The relationship between physical performance measures, bone mineral density, falls, and the risk of peripheral fracture: a cross-sectional analysis

Khazzani, Hamza; Allali, F.; Bennani, Laila; Ichchou, L.; Mansouri, Laïla El; Abourazzak, Fatima Ezzahra; Abouqal, Rédouane; Hajjaj–Hassouni, N.

doi:10.1186/1471-2458-9-297

Cited by 50 publications

(44 citation statements)

References 32 publications

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“…Notably absent are any recommendations to consider the role of balance training and physical conditioning when evaluating a patient with a fragility fracture of the forearm or elsewhere. Current practice trends mirror these guidelines, as evaluation for osteoporosis is becoming a common consideration following these injuries 32,33 , and assessment and treatment of fall risk are more often overlooked 34,35 . There were several potential limitations to this study.…”

Section: Discussionmentioning

confidence: 99%

“…To minimize the physical effects of the fracture event, we chose to evaluate patients who had sustained a distal radial fracture more than 6 months prior to the start of this study and also took steps to ensure that it was an isolated wrist injury without neurologic or musculoskeletal compromise outside of the afflicted upper extremity. Unlike proximal femoral or vertebral compression fractures, which result in permanent alterations in a patient's lower-extremity function and balance, distal radial fractures offer a unique model to potentially study a patient's preexisting postural stability deficit after injury has occurred as no permanent change in postural control should occur as a result of a wrist fracture 35,36 . Additionally, psychological effects from the fracture event itself may also affect balance.…”

Section: Discussionmentioning

confidence: 99%

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Postural Stability in Older Adults with a Distal Radial Fracture

Louer

Boone

Guthrie

et al. 2016

The Journal of Bone and Joint Surgery

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Background: The physical risk factors leading to distal radial fractures are poorly understood. The goal of this study was to compare postural stability between older adults with and without a prior distal radial fragility fracture. Methods: This case-control evaluation was performed at a single tertiary institution. The fracture cohort comprised 23 patients treated for a low-energy distal radial fracture within 6 to 24 months prior to this study. Twenty-three age and sex-matched control participants, without a prior fragility fracture, were selected from an outpatient clinic population. All participants completed a balance assessment with a computerized balance platform device. Dynamic motion analysis (DMA) scores ranging from 0 to 1,440 points are produced, with lower scores indicating better postural stability. Participants also completed validated questionnaires for general health quality (EuroQol-5D-3L [EQ-5D-3L]) and physical activity (Physical Activity Scale for the Elderly [PASE]) and comprehensive health and demographic information including treatment for compromised balance or osteoporosis. Statistical analysis compared data between cases and controls using either the Student t test or the Mann-Whitney U test. Results: There were no significant differences (p > 0.05) in age, sex, body mass index, physical activity score, or EQ-5D-3L general health visual analog scale score between participants with or without prior distal radial fracture. The fracture cohort demonstrated poorer balance, with higher DMA scores at 933 points compared with 790 points for the control cohort (p = 0.008). Nineteen patients (83%) in the fracture cohort reported having dual x-ray absorptiometry (DXA) scans within 5 years prior to this study, but only 2 patients (9%) had ever been referred for balance training with physical therapy. Conclusions: Older adults who sustain low-energy distal radial fractures demonstrate impaired postural stability compared with individuals of a similar age who have not sustained such fractures. Following a distal radial fracture, these patients may benefit from interventions to improve postural stability. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postural Stability in Older Adults with a Distal Radial Fracture

Louer

Boone

Guthrie

et al. 2016

The Journal of Bone and Joint Surgery

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“…Among healthy men and women poor performance on tests of neuromuscular function (such as grip strength, the timed up and go (TUG) test, five times sit-to-stand test, and 8-feet timed walk test) are associated with falls, low BMD, and fractures [69][70][71].…”

Section: Tests Of Neuromuscular Functionmentioning

confidence: 99%

Fracture risk assessment in patients with chronic kidney disease

2011

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Fractures are common in patients with chronic kidney disease (CKD) and associated with substantially high morbidity and mortality. Bone mass measurements are commonly used to assess fracture risk in the general population, but the utility of these measurements in patients with CKD, and specifically among those on hemodialysis, is unclear. This review will outline the epidemiology and etiology of fractures in patients with CKD with a particular emphasis on men and women on hemodialysis. As well, we will summarize the published data, which describes the association between risk factors for fracture (including bone mass measurements, biochemical markers of mineral metabolism, and muscle strength) and fractures in patients with CKD. Patients with CKD suffer from fractures due to impairments in bone quantity, bone quality, and abnormalities of neuromuscular function. There is a paucity of evidence on the associations between bone quality, bone turnover markers, neuromuscular function, and fractures in patients with CKD. Furthermore, the complex etiology of fractures combined with the technical limitations of bone mineral density testing, both by dual energy X-ray absorptiometry (DXA) and by peripheral quantitative tomography (pQCT), limits the clinical utility of bone mass measurements for fracture prediction in CKD; this is particularly true among patients with stages 4 and 5 CKD. Further prospective studies to identify noninvasive measures of bone strength that can be used for fracture risk assessment are needed.

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“…Besides, the results show that women with osteopenia also have increase in the trunk dislocation, and based on a study by Siris et al, 2001 which shown that osteopenic women had 1.8-fold higher rate of fracture than women with normal BMD, a careful attention should be paid to this population in order to reduce the risk of falls. A recent study evaluated the physical performance of women aged 45 to 64 years, through evaluations that included sit-to-stand test (Khazzani et al, 2009). The results showed that low physical performance was associated with low BMD of spine and hip.…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that low physical performance was associated with low BMD of spine and hip. In addition, some studies shown that regular training to strengthen the muscles of the lower limbs, especially the quadriceps, are effective for increasing muscle power, static and dynamic balance, thus improving performance activities of daily living, which includes the act of sitting down and up (Khazzani et al, 2009;Teixeira et al, 2010). Also, high-impact loading exercise has shown to be efficient to increase bone mass and geometry in postmenopausal women (Hamilton et al, 2010;Iwamoto et al, 2010).…”

Section: Discussionmentioning

confidence: 99%