Journal of Nursing Theory and Practice

[The Role of Movement Therapy in Balance Training and Fall Prevention of Patients with Osteo­porosis: A Systematic Review]

MISZORY Erika Viktória1,2, JÁROMI Melinda3, PAKAI Annamária4

SEPTEMBER 30, 2020

Journal of Nursing Theory and Practice - 2020;33(05)


[Introduction: The frequent occuring of traumatic events resulting from falls among the patients with osteoporosis and their negative consequencies to the life quality make the application of efficient movement therapy interventions for preventing falls. The aim of the study: The authors’ purpose is to revise the effectiveness of movement therapy interventions regarding osteoporosis, mainly in the field of balance training and fall prevention. We carried out a detailed systematic literature reasearch in the database of Ebsco Discovery Service concerning the period of January 2014 and December 2019. We only searched for articles available in full and in English language using appropriate keywords. We found 42 publications potentially relevant, of which 12 met the inclusion criteria. The programs performed in different media, intensity and time period highlighted the significance of each exercise form in the functional variables. The different exercise programs prove to be effective for muscle and balance training as well as there is a growing number of evidences which emphasize the role of multimodal programs.]


  1. Pécsi Tudomány­egyetem Egészségtudományi Kar Egészségtudományi Doktori Iskola, Pécs
  2. Honvédség Egészségügyi Központ Hévízi Mozgásszervi Rehabilitációs Intézet, Hévíz
  3. Pécsi Tudomány­egyetem Egészségtudományi Kar, Fizioterápiás és Sport­tudományi Intézet, Pécs
  4. Pécsi Tudományegyetem Egészségtudományi Kar, Ápolástudományi, Alapozó Egészségtudományi és Védőnői Intézet, Szombathely



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Journal of Nursing Theory and Practice

[Investigation of Diabetes Mellitus screening in Hungarian General Practices]

GALVÁCS Henrietta, BALOGH Zoltán

[To examine the knowledge about diabetes and its screening practices and the role of advanced practice nurses in the prevention, among general practice employees. Our study was carried out via an online questionnaire which was completed by 94 general practitioners and 83 nurses. 20% of nurses did not possess appropriate qualifications. Overall, advanced practice nurses produced the highest results in the study. 55.4% of the practices performed regular diabetes screening, while only 35.5% of the nurses recommended screening examinations to patients. The most frequently cited causes for not performing screenings were the high number of daily patient visits and inadequate infrastructure and personnel resources. According to the opinions of general practitioners, the efficacy of prevention could be improved by increased financing, hiring dietitians, organising lifestyle clubs and limiting the number of daily patient visits. Independent work by advanced practice nurses was supported by the general practitioners. Emphasis on preventative methods should be expanded in the training of nurses with secondary education and these nurses should take on additional responsibilities in screening examinations. Integrate of advanced practice nurses is essential as soon as possible, into development of primary health care. ]

Journal of Nursing Theory and Practice

[Effectiveness of video-supported Resuscitation Training among Primary School Children ]

NAGY Richárd , BÁNFAI-CSONKA Henrietta, MUSCH János, DERZSI-HORVÁTH Martina, BÁNFAI Bálint

[In sudden cardiac arrest situations laypeople are important parts of the chain of survival. The aim of the study: Our aim was to compare different resuscitation education methods and to measure the effectiveness of video-supported method among primary school children. In our study participants were 10-15 years old primary school children (N=147). There were made a pre-test and two post-tests (1 and 4 months later). Data collection was made by a self-fill-in questionnaire and a practical test with a BLS manikin. There were made three groups: the FRONTAL group was teached with traditional methods; the VIDEO group was teached by a 5-minutes long, self made video; the PHANTOM group was teached by the video and a self-made manikin. Based on the tests the FRONTAL group performed the highest scores (p<0.001). However, the best performance in the depth of the chest compression scored the PHANTOM group (p<0.001). The frequency of the chest compressions was the best in the FRONTAL group (p=0.01). Body weight >50 kg (p=0.042) and age >12 years (p<0.001) associated with significantly deeper chest compressions. In our study, the traditional method was the most effective. However, using a video the results can be similar.]

Journal of Nursing Theory and Practice

[The possible implication and challanges of Artificial Intelligence and Robotics on the field of Nursing Practice: Friend or Foe?]

FULLÉR Noémi, LAMPEK Kinga, ROZMANN Nóra , SZUNOMÁR Szilvia , ZRÍNYI Miklós, OLÁH András

[The paper discusses latest developments in the field of artificial intelligence (AI) and its applications for the future of nursing care and services. Authors emphasize that AI should not be treated as a threat to nurses but as a potential support that may relieve nurses from performing routine tasks which can be automated by AI and robotics. The article cites examples from international experiments with AI and nursing robots that make the case for the controlled and intelligent use of technology in support of a nursing workforce that experiences pressures and stress because of increasing workloads and decreasing number of nursing staff. Authors call for the recognition that nurses fall behind in participating in the development of future nurse specific technologies, also due to the fact that nurses receive no education in the field of AI and robotics. Authors conclude that for nurses to stay in the driving seat of future nurse technologies, graduate and/or postgraduate level education for nurses in AI and robotics is a must.]

