Effects of hormonal replacement therapy on the postural balance among postmenopausal women

Hammar, Mats; Lindgren, R.; Berg, Göran; Möller, Claes; Niklasson, Magnus

doi:10.1016/s0029-7844(96)00356-0

Cited by 62 publications

(35 citation statements)

References 17 publications

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“…We note that neural factors might be primarily responsible for increases in strength in the elderly after short-term exposure to training and hypertrophy is not essential for establishing a strength gain in an older population [62]. Results of a cross-sectional study and a small longitudinal study noted an association between estrogen and improved balance [14,43]. However, these results have not been replicated in three subsequent randomized controls [1,7,30].…”

Section: Static and Dynamic Balance In Women With Osteoporosismentioning

confidence: 82%

Knee Extension Strength Is a Significant Determinant of Static and Dynamic Balance as Well as Quality of Life in Older Community-Dwelling Women with Osteoporosis

et al. 2002

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Background: Determinants of balance have not been well studied in women with osteoporosis yet falls are the major cause of fracture in this population. Objective: To describe the associations among knee extension strength, medication history, medical history, physical activity and both static and dynamic balance in women diagnosed with osteoporosis. Methods: We assessed health history, current medication and quality of life by questionnaire in 97 community-dwelling women with osteoporosis. Static balance was measured by computerized dynamic posturography (Equitest), dynamic balance by timed figure-eight run, and knee extension strength by dynamometry. Results: The 97 participants (mean (SD) age 69 (3.2) years) had a mean lumbar spine BMD of T = –3.3 (0.7) and total hip BMD of –2.9 (0.4). In stepwise linear regression, the significant determinants of static balance that explained 18% of total variance were knee extension strength (10%, p < 0.001), age (5%, p < 0.01) and tobacco use (3%, p < 0.05). The significant predictors of dynamic balance were knee extension strength (26%, p < 0.001), medications (6%, p < 0.05), age (4%, p < 0.05), height (4%, p < 0.001), as well as years of estrogen use (2%), tobacco use (2%) and weight (2%) (all p < 0.05). Knee extension strength was also associated with quality of life (r² = 0.12, p < 0.001). Based on these models, a 1 kg/cm (∼3%) increase in mean knee extension strength was associated with 1.2, 2.4 and 3.4% greater static balance, dynamic balance and quality of life, respectively. Conclusions: Knee extension strength is a significant determinant of performance on static and dynamic balance tests in 65- to 75-year-old women with osteoporosis. In this cross-sectional study, knee extension strength explained a greater proportion of the variance in balance tests than did age. Investigation into the effect of intervention to improve knee extension strength in older women with osteoporosis is warranted.

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Section: Static and Dynamic Balance In Women With Osteoporosismentioning

confidence: 82%

Knee Extension Strength Is a Significant Determinant of Static and Dynamic Balance as Well as Quality of Life in Older Community-Dwelling Women with Osteoporosis

et al. 2002

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“…Impaired postural control has been associated with low levels of estrogen [19, 20] and long-term estrogen supplementation has demonstrated improvements [19]. Postural control in premenopausal women during the menstrual cycle has been less investigated.…”

Section: Discussionmentioning

confidence: 99%

Altered Postural Control during the Luteal Phase in Women with Premenstrual Symptoms

et al. 2005

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The purpose of this study was to investigate postural control in women with and without premenstrual symptoms (PMS) in three hormonally verified phases of the menstrual cycle. Thirty-two women were recruited to participate in the study and 25 of these women were included in the results. Menstrual cycle phases were determined by sex hormone analyses in serum and LH detection in urine. A prospective rating of PMS was used to divide the subjects into two groups: one with PMS (cyclic) and one without (non-cyclic). For measurement of postural control, subjects stood on a force platform (AMTI^®) in two-legged stance (eyes open and closed) and one-legged stance (eyes open and closed). There were no significant differences in the two-legged stance between the phases of the menstrual cycle or between groups. In one-legged stance with eyes open, there was a significant increase in postural displacement in the mid-luteal phase in the cyclic group, but no differences were detected between phases in the non-cyclic group. These findings may be related to the previously reported increased injury rate and psychomotor slowing in the luteal phase in women with PMS.

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“…The importance of bioavailable estrogen has recently been emphasized, not only for the rapid bone loss in the early postmenopausal period but also in late postmenopausal life [33]. However, the antifracture effect of estrogens might be due not solely to reduced bone loss but also to nonskeletal factors, such as improved balance [34,35]. Such an effect could explain the short time lag between initiation of estrogen exposure and fracture protection [35] and also the similar benefits of current estrogen use for cervical and trochanteric fractures in our study.…”

Section: Discussionmentioning

confidence: 99%

Differences in Risk Factor Patterns Between Cervical and Trochanteric Hip Fractures

Michaëlsson

Weiderpass

Farahmand

et al. 1999

Osteoporosis International

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The two types of hip fracture--cervical and trochanteric femoral fractures--are generally considered together in etiologic studies. However, women with a trochanteric fracture may be more osteoporotic than those with cervical hip fractures, and have higher post-fracture mortality. To explore differences in risk factor patterns between the two types of hip fracture we used data from a large population-based case-control study in Swedish women, 50-81 years of age. Data were collected by questionnaire, to which more than 80% of subjects responded. Of the cases included, 811 had had a cervical fracture and 483 a trochanteric fracture during the study period; these cases were compared with 3312 randomly selected controls. Height and hormonal factors appeared to affect the risk of the two types of hip fracture differently. For every 5 cm of current height, women with a cervical fracture had an adjusted odds ratio (OR) of 1.23 (95% CI 1.15-1.32) compared with an OR of 1.06 (95% CI 0.97-1.15) for women with trochanteric fractures. Later menopausal age was protective for trochanteric fractures (OR 0.95, 95% CI 0. 91-0.99 per 2 years) but no such association was found for cervical fractures. Compared with never smokers, current smokers had an OR of 1.48 (95% CI 1.12-1.95) for trochanteric fractures and 1.22 (95% CI 0.98-1.52) for cervical fractures. Current hormone replacement therapy was similarly protective for both fracture types, but former use substantially reduced risk only for trochanteric fractures: OR 0. 55 (95% CI 0.33-0.92) compared with 1.00 (95% CI 0.71-1.39) for cervical fractures. These risk factor patterns suggest etiologic differences between the fracture types which have to be considered when planning preventive interventions.

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Effects of hormonal replacement therapy on the postural balance among postmenopausal women

Cited by 62 publications

References 17 publications

Knee Extension Strength Is a Significant Determinant of Static and Dynamic Balance as Well as Quality of Life in Older Community-Dwelling Women with Osteoporosis

Knee Extension Strength Is a Significant Determinant of Static and Dynamic Balance as Well as Quality of Life in Older Community-Dwelling Women with Osteoporosis

Altered Postural Control during the Luteal Phase in Women with Premenstrual Symptoms

Differences in Risk Factor Patterns Between Cervical and Trochanteric Hip Fractures

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