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Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers

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Abstract

Summary

This study compared spinal alignment, muscular strength, and quality of life (QOL) between women with postmenopausal osteoporosis and healthy volunteers. The results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness.

Introduction

Increased spinal kyphosis is common in patients with osteoporosis and negatively impacts quality of life (QOL). Muscular strength is also important for QOL in patients with osteoporosis. However, spinal kyphosis and muscle weakness also occur in healthy individuals with advancing age. The purposes of this study were thus to compare spinal alignment, muscular strength, and QOL between women with postmenopausal osteoporosis and healthy volunteers.

Methods

Participants comprised 236 female patients with postmenopausal osteoporosis (mean age, 68.7 years) and 93 healthy volunteer women (mean age, 71.0 years). Body mass index (BMI), angles of spinal kyphosis, back extensor strength, grip strength, and QOL were compared between groups.

Results

BMI, back extensor strength, and grip strength were significantly higher in the volunteer group than in the osteoporosis group (p < 0.01). Both thoracic kyphosis and lumbar lordosis were significantly greater in the osteoporosis group than in the volunteer group (p < 0.01). With regard to QOL, the 36-Item Short-Form Health Survey (SF-36) subscale scores of role physical, bodily pain, general health, and role emotional were all significantly lower in the osteoporosis group than in the volunteer group (p < 0.05 each). SF-36 physical component summary (PCS) score was significantly lower in the osteoporosis group than in the volunteer group (p < 0.001). SF-36 PCS score correlated positively with thoracic kyphosis and negatively with BMI only in the osteoporosis group (p < 0.05 each).

Conclusions

These results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness.

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References

  1. Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R, National Osteoporosis Foundation (2014) Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Randell A, Sambrook PN, Nguyen TV, Lapsley H, Jones G, Kelly PJ, Eisman JA (1995) Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int 5:427–432

    Article  CAS  PubMed  Google Scholar 

  3. Hongo M, Miyakoshi N, Shimada Y, Sinaki M (2012) Association of spinal curve deformity and back extensor strength in elderly women with osteoporosis in Japan and the United States. Osteoporos Int 23:1029–1034

    Article  CAS  PubMed  Google Scholar 

  4. Miyakoshi N, Itoi E, Kobayashi M, Kodama H (2003) Impact of postural deformities and spinal mobility on quality of life in postmenopausal osteoporosis. Osteoporos Int 14:1007–1012

    Article  CAS  PubMed  Google Scholar 

  5. Miyakoshi N, Hongo M, Maekawa S, Ishikawa Y, Shimada Y, Itoi E (2007) Back extensor strength and lumbar spinal mobility are predictors of quality of life in patients with postmenopausal osteoporosis. Osteoporos Int 18:1397–1403

    Article  CAS  PubMed  Google Scholar 

  6. He H, Liu Y, Tian Q, Papasian CJ, Hu T, Deng HW (2016) Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int 27:473–482

    Article  CAS  PubMed  Google Scholar 

  7. Miyakoshi N, Hongo M, Mizutani Y, Shimada Y (2013) Prevalence of sarcopenia in Japanese women with osteopenia and osteoporosis. J Bone Miner Metab 31:556–561

    Article  PubMed  Google Scholar 

  8. Yoshimura N, Muraki S, Oka H, Iidaka T, Kodama R, Kawaguchi H, Nakamura K, Tanaka S, Akune T (2017) Is osteoporosis a predictor for future sarcopenia or vice versa? Four-year observations between the second and third ROAD study surveys. Osteoporos Int 28:189–199

    Article  CAS  PubMed  Google Scholar 

  9. Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, Abellan van Kan G, Andrieu S, Bauer J, Breuille D, Cederholm T, Chandler J, De Meynard C, Donini L, Harris T, Kannt A, Keime Guibert F, Onder G, Papanicolaou D, Rolland Y, Rooks D, Sieber C, Souhami E, Verlaan S, Zamboni M (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12:249–256

    Article  PubMed  Google Scholar 

  10. Morley JE (2008) Sarcopenia: diagnosis and treatment. J Nutr Health Aging 12:452–456

    Article  CAS  PubMed  Google Scholar 

  11. Blain H, Vuillemin A, Teissier A, Hanesse B, Guillemin F, Jeandel C (2001) Influence of muscle strength and body weight and composition on regional bone mineral density in healthy women aged 60 years and over. Gerontology 47:207–212

    Article  CAS  PubMed  Google Scholar 

  12. Douchi T, Oki T, Nakamura S, Ijuin H, Yamamoto S, Nagata Y (1997) The effect of body composition on bone density in pre- and postmenopausal women. Maturitas 27:55–60