Journal of Nursing Theory and Practice

[Functioning of SMART Hospitals from a Nursing Perspective ]


[More and more people hear about the need for smart hospitals to operate in the 21st century. Looking at the hospital developments of the past decades, we can see that actually it is the mainstream. Widespread, simultaneous and effective access to health care data is the key issue for future professionals and patients. In the following study, I would like to briefly outline the prerequisites for setting up and operating an intelligent hospital.]

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Related contents

Journal of Nursing Theory and Practice

[Identifying osteoporosis in a primary care setting with quantitative ultrasound]

HIRDI Henriett Éva, SZOBOTA Lívia

[Osteoporosis is one of the most under-diagnosed and under-treated health conditions. In recent decades, several risk indices have been developed to identify women at risk for low bone mineral density (BMD) who require a BMD test. This study aimed to demonstrate that quantitative ultrasound bone density measurement can indeed be performed simply by nurses working in primary care, which can significantly facilitate early detection of osteopenic and osteoporotic conditions. Method: The medical records of all patients who had an ultrasound of the left heel using the quantitative heel ultrasound machine between March 2021 through December 2021 were reviewed retrospectively. The subjects were 20-64-year-old adults (N=1032). Calcaneal quantitative ultra­sound parameters were registered with Sonost-2000 bone densitometer. The body composition was measured using a multi-frequency segmental body composition analyzer. The measurement results were evaluated with SPSS 22.0 statistical program and descriptive statistics. The mean age of the population studied was 43.12±9.6 years; 29.7% were men and 70.3% were women. Of the women in our study, 2.4% were osteoporotic (T ≤ −2.5), and 49.86% were classified as osteopenic according to the WHO operational definition. Osteopenic values were measured in 32.35% of men. A total of 273 subjects (26.45%) in the study sample were in the 50-64 age group (223 women and 50 men). 4% of women over the age of 50 had osteoporosis and 63.7% had osteopenia. Rating of the OST score no one was placed in the high-risk group. Of the 9 women with osteoporosis, 8 were classified as low-risk and 1 as medium based on OST. Nurses in primary care are able to identify key risk factors for osteoporosis, examine the measurement with quantitative ultrasound, and identify individuals with the disease. ]

Clinical Neuroscience

Management of bone metabolism in epilepsy

UÇAN TOKUÇ Ezgi Firdevs , FATMA Genç, ABIDIN Erdal, YASEMIN Biçer Gömceli

Many systemic problems arise due to the side effects of antiepileptic drugs (AEDs) used in epilepsy patients. Among these adverse effects are low bone mineral density and increased fracture risk due to long-term AED use. Although various studies have supported this association with increased risk in recent years, the length of this process has not been precisely defined and there is no clear consensus on bone density scanning, intervals of screening, and the subject of calcium and vitamin D supplementation. In this study, in accordance with the most current recommendations, our applications and data, including the detection of possible bone mineralization disorders, treatment methods, and recommendations to prevent bone mineralization disorders, were evaluated in epilepsy patients who were followed up at our outpatient clinic. It was aimed to draw attention to the significance of management of bone metabolism carried out with appropriate protocols. Epilepsy patients were followed up at the Antalya Training and Research Hospital Department of Neurology, Epilepsy Outpatient Clinic who were at high risk for osteoporosis (use of valproic acid [VPA] and enzyme-inducing drugs, using any AED for over 5 years, and postmenopausal women) and were evaluated using a screening protocol. According to this protocol, a total of 190 patients suspected of osteoporosis risk were retrospectively evaluated. Four patients were excluded from the study due to secondary osteoporosis. Of the 186 patients who were included in the study, 97 (52.2%) were women and 89 (47.8%) were men. Prevalence of low bone mineral density (BMD) was 42%, in which osteoporosis was detected in 11.8% and osteopenia in 30.6% of the patients. Osteoporosis rate was higher at the young age group (18-45) and this difference was statistically significant (p=0.018). There was no significant difference between male and female sexes according to osteoporosis and osteopenia rates. Patients receiving polytherapy had higher osteoporosis rate and lower BMD compared to patients receiving monotherapy. Comparison of separate drug groups according to osteoporosis rate revealed that osteoporosis rate was highest in patient groups using VPA+ carbamazepine (CBZ) (29.4%) and VPA polytherapy (19.4%). Total of osteopenia and osteoporosis, or low BMD, was highest in VPA polytherapy (VPA+ non-enzyme-inducing AED [NEID]) and CBZ polytherapy (CBZ+NEID) groups, with rates of 58.3% and 55.1%, respectively. In addition, there was no significant difference between drug groups according to bone metabolism markers, vitamin D levels, and osteopenia-osteoporosis rates. Assuming bone health will be affected at an early age in epilepsy patients, providing lifestyle and diet recommendations, avoiding polytherapy including VPA and CBZ when possible, and evaluating bone metabolism at regular intervals are actions that should be applied in routine practice.


