Combined Measures of Dynamic Bone Quality and Postural Balance—A Fracture Risk Assessment Approach in Osteoporosis

详细信息    查看全文

• 作者：Amit Bhattacharya¹ ; ^{bhattaat@uc.edu" class="auth_mail" title="E-mail the corresponding author} ; Nelson B. Watts² ; Alok Dwivedi³ ; Rakesh Shukla¹ ; Ashutosh Mani¹ ; Dima Diab⁴
• 关键词：Bone shock absorption ; dynamic bone quality ; fracture ; functional postural balance ; osteoporosis
• 刊名：Journal of Clinical Densitometry
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：19
• 期：2
• 页码：154-164
• 全文大小：1497 K

文摘

We evaluated functional measures of neuromuscular integrity and bone's resistance to fracture as a combined tool in discriminating osteoporosis patients with and without fractures. Functional aspects of neuromuscular integrity were quantified with a noninvasive measure of static and dynamic functional postural stability (FPS), and fracture resistance was obtained with bone shock absorption in patients with osteoporosis aged 65–85 and compared our measures with dual-energy X-ray absorptiometry and Fracture Risk Assessment Tool (FRAX [World Health Organization Collaborating Center for Metabolic Bone Diseases, Sheffield, UK]) in women with osteoporosis, some with and some without vertebral fractures. Patients with vertebral fracture showed larger static FPS (postural sway excursion) in the mediolateral and anterior-posterior directions, suggesting poorer balance. Most of the variables of dynamic FPS showed significant differences between fracture and no-fracture groups (e.g., the fracture group took significantly longer during turning, implying poorer dynamic balance control). Also, compared with healthy control subjects, all 4 dynamic FPS responses for osteoporosis patients with and without fracture were significantly poorer, suggesting potential risk for falls. In summary, patients with osteoporosis who have vertebral fractures (compared with patients with similarly low bone mineral density and other nonfracture risk fractures) have not only lower bone shock absorption damping (ζ) but also increased postural imbalance.