The Relationship of Intrinsic Fall Risk Factors to a Recent History of Falling in Older Women With Osteoporosis

Abstract

Study Design: Cross-sectional descriptive analysis investigating intrinsic fall risk factors in postmenopausal women with osteoporosis. Objective: To examine the relationships between history of recent falls and balance, pain, quality of life, function, posture, strength, and mobility. Background: Women with osteoporosis who fall are at a high risk of fracture due to decreased bone strength. Identifying fall risk factors for older women with osteoporosis is a crucial step in decreasing the incidence of falls and fracture. Method and Measures: Seventy-three women over 60 years of age with established osteoporosis participated in comprehensive testing of fall history, physical function, and quality of life. Results: Significant correlations were found between a recent history of falls and degree of kyphosis (r = 0.29), fear of falls/emotional status (r = -0.27), and balance (r = -0.27). Degree of kyphosis and fear of falls/emotional status explained 20% of the variance of recent fall history using binary logistic regression. Women with an increased kyphosis were more likely to have had a recent fall (odds ratio [OR], 1.17; 95% CI, 1.03-1.34) and those with better emotional status and less fear of falling were less likely to have had a recent fall (OR, 0.61; 95% CI, 0.38-0.97). Conclusion: Increased thoracic kyphosis and fear of falling are 2 intrinsic factors associated with recent falls in women with osteoporosis. To design more effective interventions to decrease fall risk in this population, future prospective, longitudinal studies should monitor kyphosis, fear of falling, balance reactions, and other potential risk factors not identified in this study . J Orthop Sports Phys Ther 2005;35:452-460.

A Pilot Study of Factors Associated With Falls in Individuals With Incomplete Spinal Cord Injury

“…A fear of falling and subsequent limitation in community activity has long been recognized as a risk factor for falls in older adults (34). Recent research indicates that a fear of falling continues to be associated with falls (35)(36)(37). Implementation of an exercise program and/or use of a walker may reduce the fear of falling and increase confidence in the ability to engage in community activities for ambulatory individuals with SCI.…”

A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis

“…A review of the literature has noted the impact of AE on improving pain, function, and self-efficacy. 21 An individual's expectation of outcome has been found to be one of the most important predictors of exercise behaviour in older women, and had a significant affect on perception of barriers to exercise. 45 Improvement in self-efficacy has also been reported to have an affect on increasing the duration and intensity of exercise performed, 46 and feelings of health improvement following exercise can have a profound affect, lasting as long as 2 years, on behaviour change toward exercise.…”

“…In addition to being a common physical measurement of spinal change associated with OP, the index of kyphosis is associated with detriments in balance and a history of falls specific to the female OP population. 20,21 The modified Baecke physical activity questionnaire for Figure 1 Flow diagram of participants' progress through the phases of the randomized trial older adults, which exhibits good test-retest reliability, 22 was used to measure the level of physical activity.…”

“…Index of kyphosis was chosen as a covariate based on a previous study of this population in which a more kyphotic posture was significantly related to fall history. 21 We used Roy's largest root to obtain the F-statistic.…”

Review of safety and mobility issues among older pedestrians

“…Another risk of osteoporosis is that it exacerbates the over-curvature of the thoracic vertebrae, a condition called kyphosis (Arnold et al, 2005). Kyphosis increases during aging, and excessive kyphosis is associated with poor walking and stair-climbing performance, poor postural control during obstacle avoidance, and a higher risk of falling (Arnold et al, 2005;Katzman et al, 2011;Sinaki et al, 2005).…”