Studies have shown that 50 percent of falls occur during some form of movement. Tripping over obstacles and loss of balance are two of the most common causes of falls in older people. Individuals who are diagnosed with osteoporosis have a greater tendency to fall and must work on improving both posture and balance to reduce the chance of fall-related fractures and increase the confidence we all need to lead full and active lives.
A Mayo Clinic study by Dr. Mehrsheed Sinaki and colleagues of 25 older women investigated the influence of osteoporosis-related hyperkyphosis — commonly known as Dowager’s Hump — on balance and the risk of falling. Investigators from the Mayo Clinic’s Department of Physical Medicine and Rehabilitation and divisions of Audiology, Orthopedic Research, and Biostatistics studied 12 women with osteoporosis and a 13-woman control group without osteoporosis to determine how osteoporosis and kyphosis might be implicated in falls.
The researchers measured the women’s height, weight, and bone density and took lateral x-rays of their spines. They analyzed their gait and the strength of the muscles in their lower extremities. They performed computerized dynamic “posturography” to help them determine how the women were using sight, hearing, and muscle coordination to help them maintain their balance.
The results of gait analysis and dynamic posturography were particularly interesting. In gait analysis, the women moved along a walkway at a comfortable speed. An important part of the test measured their ability to navigate obstacles the height of a threshold or a standard step. Tripping was defined as contact of the “swing” foot with the obstacle. In dynamic posturography, the investigators used a computerized platform that measured the sway of a subject’s body relative to her height and weight.
The study revealed that, across the board, women with osteoporosis had a greater tendency to fall than the control group and that the strength of the muscles in their lower extremities was significantly lower. Hyperkyphosis may “play a considerable role” in gait, balance, and the risk of falls, perhaps making a greater contribution to lack of stability than muscle weakness. But, adults naturally lose 1% of their leg strength per year over age 50. So, working on spinal extension and leg muscle strength are two of the best activities to prevent falls and age related changes in posture. In addition, the women with osteoporosis believed they were more likely to fall, which affected their confidence.