ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P99 | DOI: 10.1530/endoabs.63.P99

The factors affecting balance function in patients with osteoporotic vertebral fractures

Larisa Marchenkova, Ekaterina Makarova, Mikhail Eryomushkin & Lilia Shakurova

National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation.

Aim: The aim of the study was to estimate the main factors influence on static and dynamic balance function in osteoporotic patient with vertebral fractures (VF).

Methods: 90 patients aged 43-80 with primary osteoporosis were enrolled. Study group comprised of 56 women and 4 men (age 65.4±7.1 years, BMI 26.7±4.4 kg/m2) with at least 1 VF confirmed by X-rays. Control group included 28 women and 2 men (age 62.0±5.2 years, BMI 28.7±5.9 kg/m2) with the same BMD and without any osteoporotic fracture. The examination program included stabilometry, static and dynamic balance tests (Fukuda-Unterberger test, One-leg-standing test) and 25(OH)D level evaluation.

Results: Study group was characterized by change vs control group in balance coefficient (BC) (77.2±7.6 vs 85.7±9.4% with opened eyes, P=0.002, 67.1±9.8 vs 73.4±9.9% with closed eyes, P=0.03), pressure center of media-lateral (PCML) deviation in sagittal plane (1.2 [−1.1;1.5] vs −1.2 [−1.5;1.2] mm, P=0.025) and PCML displacement in sagittal plane (6.8 [3.1;37.7] vs to 4.8 [1.8;10.7] mm, P=0.01). BC correlated with age (r=0.41 with opened eyes, r=0.40 with closed eyes, P=0<0.01) and BMI (r=0.16 with opened eyes, P=0<0.05). PCML deviation in sagittal plane correlated with age (r=−0.42, P=0<0.01), number of VFs (r=0.40, P=0<0.001) and femoral neck BMD (r=−0.43, P=0<0.05), and in frontal plane only with age (r=−0.27, P=0<0.05). PCML displacement in sagittal plane correlated with age (r=−0.29, P=0<0.01), number of VFs (r=0.22, P=0<0.01) and femoral neck BMD (r=−0.38, P=0<0.05) and in frontal plane only with BMI (r=−0.15, P=0<0.05). PCML deviation in sagittal plane was higher in patients with vitamin D deficiency vs subjects with normal or suboptimal 25(OH)D level (P=0.04). Fukuda-Unterberger test showed greater side dislocation in patients with VF vs controls (40° [25.0;45.0] vs 30° [10.0;45.0], P=0.02). Side dislocation correlated with number of VFs (r=−0.30, P<0.05). Patients with VF lose their balance duting One-leg-standing test faster vs controls with open eyes (5.0 [1.0;10.0] vs 7.5 [5.0;10.5] sec, P<0.05) and with closed eyes (2.0 [0;3.0] vs 3.5 [3.0;5.0] sec, P<0.05). Balance time during One-leg-standing test correlated with age (r=−0.35, P<0.001 with open eyes, r=−0.42, P<0.01 with closed eyes) and with 25(OH)D level (r=0.25, P=0.01 with open eyes, r=0.24, P=0.04 with closed eyes).

Conclusions: VFs negatively affect static and dynamic balance function that may lead increasing risk of falls and new fractures in osteoporotic patients. Elderly age, high BMI, low BMD, multiple VFs and vitamin D deficiency are main factors of balance dysfunction in osteoporotic patients with VFs.

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