[Evaluation of quality of life following treatment with calcitonin nasal spray in patients with osteoporosis: preliminary results of the MERLIN study]


[INTRODUCTION - MERLIN (Management of Osteoporosis in Elderly with Calcitonin) is an open-label, multicenter, prospective, follow-up study conducted in Hungary, part of which is to assess the impact of treatment with Miacalcic, - an intranasal salmon calcitonin, on the quality of life (QoL) among patients with osteoporosis. In this paper we report the preliminary results of the MERLIN study. PATIENTS - The study initially involved 1949 senior patients (aged >65 years) to whom calcitonin was prescribed for osteoporosis according to the application instructions. Patients presented at outpatient clinics and consisted of two groups; they were either newly diagnosed or they had been receiving a therapy for osteoporosis other than calcitonin. METHODS - This latter group discontinued their previous treatment and all patients received 200 IU intranasal salmon calcitonin (SCT) once daily for three months. Patient and physician questionnaires were used to collect information on the patients' QoL (EQ-5D VAS) and their general well-being at baseline and at follow-up visits at week 4 and week 12. RESULTS - Calcitonin use was associated with improvements in all EQ-5D domains and component scores as well as in VAS. Patients with previously known osteoporosis who, switched to calcitonin therapy achieved better results (0,046 QALY), than the newly diagnosed patients (0,0405 QALY). CONCLUSIONS - We conclude that intranasal SCT 200 IU daily is safe and effective in improving QoL of both, male and female patients with low bone mineral density.The conclusions that can be drawn from this study are limited due to the lack of a control group and to the unblinded design. Further placebo-controlled studies are needed to confirm these results. Nevertheless, our study was the first in Hungary to evaluate the quality of life impact of an osteoporosis treatment, and hopefully it will be followed by more such studies directed to other osteoporosis treatments.]


[Bone metabolism and body mass index in postmenopausal women]

TÁRCZY Csaba, TOLDY Erzsébet, SZERB János, VARGA László

[INTRODUCTION - In addition to several other causes constitutional factors play an important role in the development of osteoporosis.Various aspects of bone metabolism were examined to explain the differences in bone density between women with low and high body mass index (BMI). PATIENTS AND METHOD - One hundred and ninetytwo postmenopausal women were included in the study. Bone density was measured by forearm densitometry.To assess bone formation, serum osteocalcin levels were measured, while the rate of bone absorption was estimated from C-terminal telopeptide levels of collagen type I measured in urine and blood. RESULTS - The prevalence of osteoporosis was higher in women with low BMI than in those with normal or higher BMI. Bone metabolism - both formation and absorption - was increased in both groups, however, in women with low BMI this increase was more pronounced and bone metabolism tended to be shifted to absorption compared to patients with normal or higher BMI. CONCLUSION - Postmenopausal lean women have accelerated bone metabolism compared to obese women. This fact and the shift to absorption may be the main reasons for the higher frequency of osteoporosis found by densitometry in women with low BMI than in those with higher BMI.]


[Bone mineral density and diabetes mellitus - First results]


[INTRODUCTION - Data on bone mineral density (BMD) in diabetes mellitus are contradictory in the literature. Early studies described a decreased bone mineral density in type 1 diabetes mellitus (T1DM), but recent studies report no osteopenia in T1DM.The BMD may depend on the quality of treatment for diabetes mellitus and on the presence of chronic complications. In type 2 diabetes mellitus (T2DM) the BMD is not decreased, occasionally it can even be increased. PATIENTS AND METHODS - Bone mineral density was measured in 122 regularly controlled diabetic patients (T1DM: n=73, mean age: 43.6±11.1 years,T2DM: n=49, mean age: 61.8±9.8 years) by dual energy X-ray absorptiometry at the lumbar spine and at the femur. Results were compared to those of 40 metabolically healthy control persons with a mean age of 47.5±11.9 years.The patients’ carbohydrate metabolism was assessed by the average HbA1c level of the last three years.These values were 7.9±1.4 % in T1DM, and 7.5±1.7 % in T2DM. BMDs were classified based on the T-score and Z-score using the WHO criteria. RESULTS - There was no significant difference in T1DM or in T2DM compared to the reference group in the prevalence of either osteoporosis or of osteoporosis and osteopenia combined. CONCLUSION - BMD was not found to be decreased in patients with well-controlled metabolism compared to healthy controls.]