    Article  CAS  PubMed  Google Scholar 

  13. Hasegawa K, Okamoto M, Hatsushikano S, Shimoda H, Ono M, Watanabe K (2016) Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects. Eur Spine J 25:3675–3686

    Article  PubMed  Google Scholar 

  14. Yau MS, Demissie S, Zhou Y, Anderson DE, Lorbergs AL, Kiel DP, Allaire BT, Yang L, Cupples LA, Travison TG, Bouxsein ML, Karasik D, Samelson EJ (2016) Heritability of thoracic spine curvature and genetic correlations with other spine traits: the Framingham study. J Bone Miner Res 31:2077–2084

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Landi F, Calvani R, Tosato M, Martone AM, Fusco D, Sisto A, Ortolani E, Savera G, Salini S, Marzetti E (2017) Age-related variations of muscle mass, strength, and physical performance in community-dwellers: results from the Milan EXPO survey. J Am Med Dir Assoc 18:88.e17–88.e24

  16. Soen S, Fukunaga M, Sugimoto T, Sone T, Fujiwara S, Endo N, Gorai I, Shiraki M, Hagino H, Hosoi T, Ohta H, Yoneda T, Tomomitsu T (2013) Diagnostic criteria for primary osteoporosis: year 2012 revision. J Bone Miner Metab 31:247–257

    Article  PubMed  Google Scholar 

  17. Miyakoshi N, Hongo M, Maekawa S, Ishikawa Y, Shimada Y, Okada K, Itoi E (2005) Factors related to spinal mobility in patients with postmenopausal osteoporosis. Osteoporos Int 16:1871–1874

    Article  PubMed  Google Scholar 

  18. Post RB, Leferink VJ (2004) Spinal mobility: sagittal range of motion measured with the SpinalMouse, a new non-invasive device. Arch Orthop Trauma Surg 124:187–192

    Article  CAS  PubMed  Google Scholar 

  19. Miyakoshi N, Hongo M, Tani T, Maekawa S, Shimada Y, Itoi E (2004) Relationship between spinal mobility and quality of life in patients with osteoporosis. Osteoporosis Jpn 12:143–146 (in Japanese)

    Google Scholar 

  20. Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K (1998) Translation, adaptation, and validation of the SF-36 health survey for use in Japan. J Clin Epidemiol 51:1037–1044

    Article  CAS  PubMed  Google Scholar 

  21. Ware JE Jr (2000) SF-36 health survey update. Spine (Phila Pa 1976) 25:3130–3139

    Article  Google Scholar 

  22. Fukuhara S, Suzukamo Y (2004) Manual of SF-36v2 Japanese version. Institute for Health Outcomes & Process Evaluation Research, Kyoto (in Japanese)

    Google Scholar 

  23. Murata K, Yano E (2002) Medical statistics for evidence-based medicine with SPBS user’s guide. Nankodo, Tokyo (in Japanese)

    Google Scholar 

  24. Berger MJ, Doherty TJ (2010) Sarcopenia: prevalence, mechanisms, and functional consequences. Interdiscip Top Gerontol 37:94–114

    Article  PubMed  Google Scholar 

  25. Kitahara H, Ye Z, Aoyagi K, Ross PD, Abe Y, Honda S, Kanagae M, Mizukami S, Kusano Y, Tomita M, Shindo H, Osaki M (2013) Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study. Osteoporos Int 24:907–915

    Article  CAS  PubMed  Google Scholar 

  26. Miyakoshi N, Hongo M, Shimada Y (2012) Prevalence of back pain in postmenopausal osteoporosis and associations with multiple spinal factors. In: Dionyssiotis Y (ed) Osteoporosis. InTech, Rijeka, pp 103–114

    Google Scholar 

  27. Silverman S, Viswanathan HN, Yang YC, Wang A, Boonen S, Ragi-Eis S, Fardellone P, Gilchrist N, Lips P, Nevitt M, Palacios Gil-Antuñano S, Pavelka K, Revicki D, Simon J, Macarios D, Siris ES (2012) Impact of clinical fractures on health-related quality of life is dependent on time of assessment since fracture: results from the FREEDOM trial. Osteoporos Int 23:1361–1369

    Article  CAS  PubMed  Google Scholar 

  28. Sangtarash F, Manshadi FD, Sadeghi A (2015) The relationship of thoracic kyphosis to gait performance and quality of life in women with osteoporosis. Osteoporos Int 26:2203–2208

