Osteoporosis is a silent disease that leads to fractures, postural deformities, and impaired balance, especially in postmenopausal women. In Pakistan, prevalence is high, with 39% of women reported as severely osteoporotic. Postmenopausal women with osteoporosis and balance issues face increased fall risk due to poor bone density, weakened muscles especially in the lower limb band altered posture .Balance and strength training reduce fall risk, but access to in-person rehabilitation is limited. Telerehabilitation provides remote delivery of structured exercise programs and has shown positive outcomes in balance and bone health. Few studies, however, have compared telerehabilitation with conventional training across all balance domains. The goal of this randomized controlled trial is to compare the effect of Telerehabilitation and Traditional Balance Training in Post Menopausal Women with osteoporosis. Participants will be randomly assigned to one of the two groups, and both will receive an identical standardized balance training program . The results of this clinical trial will help evaluate how telerehabilitation can improve the balance of postmenopausal women with osteoporosis and improve health outcomes.
• Women diagnosed with osteopenia and osteoporosis at hip and lumbar spine through DEXA
Age 50-70 years
Have mobile phones and can communicate in video call
Have Balance score (21-44) on berg balance scale
• Women with severe mobility impairments.
Women with cognitive conditions affecting participation.
Women with lower limb joint injury or surgery
Parallel
Telerehabilitation group
Other interventionThe telerehabilitation group participated in balance training sessions delivered through secure virtual platforms such as WhatsApp video calls. Participants completed 3 sessions per week, each lasting 45-60 minutes, over a total of 6 weeks (18 sessions). The program target static, dynamic, anticipatory, and reactive balance. participants will use households items.session began with warm-up exercises such as gentle marching, arm circles, and hamstring stretches, followed by balance training targeting static, dynamic, anticipatory, and reactive components. Exercises included heel-to-toe standing, single-leg stance, tandem stance, obstacle walking, heel-to-toe walking, side stepping, functional reach, weight shifting, caregiver-assisted perturbations, and foam surface standing. All exercises were performed in 3 sets with specified holds or repetitions. Sessions concluded with cool-down activities including tricep stretches, forward bends, and deep breathing.
Traditional balance training group
Other interventionSame as telerehabilitation group but it will concluded in a clinical setting.
Change in Berg Balance Scale score
The Berg Balance Scale (BBS) is a widely used clinical tool to assess static and dynamic balance in individuals, particularly older adults. It's a 14-item test that evaluates a person's ability to perform various balance-related tasks, such as sitting, standing, reaching, and turning. Each item is scored on a 0-4 scale, with 0 indicating the lowest level of function and 4 indicating the highest. The total score ranges from 0 to 56, with lower scores suggesting a higher risk of falls
Change in Time up and Go test score
The Timed Up and Go Test (TUG) is a simple yet widely validated tool used to assess mobility and fall risk. It measures how quickly an individual can rise from a chair, walk three meters, turn, walk back, and sit down
Functional reach test
The Functional Reach Test (FRT) assesses how far an individual can reach forward while standing, without stepping or losing balance. It's particularly effective for identifying balance limitations in frail or elderly populations
Change in Push and release test score
Push and Release Test is designed to measure reactive postural control by observing how a person recovers after being released from a supported backward lean.
Change in Single leg stance test score
The Single Leg Stance Test (SLS) is a simple but powerful tool to evaluate balance and stability, particularly in older adults or individuals with conditions like osteoporosis. In this test, the person is asked to stand on one leg usually with eyes open and hands on hips while the clinician times how long they can maintain that position without support. It's an effective way to spot balance problems that could lead to falls
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