Okutan Dilara, Terlemez Rana, Palamar Deniz, Tüzün Şansın
Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.
Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.
J Bodyw Mov Ther. 2025 Jun;42:109-114. doi: 10.1016/j.jbmt.2024.12.006. Epub 2024 Dec 10.
To evaluate the effect of the presence of a vertebral fracture on balance and physical performance and its contribution to fall and fracture risk in patients with postmenopausal osteoporosis.
Ninety-five individuals with postmenopausal osteoporosis were included in this study. Patients were divided into 2 groups with a history of vertebral fracture (n = 45) and those without (n = 50). The control group consisted of patients without fractures while the study group was subdivided into 2 subgroups: single-level (n = 29) and multiple-level vertebral fractures (n = 16). None of the study participants had a history of non-vertebral fracture. All patients with a history of vertebral fracture were in the chronic phase without any complaints of pain. Thoracolumbar radiograph, computed static posturography, FRAX (fracture risk assessment tool) scores, DXA (Dual-energy x-ray absorptiometry) measurements, serum 25(OH)D values, tandem test, timed up and go test (TUG), Berg balance scale (BBS) were performed.
The probability of FRAX-major osteoporotic fracture, lumbar total T-score and TUG time were significantly higher and the BBS score was lower in the study group. The mean TUG time was 11.69 ± 3.81 s in the study group and 9.87 ± 2.57 s in the controls, while the mean BBS score was 52.73 ± 3.80 s in the study group and 55,28 ± 1,59 s in the control group (p < 0,005). The probability of FRAX-major osteoporotic fractures was significantly higher in patients with multiple level fractures compared to the patients with a single level fracture. There was also a moderately negative correlation between TUG and BBS, and between the BBS and fall index. The fall index was 43.73% ± 26.34% in the study group and 34.14 % ± 24.04% in the controls (p: 0.058).
This study showed that the presence of a vertebral fracture may have a negative impact on balance and physical performance, leading an increase in the risk of falls and fractures in patients with postmenopausal osteoporosis. The risk factors should be evaluated cautiously to prevent the patients from this vicious circle.
评估椎体骨折对绝经后骨质疏松症患者平衡能力和身体机能的影响，以及其对跌倒和骨折风险的作用。
本研究纳入了95例绝经后骨质疏松症患者。患者被分为有椎体骨折史组（n = 45）和无椎体骨折史组（n = 50）。对照组由无骨折的患者组成，研究组又分为两个亚组：单节段椎体骨折组（n = 29）和多节段椎体骨折组（n = 16）。所有研究参与者均无非椎体骨折史。所有有椎体骨折史的患者均处于慢性期，无任何疼痛主诉。进行了胸腰椎X线检查、静态姿势描记法、FRAX（骨折风险评估工具）评分、双能X线吸收法（DXA）测量、血清25(OH)D值、串联试验、计时起立行走测试（TUG）、伯格平衡量表（BBS）检查。
研究组中FRAX主要骨质疏松性骨折的概率、腰椎总T值和TUG时间显著更高，而BBS评分更低。研究组的平均TUG时间为11.69 ± 3.81秒，对照组为9.87 ± 2.57秒；研究组的平均BBS评分为52.73 ± 3.80分，对照组为55.28 ± 1.59分（p < 0.005）。与单节段骨折患者相比，多节段骨折患者发生FRAX主要骨质疏松性骨折的概率显著更高。TUG与BBS之间以及BBS与跌倒指数之间也存在中度负相关。研究组的跌倒指数为43.73% ± 26.34%，对照组为34.14% ± 24.04%（p：0.058）。
本研究表明，椎体骨折的存在可能对绝经后骨质疏松症患者的平衡能力和身体机能产生负面影响，导致跌倒和骨折风险增加。应谨慎评估危险因素，以防止患者陷入这种恶性循环。
