BMC Musculoskeletal Disorders | |
Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study | |
Gilberto Uemura1  Davi de Araujo Buttros1  Ana Beatriz Cesar Rodrigues Barral1  Eliana Aguiar Petri Nahas1  Jorge Nahas-Neto1  Luciana Mendes Cangussu1  | |
[1] Department of Gynecology and Obstetrics, Botucatu School of Medicine, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil | |
关键词: Falls; Bone Mineral Density; Postural Balance; Menopause; | |
Others : 1150820 DOI : 10.1186/1471-2474-13-2 |
|
received in 2011-08-30, accepted in 2012-01-16, 发布年份 2012 | |
【 摘 要 】
Background
Low bone mineral density (BMD) and falls are common problems encountered in the postmenopausal women. The purpose was to evaluate the association between postural balance and BMD in postmenopausal women and its relation to risk for falls.
Methods
In this cross-sectional study, 225 women in amenorrhea > 12 months and age ≥ 45 years were included and divided, according to BMD, in T-score values > -2.0 SD (n = 140) and ≤ -2 SD (n = 85). Those with neurological or musculoskeletal disorders, history of vestibulopathies, uncorrected visual deficit or drug use that could affect balance were excluded. History of falls (last 24 months), clinical and anthropometric characteristics were evaluated. Postural balance was assessed by stabilometry (force platform). For statistical analysis were used Wilcoxon's Test, Chi-Square Test and logistic regression method for fall risk (Odds Ratio-OR).
Results
Patients with BMD > -2.0 SD were younger, with shorter time since menopause, and showed higher BMI as compared to those with low BMD (≤ -2 SD) (p < 0.05). It was observed that 57.8% of the participants reported fall episodes without significant difference distribution between the groups (p = 0.055). No differences were found from the comparison between the groups (p > 0.05) for stabilometric parameters. Risk for falls increased with age (OR 1.07; CI 95% 1.01-1.13), current smoking (OR 2.19; CI 95% 1.22-3.21) and corrected visual deficit (OR 9.06; CI 95% 1.14-4.09). In contrast, hormone therapy (HT) use was significantly associated with reduced risk for falls (OR 0.48; CI 95% 0.26-0.88).
Conclusions
In postmenopausal women, BMD did not show association with postural balance or risk for falls. Age, smoking and corrected visual deficit were clinical indicators of risk for falls whereas HT use showed to be a protective factor.
【 授权许可】
2011 Cangussu et al; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150405230845687.pdf | 255KB | download |
【 参考文献 】
- [1]Sinaki M, Brey RH, Hughes CA, Larson DR, Kaufman KR: Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int 2005, 16(8):1004-1010.
- [2]Arnold CM, Busch AJ, Schachter CL, Harrison L, Olszynski W: The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis. J Orthop Sports Phys Ther 2005, 35(7):452-460.
- [3]Barrett-Cornor E, Weiss TW, McHorney CA, Miller PD, Siris ES: Predictors of falls among postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 2009, 20(5):715-722.
- [4]Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988, 319(26):1701-1707.
- [5]Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH: Interventions for preventing fall in elderly people. Cochrane Database Syst Rev 2003, (4):CD000340.
- [6]Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet 2002, 359(9319):1761-1767.
- [7]Siris ES, Brenneman SK, Barrett-Connor E, Miller PD, Sajjan S, Berger ML, et al.: The effect of age and bone mineral density on the absolute, excess and relative risk of fracture in postmenopausal women age 50-99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 2006, 17(1):565-574.
- [8]Kanis JA, Burlet N, Cooper C, et al.: European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008, 19(4):399-428.
- [9]Melzer I, Benjuya N, Kaplanski J: Postural stability in the elderly: a comparison between fallers and non-fallers. Age Ageing 2004, 33(6):602-607.
- [10]Ersoy Y, MacWalter RS, Durmus B, Altay ZE, Baysal O: Measures and the fear of falling on falls in postmenopausal women aged 50 years and over. Gerontol 2009, 55(6):660-665.
- [11]Gunend Z, Demirsoy N: Clinical and Computerized Stabilometrical Evaluation of Postural Balance in Postmenopausal Women with Osteoporosis. Turk J Phys Med Rehab 2007, 53(1):130-133.
