Postural control is associated with muscle power in post-menopausal women with low bone mass

Abstract

Summary

Older women with low bone mass are at higher risk of fracture and there is limited data on what is associated with risk of falls. We found explosive jumping to relate most strongly to postural control. It may be beneficial to include power or speed training into falls prevention programs.

Introduction

Post-menopausal women with low bone mass are at higher risk of bone fractures subsequent to falls. Understanding the correlates of postural control in this collective informs intervention design for falls prevention.

Methods

We examined postural control in single-leg stance on stable and unstable surfaces in 63 community-dwelling post-menopausal women with osteopenia or osteoporosis but without diagnosed neuromuscular, vestibular or arthritic diseases. Postural measures were compared to countermovement jump performance (height, force and power), leg-press strength (10 repetition maximum), calf muscle area and density (via peripheral quantitative computed tomography), body mass, height and age.

Results

On step-wise regression, peak countermovement jump power and jump height (p ≤ 0.014), but not jump force, leg-press strength or calf muscle size, were related to postural control in single-leg stance on, respectively, an unstable surface (eyes open) and standing on a stable surface (eyes open). None of the parameters measured were significantly related to the postural control parameters in single-leg stance on a stable surface with eyes closed. With testing on the stable surface, body mass was associated with slow mean centre of pressure movement speed (p ≤ 0.030).

Conclusions

Our findings show that, in post-menopausal women with low bone mass, neuromuscular power is a more important determinant of postural control than muscle strength or size. Our findings provide evidence to support the integration of power or speed training into falls prevention and balance training programs in post-menopausal women with osteopenia and osteoporosis.

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Acknowledgements

The subjects who participated in the study are thanked for their involvement. We also thank the staff from the radiology department (Charité Campus Benjamin Franklin) and the Center of Muscle and Bone Research for their assistance. The Sport-Gesundheitspark Berlin e.V. assisted with the medical screening. We also acknowledge the assistance of the Immanuel Krankenhaus Berlin, particularly Drs. Semler and Hellmich, as well as the SBK Siemens Krankenkasse for the assistance with subject recruitment. The lead author thanks his family for their support during the course of his PhD. The companies Zebris (CMS 10 system) and Haider-Bioswing (Posturomed system) loaned equipment for use in the current project.

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Correspondence to D. L. Belavy.

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The current study was approved by the ethical commission of the Charité Universitätsmedizin Berlin and the subjects gave their informed written consent.

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None.

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Stolzenberg, N., Felsenberg, D. & Belavy, D.L. Postural control is associated with muscle power in post-menopausal women with low bone mass. Osteoporos Int 29, 2283–2288 (2018). https://doi.org/10.1007/s00198-018-4599-1

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Keywords

  • Elderly
  • Function
  • Falls
  • Jumping mechanography
  • Leg press
  • Muscle force
  • Muscle power
  • Postural control
  • pQCT