Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
University of Western Ontario, London, Canada.
Arch Osteoporos. 2019 Feb 28;14(1):27. doi: 10.1007/s11657-019-0582-5.
This study of women with a suspected vertebral fracture determined the association between vertebral fracture characteristics and posture. The number of fractures was associated with posture. Severity of fracture was associated with posture when adjusting for pain. Fracture characteristics explain some variability in posture in women with a suspected vertebral fracture.
Osteoporotic vertebral fractures are associated with increased morbidity and mortality. An accumulation of vertebral fractures may lead to forward head posture, which has been independently associated with mortality. It is unclear how fracture characteristics, including the number, severity, and location of fracture, contribute to occiput-to-wall distance (OWD).
This was a cross-sectional secondary data analysis using baseline data from a randomized controlled trial, in community-dwelling women aged 65 years and older with a suspected vertebral fragility fracture. Lateral thoracic and lumbar spine radiographs were used to determine the number, location, and severity of fracture. Occiput-to-wall distance (OWD) was used to assess forward head posture. Pain during movement (0-10 scale) and age were considered as confounding variables. Multivariable regression models were used to evaluate relationships between fracture variables and OWD.
Participants (n = 158) were of mean age 75.9 (SD 6.5) years with a mean (SD) BMI = 26.7 (5.3) kg/m, OWD = 5.7 (4.6) cm, and number of fractures = 2.4 (2.4). In unadjusted analyses, the number of fractures (B = 0.82, 95% CI = 0.04, 1.59) was associated with OWD. When adjusting for pain, severity of fractures (B = 1.08, 95% CI = 0.001, 2.15) was independently associated with OWD. Location was not associated with OWD in any of the models.
The number of fractures was significantly associated with OWD in the unadjusted model, explaining more of the variability in OWD than other fracture characteristics. Severity of fracture was associated with OWD in the adjusted model. However, pain may confound the relationship between OWD and fracture characteristics.
本研究调查了疑似椎体骨折的女性，以确定椎体骨折特征与姿势之间的关系。骨折数量与姿势相关，在调整疼痛因素后，骨折严重程度与姿势相关。骨折特征可解释疑似椎体骨折女性中姿势的部分变异性。
骨质疏松性椎体骨折与发病率和死亡率增加有关。椎体骨折的累积可能导致前探头姿势，而前探头姿势与死亡率独立相关。目前尚不清楚骨折特征（包括骨折数量、严重程度和位置）如何导致枕骨与墙壁的距离（OWD）。
这是一项使用社区居住的 65 岁及以上疑似脆性椎体骨折女性的随机对照试验基线数据进行的横截面二次数据分析。使用侧位胸腰椎 X 线片确定骨折数量、位置和严重程度。枕骨与墙壁的距离（OWD）用于评估前探头姿势。运动时的疼痛（0-10 分）和年龄被视为混杂变量。使用多变量回归模型评估骨折变量与 OWD 之间的关系。
参与者（n=158）的平均年龄为 75.9（6.5）岁，平均（标准差）BMI 为 26.7（5.3）kg/m，OWD 为 5.7（4.6）cm，骨折数为 2.4（2.4）。在未调整分析中，骨折数量（B=0.82，95%置信区间=0.04，1.59）与 OWD 相关。在调整疼痛后，骨折严重程度（B=1.08，95%置信区间=0.001，2.15）与 OWD 独立相关。在任何模型中，骨折位置与 OWD 均无关联。
在未调整模型中，骨折数量与 OWD 显著相关，比其他骨折特征更能解释 OWD 的变异性。骨折严重程度与调整模型中的 OWD 相关。然而，疼痛可能会混淆 OWD 与骨折特征之间的关系。
