Osteoporosis International

, Volume 14, Issue 12, pp 1007–1012

Impact of postural deformities and spinal mobility on quality of life in postmenopausal osteoporosis

Original Article

Abstract

The objective of the study was to evaluate the impact of postural deformities and spinal mobility on quality of life (QOL) in patients with spinal osteoporosis. A total of 157 postmenopausal women aged over 60 years with osteoporosis were divided into five groups according to their postural deformities: round back (RB, n=41), hollow round back (HRB, n=33), whole kyphosis (WK, n=40), lower acute kyphosis (LAK, n=18), and normal posture (NP, n=25). QOL was evaluated using the Japanese Osteoporosis QOL Questionnaire (JOQOL) proposed by the Japanese Society for Bone and Mineral Research. This questionnaire contains six domains, with higher scores indicating higher levels of QOL. The number of vertebral fractures, thoracic kyphosis and lumbar lordosis angles, and spinal range of motion (ROM) during maximum flexion and extension were also measured with radiographs. Total QOL scores in RB, HRB, WK, and LAK groups were significantly lower than those in the NP group, and those in WK group were even lower compared with the other groups (P<0.05). All the groups with postural deformities, but not the NP group, showed significant positive correlations between total QOL score and spinal ROM (0.521≤r≤0.747, P<0.05). Total QOL score showed a significant correlation with age, number of vertebral fractures, lumbar lordosis angle, and spinal ROM in a total of 157 patients. However, multiple regression analysis revealed that spinal ROM best correlated with total QOL score. We concluded that QOL in patients with osteoporosis was impaired by postural deformities, especially by whole kyphosis, and that spinal mobility has a strong effect on QOL in these patients.

Keywords

Osteoporosis Postural deformity Quality of life Spinal mobility 

References

  1. 1.
    Satoh K, Kasama F, Itoi E et al. (1988) Clinical features of spinal osteoporosis: spinal deformity and pertinent back pain. Contemp Orthop 16:23–30Google Scholar
  2. 2.
    Lyles KW, Gold DT, Shipp KM et al. (1993) Association of osteoporosis vertebral compression fractures with impaired functional status. Am J Med 94:595–601PubMedGoogle Scholar
  3. 3.
    Huang C, Ross PD, Wasnich RD (1996) Vertebral fracture and other predictors of physical impairment and health care utilization. Arch Int Med 15:2469–2475CrossRefGoogle Scholar
  4. 4.
    Burger H, VanDaele PLA, Grashuis K et al. (1997) Vertebral deformities and functional impairment in men and women. J Bone Miner Res 12:152–157PubMedGoogle Scholar
  5. 5.
    Nevitt MC, Ettinger B, Black DM et al. (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Int Med 128:793–800Google Scholar
  6. 6.
    Lips P, Cooper C, Agnusdei D et al. (1997) Quality of life as outcome in the treatment of osteoporosis: the development of a questionnaire for quality of life by the European Foundation for Osteoporosis. Osteoporos Int 7:36–38PubMedGoogle Scholar
  7. 7.
    Lips P, Cooper C, Agnusdei D et al. (1999) Quality of life in patients with vertebral fractures: validation of the quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporos Int 10:150–160CrossRefPubMedGoogle Scholar
  8. 8.
    Oleksik A, Lips P, Dawson A et al. (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedGoogle Scholar
  9. 9.
    Silverman SL, Minshall ME, Shen W et al. (2001) The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthr Rheum 44:2611–2619CrossRefGoogle Scholar
  10. 10.
    Adachi JD, Ioannidis G, Berger C et al. (2001) The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int 12:903–908CrossRefPubMedGoogle Scholar
  11. 11.
    Adachi JD, Ioannidis G, Olszynski WP et al. (2002) The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women. BMC Musculoskelet Disord 3:11CrossRefPubMedGoogle Scholar
  12. 12.
    Nicholas J, Wilson P (1963) Osteoporosis of the aged spine. Clin Orthop 26:19–33PubMedGoogle Scholar
  13. 13.
    Ryan S, Fried L (1997) The impact of kyphosis on daily functioning. J Am Gerontol Soc 45:1479–1486Google Scholar
  14. 14.
    Martin AR, Sornay-Rendu E, Chandler JM et al. (2002) The impact of osteoporosis on quality-of-life: the OFELY cohort. Bone 31:32–36CrossRefPubMedGoogle Scholar
  15. 15.
    Tsauo JY, Chien MY, Yang RS (2002) Spinal performance and functional impairment in postmenopausal women with osteoporosis and osteopenia without vertebral fracture. Osteoporos Int 13:456–460CrossRefGoogle Scholar
  16. 16.
    Orimo H, Hayashi Y, Fukunaga M et al. (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337CrossRefPubMedGoogle Scholar
  17. 17.
    Takahashi H, Iwaya C, Iba K et al. (2001) The Japanese Osteoporosis QOL Questionnaire (JOQOL): 2000 edition. J Jpn Soc Bone Miner Res 18:85–101 (in Japanese)Google Scholar
  18. 18.
    Randell AG, Bhalerao N, Nguyen TV et al. (1998) Quality of life in osteoporosis: reliability, consistency, and validity of the Osteoporosis Assessment Questionnaire. J Rheum 25:1171–1179PubMedGoogle Scholar
  19. 19.
    Orimo H, Shiraki M, Hayashi Y et al. (1994) Effects of 1α-hydroxyvitamin D3 on lumbar bone mineral density and vertebral fractures in patients with postmenopausal osteoporosis. Calcif Tissue Int 54:370–376PubMedGoogle Scholar
  20. 20.
    Takemitsu Y, Harada Y, Iwahara T et al. (1988) Lumbar degenerative kyphosis. Clinical, radiological and epidemiological studies. Spine 13:1317–1326PubMedGoogle Scholar
  21. 21.
    Liu-Ambrose T, Eng JJ, Khan KM et al. (2002) The influence of back pain on balance and functional mobility in 65- to 75-year-old women with osteoporosis. Osteoporos Int 13:868–873CrossRefGoogle Scholar
  22. 22.
    Matthis C, Weber U, O’Neill T et al. (1998) Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS). Osteoporos Int 8:364–372CrossRefPubMedGoogle Scholar
  23. 23.
    Lynn S, Sinaki M, Westerlind K (1997) Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil 78:273–277PubMedGoogle Scholar
  24. 24.
    Itoi E (1991) Roentgenographic analysis of posture in spinal osteoporotics. Spine 16:750–756PubMedGoogle Scholar
  25. 25.
    World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report Series 843, World Health Organization, GenevaGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • N. Miyakoshi
    • 1
  • E. Itoi
    • 1
  • M. Kobayashi
    • 1
  • H. Kodama
    • 2
  1. 1.Department of Orthopedic SurgeryAkita University School of MedicineAkitaJapan
  2. 2.South Akita Orthopedic ClinicAkitaJapan

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