Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study

Abstract

BackgroundLow bone mineral density (BMD) and falls are common problems encountered in the postmenopausal women. The purpose was to evaluate the association between postural balance and BMD in postmenopausal women and its relation to risk for falls.MethodsIn this cross-sectional study, 225 women in amenorrhea > 12 months and age ≥ 45 years were included and divided, according to BMD, in T-score values > -2.0 SD (n = 140) and ≤ -2 SD (n = 85). Those with neurological or musculoskeletal disorders, history of vestibulopathies, uncorrected visual deficit or drug use that could affect balance were excluded. History of falls (last 24 months), clinical and anthropometric characteristics were evaluated. Postural balance was assessed by stabilometry (force platform). For statistical analysis were used Wilcoxon's Test, Chi-Square Test and logistic regression method for fall risk (Odds Ratio-OR).ResultsPatients with BMD > -2.0 SD were younger, with shorter time since menopause, and showed higher BMI as compared to those with low BMD (≤ -2 SD) (p < 0.05). It was observed that 57.8% of the participants reported fall episodes without significant difference distribution between the groups (p = 0.055). No differences were found from the comparison between the groups (p > 0.05) for stabilometric parameters. Risk for falls increased with age (OR 1.07; CI 95% 1.01-1.13), current smoking (OR 2.19; CI 95% 1.22-3.21) and corrected visual deficit (OR 9.06; CI 95% 1.14-4.09). In contrast, hormone therapy (HT) use was significantly associated with reduced risk for falls (OR 0.48; CI 95% 0.26-0.88).ConclusionsIn postmenopausal women, BMD did not show association with postural balance or risk for falls. Age, smoking and corrected visual deficit were clinical indicators of risk for falls whereas HT use showed to be a protective factor.

Correlation between bone mineral density, isokinetic peak torque and postural balance in postmenopausal women

“…Cangrussu et al (16) did not find significant differences between women with and without osteoporosis, for any variable of the force platform in bipodal support with eyes open. However, Burke et al (15) identified significantly higher postural oscillation in the eyes open task on the force platform on a stable surface in the group of women with osteoporosis.…”

“…A few studies have found linear and consistent relations between muscular strength and BMD (7,8) , while the majority have found inconsistent results (9)(10)(11)(12)(13) . Similarly, when the variable refers to postural balance, a few studies have shown an inverse relationship between greater postural oscillation and BMD (14,15) , while the majority of studies have not identified any relationship (9,11,12,16) . However, to determine correlations between BMD and muscular strength or postural balance in postmenopausal women, some measurement conditions of these variables have not yet been tested, such as the isokinetic peak torque of knee extensors and flexors on an isokinetic dynamometer, or stabilographic analysis of postural oscillation on a force platform under challenging conditions, such as semi-tandem or unipodal support.…”

Adapted physical activity in the prevention and therapy of osteoporosis

“…Ne postoji režim vežbanja koji je najbolji za sve osobe sa osteoporozom. Režim vežbi treba da bude individualno prilagođen na osnovu medicinske procene: rizika za prelom, mišićne snage, obima pokreta, nivoa fizičke aktivnosti, sposobnosti, hoda i balansa [16].…”

Kwas zoledronowy stosowany przez dwa lata u Chinek z osteoporozą pomenopauzalną zwiększa gęstość mineralną tkanki kostnej i poprawia jakość życia związaną ze stanem zdrowia

“…Postural stability and balance decrease with age [8]. Loss of balance and increased body sway are important risk factors for falls in postmenopausal women.…”

“…The age-associated increase in the incidence of osteoporotic fractures results from a combination of increased fall risk and reduced bone strength. Although various factors are associated with falls, impaired balance and mobility have been consistently identified as the main risk factors [8]. Fall prevention should be routine in the management of postmenopausal women.…”