Osteoporosis International

, Volume 16, Issue 8, pp 1004–1010 | Cite as

Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength

  • Mehrsheed Sinaki
  • Robert H. Brey
  • Christine A. Hughes
  • Dirk R. Larson
  • Kenton R. Kaufman
Original Article

Abstract

This controlled trial was designed to investigate the influence of osteoporosis-related kyphosis (O-K) on falls. Twelve community-dwelling women with O-K (Cobb angle, 50–65° measured from spine radiographs) and 13 healthy women serving as controls were enrolled. Mean age of the O-K group was 76 years (±5.1), height 158 cm (±5), and weight 61 kg (±7.9), and mean age of the control group was 71 years (±4.6), height 161 cm (±3.8), and weight 66 kg (±11.7). Quantitative isometric strength data were collected. Gait was monitored during unobstructed level walking and during stepping over an obstacle of four different heights randomly assigned (2.5%, 5%, 10%, and 15% of the subject’s height). Balance was objectively assessed with computerized dynamic posturography consisting of the sensory organization test. Back extensor strength, grip strength, and all lower extremity muscle groups were significantly weaker in the O-K group than the control group ( P <0.05), except right ankle plantar flexors ( P =0.09). There was a significant difference in the anteroposterior and mediolateral displacements and velocities. The O-K subjects had less anteroposterior displacement, greater mediolateral displacement, reduced anteroposterior velocity, and increased mediolateral velocity compared with controls for all conditions of unobstructed and obstructed level walking. Obstacle height had a significant effect on all center-of-mass variables. The O-K subjects had significantly greater balance abnormalities on computerized dynamic posturography than the control group ( P =0.002). Data show that thoracic hyperkyphosis on a background of reduced muscle strength plays an important role in increasing body sway, gait unsteadiness, and risk of falls in osteoporosis.

Keywords

Balance Gait Kyphosis Muscle strength Osteoporosis Risk of fall 

Notes

Acknowledgments

The authors are grateful to Ms. Toni D. Stabile for her support of our research program on the rehabilitation of osteoporosis. The authors also thank the study coordinator, Ms. Sandra K. Fitzgerald, for her assistance in screening the subjects, organizing the data collection, and typing the manuscript.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • Mehrsheed Sinaki
    • 1
  • Robert H. Brey
    • 2
  • Christine A. Hughes
    • 3
  • Dirk R. Larson
    • 4
  • Kenton R. Kaufman
    • 3
  1. 1.Department of Physical Medicine and RehabilitationMayo ClinicRochesterUSA
  2. 2.Division of AudiologyMayo ClinicRochesterUSA
  3. 3.Division of Orthopedic ResearchMayo ClinicRochesterUSA
  4. 4.Division of BiostatisticsMayo ClinicRochesterUSA

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