Stief Felix, Sohn Anna, Vogt Lutz, Meurer Andrea, Kirchner Marietta
Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
Bioengineering (Basel). 2023 Mar 24;10(4):403. doi: 10.3390/bioengineering10040403.
The mechanisms underlying the altered postural control and risk of falling in patients with osteoporosis are not yet fully understood. The aim of the present study was to investigate postural sway in women with osteoporosis and a control group. The postural sway of 41 women with osteoporosis (17 fallers and 24 non-fallers) and 19 healthy controls was measured in a static standing task with a force plate. The amount of sway was characterized by traditional (linear) center-of-pressure (COP) parameters. Structural (nonlinear) COP methods include spectral analysis by means of a 12-level wavelet transform and a regularity analysis via multiscale entropy (MSE) with determination of the complexity index. Patients showed increased body sway in the medial-lateral (ML) direction (standard deviation in mm: 2.63 ± 1.00 vs. 2.00 ± 0.58, = 0.021; range of motion in mm: 15.33 ± 5.58 vs. 10.86 ± 3.14, = 0.002) and more irregular sway in the anterior-posterior (AP) direction (complexity index: 13.75 ± 2.19 vs. 11.18 ± 4.44, = 0.027) relative to controls. Fallers showed higher-frequency responses than non-fallers in the AP direction. Thus, postural sway is differently affected by osteoporosis in the ML and AP directions. Clinically, effective assessment and rehabilitation of balance disorders can benefit from an extended analysis of postural control with nonlinear methods, which may also contribute to the improvement of risk profiles or a screening tool for the identification of high-risk fallers, thereby prevent fractures in women with osteoporosis.
骨质疏松症患者姿势控制改变和跌倒风险的潜在机制尚未完全明确。本研究旨在调查骨质疏松症女性患者和对照组的姿势摆动情况。使用测力板对41名骨质疏松症女性患者（17名有跌倒史者和24名无跌倒史者）以及19名健康对照者进行静态站立任务时的姿势摆动测量。摆动量通过传统（线性）压力中心（COP）参数来表征。结构（非线性）COP方法包括通过12级小波变换进行频谱分析以及通过多尺度熵（MSE）进行规律性分析并确定复杂性指数。与对照组相比，患者在内外侧（ML）方向的身体摆动增加（毫米标准差：2.63±1.00 vs. 2.00±0.58，P = 0.021；毫米运动范围：15.33±5.58 vs. 10.86±3.14，P = 0.002），并且在前后（AP）方向的摆动更不规则（复杂性指数：13.75±2.19 vs. 11.18±4.44，P = 0.027）。有跌倒史者在AP方向的高频反应高于无跌倒史者。因此，姿势摆动在ML和AP方向受骨质疏松症的影响不同。临床上，通过非线性方法对姿势控制进行扩展分析有助于有效评估和康复平衡障碍，这也可能有助于改善风险评估或用于识别高危跌倒者的筛查工具，从而预防骨质疏松症女性患者发生骨折。
