Combined Measures of Dynamic Bone Quality and Postural Balance--A Fracture Risk Assessment Approach in Osteoporosis.
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.
Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: bhattaat@uc.edu.
Amit
A
Bhattacharya
Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA.
Nelson B
NB
Watts
Department of Biomedical Sciences, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Alok
A
Dwivedi
Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Rakesh
R
Shukla
Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Ashutosh
A
Mani
Department of Internal Medicine, Bone Health and Osteoporosis Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Dima
D
Diab
D015502:Absorptiometry, Photon / Q000379:methods; D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D006801:Humans; D008297:Male; D009469:Neuromuscular Junction / Q000503:physiopathology*; D010024:Osteoporosis / Q000175:diagnosis / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004856:Postural Balance; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014481:United States
Bone shock absorption; dynamic bone quality; fracture; functional postural balance; osteoporosis