By Amaeze Augustine Amaeze
The study determined the effects of progressive resistant training programmes and free active exercises on serum calcium, serum phosphate, muscle strength (MS), body mass index (BMI), range of motion (ROM), thigh circumference (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and resting heart rate (RHR) of subjects with fracture of the lower limbs undergoing rehabilitation at Physiotherapy Department of National Orthopedic Hospital, Enugu. A total number of sixty (60) subjects with lower limb fractures participated in this study. They were randomized into two groups: A (31) and group B (29) through balloting. The ethical approval of the research and ethical committee of University of Nigeria Teaching Hospital and written informed consent of the subjects were obtained. Group A participated in progressive resistant training three times a week for 8 weeks, while group B was involved in free active exercise three times a week for 8 weeks. The height, age, weight, thigh circumference, range of motion, and muscle strength were measured and recorded. Blood samples (5ml) were collected from each of the subjects before and after eight weeks. Analysis for the bone markers of calcium ion (Ca2+) and phosphate ion levels were done. The cardiovascular parameter of SBP, DBP and RHR were checked before and after eight weeks. The collected data were analyzed using descriptive and inferential statistics of mean, standard deviation, independent sample t-test and Pearson Product Moment Correlation. Results showed significant decrease of serum calcium post and pre tests of (PRT), showing post-test calcium lower than the pre-test calcium-post-PRT mean value 9.39 0.63. Pre - (PRT) mean value 10.19 0.46. p-value = 0.000, p < 0.05. Pre-and –post (FAE) serum calcium showed no significant difference. Pre-and post (PRT) of serum phosphate showed significant difference. Post – (PRT) calcium is higher than pre- (PRT) calcium, showing a significant increase in serum phosphate. Mean value and standard deviation of post- (PRT) phosphate was 39.54 14.27, pre- (PRT) = 31.06 6.20, p = 0.004 showing a significant increase in phosphate after 8 weeks of PRT. Pre- and – post free active exercise showed no significant difference, p = 0.805 (p > 0.05). The muscular function of MS, mean value of post-RTE, 16.80 8.39 is higher than pre-RTE, 9.51 8.16, p = 0.001, (p < 0.05), showed a significant increase in muscle strength. Pre-and post FAE. MS showed no significant difference p = 0.141 (p > 0.05). Pre-PRT and – post (TC) showed no significant difference, p = 0.979 (p > 0.05), pre-and post FAE TC, also showed no significant difference, p = 0.626, (p > 0.05). Pre-and post (PRT)- ROM showed no significant difference, p = 0.847 (p > 0.05). pre-and-post (FAE) ROM showed no significant difference, p = 0.081, (p > 0.05). Pre-and –post PRT BMI, p = 0.983, (p > 0.05), showed no significant difference. Pre- and –post FAE BMI, p = 0.782 (p >0.05), showed no significant difference. Pre-and – post SBP, P = 0.983, p > 0.05. Pre-and-post FAE SBP, showed no significant difference, p = 0.091 (p > 0.05). Pre- and post DBP (PRT), 81.09 9.43, 75.45 9.53, p = 0.023 p < 0.05, showed a significant decrease in DBP. Pre-and-post FAE DBP, p = 0.202, (p >0.05) showed no significant decrease. Pre-and post (PRT) RHR, showed a significant decrease, post-(PRT) RHR mean value 65.88 ± 4.12, is lower than pre- PRT- RHR 73.00 6.93, p = 0.000 (p < 0.05). Pre – and – post FAE RHR, showed no significant difference. Changes in MS correlated with all the variables showed no significant correlation. In conclusion, resistant exercise training is an important factor for improving serum calcium and phosphate bone biomarker capacity, strength development and blood pressure control in subjects with fracture of lower limbs during their rehabilitation periods.