40岁及以上日本社区居住女性椎体压缩性骨折与身体机能指标的关联
Association of vertebral compression fractures with physical performance measures among community-dwelling Japanese women aged 40 years and older.
作者信息
Arima Kazuhiko, Abe Yasuyo, Nishimura Takayuki, Okabe Takuhiro, Tomita Yoshihito, Mizukami Satoshi, Kanagae Mitsuo, Aoyagi Kiyoshi
机构信息
Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan.
出版信息
BMC Musculoskelet Disord. 2017 Apr 28;18(1):176. doi: 10.1186/s12891-017-1531-3.
BACKGROUND
Numerous reported studies have shown that vertebral compression fractures are associated with impaired function or disability; however, few examined their association with objective measures of physical performance or functioning.
METHODS
We examined the association of vertebral compression fractures with physical performance measures in 556 Japanese women aged 40-89 years. Lateral spine radiographs were obtained and radiographic vertebral compression fractures were assessed by quantitative morphometry, defined as vertebral heights more than 3 SD below the normal mean. Measures of physical performance included walking speed, chair stand time and functional reach. Adjusted means of performance-based measures according to the number and severity of vertebral compression fractures were calculated using general linear modeling methods.
RESULTS
After adjusting for age, body mass index, back pain, number of painful joints, number of comorbidities and regular physical activities, the walking speed of women with two or more compression fractures (1.17 m/s) was significantly slower than that of women without compression fracture (1.24 m/s) (p = 0.03). Compared with women without compression fracture, chair stand time was longer in women with two or more compression fractures (p = 0.01), and functional reach was shorter (p = 0.01). No significant differences were observed in walking speed, chair stand time, or functional reach between women with one compression fracture and those without compression fracture.
CONCLUSIONS
Having multiple vertebral compression fractures affects physical performance in community-dwelling Japanese women. Poor physical functioning may lead to functional dependence, accelerated bone loss, and increased risk for falls, injuries, and fractures. Preventing vertebral compression fracture is considered important for preserving the independence of older adults.
背景
大量已发表的研究表明，椎体压缩性骨折与功能受损或残疾有关；然而，很少有研究探讨其与身体表现或功能的客观指标之间的关联。
方法
我们在556名年龄在40 - 89岁的日本女性中研究了椎体压缩性骨折与身体表现指标之间的关联。获取了脊柱侧位X线片，并通过定量形态学方法评估了影像学椎体压缩性骨折，定义为椎体高度比正常平均值低3个标准差以上。身体表现的测量指标包括步行速度、从椅子上站起的时间和功能性伸展距离。使用一般线性建模方法计算根据椎体压缩性骨折的数量和严重程度调整后的基于表现的测量指标的均值。
结果
在调整了年龄、体重指数、背痛、疼痛关节数量、合并症数量和规律体育活动后，有两处或更多处压缩性骨折的女性的步行速度（1.17米/秒）明显慢于无压缩性骨折的女性（1.24米/秒）（p = 0.03）。与无压缩性骨折的女性相比，有两处或更多处压缩性骨折的女性从椅子上站起的时间更长（p = 0.01），而功能性伸展距离更短（p = 0.01）。有一处压缩性骨折的女性与无压缩性骨折的女性在步行速度、从椅子上站起的时间或功能性伸展距离方面未观察到显著差异。
结论
多处椎体压缩性骨折会影响居住在社区的日本女性的身体表现。身体功能不佳可能导致功能依赖、骨质流失加速以及跌倒、受伤和骨折风险增加。预防椎体压缩性骨折被认为对维持老年人的独立性很重要。
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