Weight-bearing exercise intensity and physiotherapy outcomes in older Nigerian women with osteoporosis: a multicenter a cross-sectional study

UNLABELLED: Weight-bearing exercise intensity in older Nigerian women with osteoporosis was mainly determined by age, not sociodemographic factors. Higher intensity was associated with better physiotherapy outcomes, highlighting the need for age-targeted rehabilitation strategies to improve bone health outcomes. PURPOSE: This study examined the association between weight-bearing exercise intensity and physiotherapy outcomes and identified associated factors of high-intensity exercise among older Nigerian women with osteoporosis. METHODS: A multicenter cross-sectional study was conducted in 18 physiotherapy clinics across Nigeria (April 2025-March 2026). Women aged ≥ 50 years with clinically confirmed osteoporosis (n = 447) were recruited using multistage sampling. Data were collected using a structured interviewer-administered questionnaire (WBI-OQ) incorporating validated physical activity instruments (BPAQ, IPAQ). The primary outcome was physiotherapy satisfaction (satisfied vs dissatisfied). The exposure variable was weight-bearing exercise intensity (high vs low). Sociodemographic and clinical variables were assessed as covariates. Associations were tested using chi-square analysis and binary logistic regression (p < 0.05). RESULTS: Mean age was 58.7 years; 57.1% engaged in high-intensity weight-bearing exercise and 76.7% reported satisfaction with physiotherapy. Age was the only independent predictor of exercise intensity. Women aged 55-59 years had higher odds of engaging in high-intensity exercise compared with those aged ≥ 60 years (OR = 2.33; 95% CI: 1.44-3.78; p < 0.01). A borderline association was observed for ages 50-54 years (OR = 1.74; 95% CI: 1.00-3.04). No significant associations were found for education, occupation, marital status, or parity. CONCLUSION: Higher weight-bearing exercise intensity was moderately prevalent but not strongly influenced by sociodemographic factors. Age was the dominant determinant of exercise intensity. Findings highlight the need for age-targeted physiotherapy strategies to optimize osteogenic exercise engagement in older women with osteoporosis.