    Article  CAS  PubMed  Google Scholar 

  29. Blechacz B, Gajic O (2008) Images in clinical medicine. Severe kyphosis N Engl J Med 358:e28

    Article  PubMed  Google Scholar 

  30. Culham EG, Jimenez HA, King CE (1994) Thoracic kyphosis, rib mobility, and lung volumes in normal women and women with osteoporosis. Spine (Phila Pa 1976) 19:1250–1255

    Article  CAS  Google Scholar 

  31. Miyakoshi N, Kasukawa Y, Sasaki H, Kamo K, Shimada Y (2009) Impact of spinal kyphosis on gastroesophageal reflux disease symptoms in patients with osteoporosis. Osteoporos Int 20:1193–1198

    Article  CAS  PubMed  Google Scholar 

  32. Kado DM, Lui LY, Ensrud KE, Fink HA, Karlamangla AS, Cummings SR, Study of Osteoporotic Fractures (2009) Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann Intern Med 150:681–687

    Article  PubMed  PubMed Central  Google Scholar 

  33. Ishikawa Y, Miyakoshi N, Kasukawa Y, Hongo M, Shimada Y (2009) Spinal curvature and postural balance in patients with osteoporosis. Osteoporos Int 20:2049–2053

    Article  CAS  PubMed  Google Scholar 

  34. Kasukawa Y, Miyakoshi N, Hongo M, Ishikawa Y, Noguchi H, Kamo K, Sasaki H, Murata K, Shimada Y (2010) Relationships between falls, spinal curvature, spinal mobility and back extensor strength in elderly people. J Bone Miner Metab 28:82–87

    Article  PubMed  Google Scholar 

  35. Imagama S, Ito Z, Wakao N, Seki T, Hirano K, Muramoto A, Sakai Y, Matsuyama Y, Hamajima N, Ishiguro N, Hasegawa Y (2013) Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males. Eur Spine J 22:1346–1353

    Article  PubMed  PubMed Central  Google Scholar 

  36. Ishikawa Y, Miyakoshi N, Kasukawa Y, Hongo M, Shimada Y (2013) Spinal sagittal contour affecting falls: cut-off value of the lumbar spine for falls. Gait Posture 38:260–263

    Article  PubMed  Google Scholar 

  37. Muramoto A, Imagama S, Ito Z, Hirano K, Ishiguro N, Hasegawa Y (2016) Spinal sagittal balance substantially influences locomotive syndrome and physical performance in community-living middle-aged and elderly women. J Orthop Sci 21:216–221

    Article  PubMed  Google Scholar 

  38. Nakamura K (2011) The concept and treatment of locomotive syndrome: its acceptance and spread in Japan. J Orthop Sci 16:489–491

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lee CS, Lee CK, Kim YT, Hong YM, Yoo JH (2001) Dynamic sagittal imbalance of the spine in degenerative flat back: significance of pelvic tilt in surgical treatment. Spine (Phila Pa 1976) 26:2029–2035

    Article  CAS  Google Scholar 

  40. Takemitsu Y, Harada Y, Iwahara T, Miyamoto M, Miyatake Y (1988) Lumbar degenerative kyphosis. Clinical, radiological and epidemiological studies. Spine (Phila Pa 1976) 13:1317–1326

  41. Wilson S, Sharp CA, Davie MW (2012) Health-related quality of life in patients with osteoporosis in the absence of vertebral fracture: a systematic review. Osteoporos Int 23:2749–2768

    Article  CAS  PubMed  Google Scholar 

  42. Crosby RD, Kolotkin RL, Williams GR (2003) Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 56:395–407

    Article  PubMed  Google Scholar 

  43. Luo J, Hendryx M, Safford MM, Wallace R, Rossom R, Eaton C, Bassuk S, Margolis KL (2015) Newly developed chronic conditions and changes in health-related quality of life in postmenopausal women. J Am Geriatr Soc 63:2349–2357

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    N. Miyakoshi, D. Kudo, M. Hongo, Y. Kasukawa, Y. Ishikawa & Y. Shimada

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  1. N. Miyakoshi
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  2. D. Kudo
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  3. M. Hongo
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  4. Y. Kasukawa
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  5. Y. Ishikawa
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  6. Y. Shimada
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Correspondence to N. Miyakoshi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Miyakoshi, N., Kudo, D., Hongo, M. et al. Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers. Osteoporos Int 28, 3153–3160 (2017). https://doi.org/10.1007/s00198-017-4184-z

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  • DOI: https://doi.org/10.1007/s00198-017-4184-z

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