- [12]Abreu DCC, Trevisan DC, Reis JG, et al.: Body balance evaluation in osteoporotic elderly women. Arch Osteoporos 2009, 4:25-29.
- [13]Silva RB, Costa-Paiva L, Oshima MM, Morais SS, Pinto-Neto AM: Frequency of fall and association with stabilometry parameters of balance in postmenopausal women with and without osteoporosis. Rev Bras Ginecol Obstet 2009, 31(10):496-502.
- [14]Piirtola M, Era P: Force platform measurements as predictors of falls among older people: a review. Gerontol 2006, 52(1):1-16.
- [15]Centers for Disease Control and Prevention[http://www.cdc.gov/nccdphp/dnpa/physical/pdf/PA_Fact_Sheet_OlderAdults.pdf] webcite
- [16]Expert Panel on the detection, and treatment of high blood cholesterol in adults: Executive summary of the Third Report of the National Cholesterol Education Program (NCEP). Adult Treatment Panel III (ATP III). JAMA 2001, 285(19):2444-2449.
- [17]Nahas EAP, Kawakami MS, Nahas-Neto J, Buttros DA, Cangussu L, Rodrigues AB: Assessment of risk factors for low bone mineral density in Brazilian postmenopausal women. Climacteric 2011, 14(2):220-227.
- [18]Bizzo G, Guillet N, Patat A, Gagey PM: Specifications for building a vertical force platform designed for clinical stabilometry. Med Biol Eng Comput 1985, 23(5):474-476.
- [19]Lafond D, Corriveau H, Hérbert R, Prince F: Intersession reliability of center of pressure measures of postural steadiness in healthy elderly people. Arch Phys Med Rehabil 2004, 85(6):896-901.
- [20]Painter JA, Elliott SJ, Hudson S: Falls in community-dwelling adults aged 50 years and older: prevalence and contributing factors. J Allied Health 2009, 38(4):201-207.
- [21]Smulders E, van Lankveld W, Laan R, Duysens J, Weerdesteyn V: Does osteoporosis predispose falls? a study on obstacle avoidance and balance confidence. BMC Musculoskelet Disord 2011, 12:1-8.
- [22]Silva RB, Costa-Paiva L, Morais SS, Mezzalira R, Ferreira NO, Pinto-Neto AM: Predictors of falls in women with and without osteoporosis. J Orthop Sports Phys Ther 2010, 40(9):582-8.
- [23]Keskin D, Borman P, Ersöz M, Kurtaram A, Bodur H, Akyüz M: The risk factors related to falling in elderly females. Geriatr Nurs 2008, 29(1):58-63.
- [24]Haber NEL, Erbas B, Hill KD, Waek JD: Relationship between age and measures of balance, strength and gait: linear and non-linear analyses. Clin Sci 2008, 114(12):719-727.
- [25]Naessen T, Lindmark B, Larssen HC: Early postmenopausal hormone therapy improves postural balance. Menopause 2007, 14(6):14-19.
- [26]Lopez D, McCaul KA, Hankey GJ, Norman PE, Almeida OP, Dobson AJ, Byles JE, Yeap BB, Flicker L: Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment--Is there a gender difference? Maturitas 2011, 69(4):359-364.
- [27]Pereira CB, Strupp M, Holzleitner T, Brandt T: Smoking and balance: correlation of nicotine-induced nystagmus and postural body sway. Neuroreport 2001, 12(6):1223-1226.
- [28]Ekblad S, Bergendhal A, Enler P, Ledin T, Möllen C, Hammar M: Disturbances in postural balance are common in postmenopausal women with vasomotor symptoms. Climacteric 2000, 3(3):192-198.
- [29]Bergström I, Ladgren BM, Pyykkö I: Training or EPT in perimenopause on balance and flushes. Acta Obstet Gynecol Scand 2007, 86(4):467-472.
- [30]Nachreiner NM, Findorff MJ, Wyman JF, McCarthy TC: Circumstances and consequences of falls in community-dwelling older women. J Womens Health (Larchmt) 2007, 16(10):1437-1446.
- [31]Panel on prevention of falls in older persons, American Geriatrics Society and British Geriatrics Society: Summary of the updated american geriatrics society/british geriatrics society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011, 59(1):148-157.