mixed methods hybrid effectiveness-implementation (Type 3) study. There are three participant groups; patients (n=2100, over 45 years being treated with usual care by their doctor for osteopenia or osteoporosis), referring doctors (n=140, GPs and specialists), and HiRIT providers (n=50, exercise physiologists, physiotherapists). Our primary outcomes are 1. number of referrals to HiRIT and 2. incident MTF.  Secondary outcomes include feasibility, quality of life, PROMIS, PREMs, bone and muscle mass, physical function, falls, adverse events and cost benefit. We will audit 2-year HiRIT referrals from GPs and specialists, and incidence of MTF (from hospital records) prior to the study as control data. We have co-designed and are currently monitoring the implementation of a referral pathway to HiRIT in the osteoporosis MOC. After the 2-year referral period, we will remeasure referral numbers, incidence of MTF and changes in secondary outcomes, and compare baseline to follow-up.

Results

Ethical approvals were obtained nationwide in 2023. Recruitment was launched in March 2024. A media launch has generated 1051 patient inquiries, of which 770 have been screened, and 570 are consented and enrolled.

Conclusions

This project will increase clinician awareness of an effective lifestyle therapy for osteoporosis and embed it into clinical practice.