title: Does osteoporosis predispose falls? A study on obstacle avoidance and balance confidence.
abstract: BACKGROUND
  Osteoporosis is associated with changes in balance and physical performance and has psychosocial consequences which increase the risk of falling. Most falls occur during walking; therefore an efficient obstacle avoidance performance might contribute to a reduction in fall risk. Since it was shown that persons with osteoporosis are unstable during obstacle crossing it was hypothesized that they more frequently hit obstacles, specifically under challenging conditions.
  
  
  METHODS
  Obstacle avoidance performance was measured on a treadmill and compared between persons with osteoporosis (n = 85) and the comparison group (n = 99). The obstacle was released at different available response times (ART) to create different levels of difficulty by increasing time pressure. Furthermore, balance confidence, measured with the short ABC-questionnaire, was compared between the groups.
  
  
  RESULTS
  No differences were found between the groups in success rates on the obstacle avoidance task (p = 0.173). Furthermore, the persons with osteoporosis had similar levels of balance confidence as the comparison group (p = 0.091). The level of balance confidence was not associated with the performance on the obstacle avoidance task (p = 0.145).
  
  
  CONCLUSIONS
  Obstacle avoidance abilities were not impaired in persons with osteoporosis and they did not experience less balance confidence than the comparison group. These findings imply that persons with osteoporosis do not have an additional risk of falling because of poorer obstacle avoidance abilities.
authors.affiliation: Sint Maartenskliniek, Research, Development and Education, PO box 9011, 6500 GM, Nijmegen, the Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Smulders
authors.forename: Wim
authors.initials: W
authors.lastname: van Lankveld
authors.forename: Roland
authors.initials: R
authors.lastname: Laan
authors.forename: Jacques
authors.initials: J
authors.lastname: Duysens
authors.forename: Vivian
authors.initials: V
authors.lastname: Weerdesteyn
mesh_terms: D000058:Accidental Falls / Q000401:mortality; D000368:Aged; D015897:Comorbidity / Q000639:trends; D005080:Exercise Test / Q000379:methods; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology*; D011859:Radiography