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Are osteoporotic vertebral fractures or forward head posture associated with performance-based measures of balance and mobility?

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Abstract

Summary

The main objective of this study was to explore whether vertebral fracture characteristics or posture is independently associated with physical performance. Posture was significantly associated with physical performance but fracture characteristics were not, suggesting posture should be the focus of physical performance variance.

Purpose

The main objective of this study was to explore whether vertebral fracture characteristics (number, severity, location) or occiput-to-wall distance (OWD) is independently associated with physical performance.

Methods

This was a secondary data analysis using baseline data from a randomized controlled trial, of 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. The dependent variables were timed up and go (TUG), five times sit-to-stand, four-meter walk, and step test. The independent variables were number, severity, location of fracture, and OWD. Pain during movement and age were covariates. Multivariable regression analyses determined the association between each of the dependent and independent variables.

Results

Participants’ (n = 158) mean (standard deviation [SD]) age was 75.9 (6.5) years. They had a mean (SD) BMI, OWD, and number of fractures of 26.7 (5.3) kg/m2, 5.7 (4.6) cm, and 2.2 (1.8), respectively. OWD was independently associated with TUG (estimated coefficient [B] = 0.29, 95% confidence interval [CI] = 0.16, 0.42), five times sit-to-stand (B = 0.33, 95% CI = 0.12, 0.55), four-meter walk (B = 0.09, 95% CI = 0.05, 0.13), and step test (B = − 0.36, 95% CI = − 0.50, − 0.23) in the unadjusted model. OWD was independently associated with TUG (B = 0.25, 95% CI = 0.12, 0.38), five times sit-to-stand (B = 0.29, 95% CI = 0.07, 0.50), four-meter walk (B = 0.08, 95% CI = 0.03, 0.12), and step test (B = − 0.22, 95% CI = − 0.47, − 0.19) in the adjusted model.

Conclusion

OWD was significantly associated with physical performance but fracture characteristics were not. These analyses were exploratory and require replication in future studies.

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Funding

The research was funded by a CIHR Operating grant (MOP: 123445). Dr. Giangregorio received funding from an Ontario Ministry of Health Research and Innovation- Early Researcher Award, CIHR New Investigator Award, the Canadian Foundation for Innovation, and the Bloomberg Manulife Prize. Dr. Ashe acknowledges the support of the Canada Research Chairs program. Dr. Cheung is supported by a Tier 1 CRC in Musculoskeletal and Postmenopausal Health as well as the Lillian Love Chair in Women’s Health at the University of Toronto and University Health Network. Dr. Gibbs received funding from a CIHR Fellowship Award.

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Authors and Affiliations

  1. Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada

    Christina Ziebart, Caitlin McArthur & Lora M. Giangregorio

  2. University of Western Ontario, London, ON, Canada

    Christina Ziebart

  3. Department of Kinesology and Physical Education, McGill University, Quebec, Canada

    Jenna C. Gibbs

  4. McMaster University, Hamilton, ON, Canada

    Caitlin McArthur, Alexandra Papaioannou, Aliya Khan, Lehana Thabane, Sadhana Prasad & Jonathan D. Adachi

  5. GERAS Centre for Aging Research, Hamilton, ON, Canada

    Caitlin McArthur & Alexandra Papaioannou

  6. Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Nicole Mittmann

  7. University of Toronto, Toronto, ON, Canada

    Judi Laprade, Sandra Kim, Angela M. Cheung & Robert R. Bleakney

  8. Women’s College Hospital, Toronto, ON, Canada

    Sandra Kim

  9. University of British Columbia, Vancouver, British Columbia, Canada

    David L. Kendler & Maureen C. Ashe

  10. University of Melbourne, Melbourne, Australia

    John D. Wark & Samuel C. Scherer

  11. Royal Melbourne Hospital, Melbourne, Australia

    John D. Wark

  12. St Joseph’s Healthcare—Hamilton, Hamilton, ON, Canada

    Lehana Thabane & Jonathan D. Adachi

  13. Broadmeadows Health Service, Melbourne, Australia

    Samuel C. Scherer

  14. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia

    Keith D. Hill

  15. University Health Network, Toronto, ON, Canada

    Lora M. Giangregorio

  16. Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada

    Maureen C. Ashe

  17. Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada

    Lora M. Giangregorio

Authors
  1. Christina Ziebart
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  2. Jenna C. Gibbs
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  3. Caitlin McArthur
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  4. Alexandra Papaioannou
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  5. Nicole Mittmann
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  9. David L. Kendler
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  18. Jonathan D. Adachi
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  19. Lora M. Giangregorio
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Contributions

Christina M.D. Ziebart, Jonathan D. Adachi, Maureen C. Ashe, Robert R. Bleakney, Angela M. Cheung, Jenna C. Gibbs, Keith D. Hill, David L. Kendler, Aliya A. Khan, Sandra Kim, Caitlin McArthur, Nicole Mittmann, Alexandra Papaioannou, Sadhana Prasad, Samuel C. Scherer, Lehana Thabane, John D. Wark, and Lora M. Giangregorio have all provided meaningful contributions to this manuscript.

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Correspondence to Lora M. Giangregorio.

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Ziebart, C., Gibbs, J.C., McArthur, C. et al. Are osteoporotic vertebral fractures or forward head posture associated with performance-based measures of balance and mobility?. Arch Osteoporos 14, 67 (2019). https://doi.org/10.1007/s11657-019-0626-x

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