How Vertebral Fractures Effect Balance In Postmenopausal Women

NCT ID: NCT06502301

Last Updated: 2024-07-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

95 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-11-01

Study Completion Date

2021-02-28

Brief Summary

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Osteoporosis is defined as low bone mineral density caused by altered bone microstructure, ultimately predisposing patients to fragility fractures. Osteoporotic fractures lead to a significant decrease in quality of life, increasing morbidity, mortality, and disability. Vertebral fracture may cause sagittal imbalance which leading to postural instability and becomes a possible risk factor for falls. The cause of balance problems in osteoporotic patients is multifactorial including increased thoracic kyphosis and postural sway, however the exact relationship between vertebral fractures and balance remains unclear. The aim of the study is; 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.

Detailed Description

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Osteoporosis is a metabolic bone disease characterized by low bone mass, deterioration of bone tissue, and disruption of bone microarchitecture . It is known that the incidence of vertebral fractures in women with osteoporosis increases especially after the age of 50. In the United States, one in four women older than 50 years suffers at least one osteoporosis-related vertebral compression fractures. Approximately one-third of vertebral fractures become symptomatic . Vertebral fracture may cause increased dorsal kyphosis and, the center of gravity of the body moves forward. Impaired postural stability is associated with fall risk and functional disability .

Many authors argue that the osteoporotic vertebral fractures are associated with an increase in the thoracic curve. There are studies revealing that hyperkyphosis may be a clinically useful marker for history of vertebral fracture and also a risk factor for a new vertebral fracture. Postmenopausal women with vertebral fracture have a 4-fold increased risk of new fractures compared to whom without spinal fracture. Recent vertebral fractures have a strong impact on daily living activities and are significant predictors of poor performance in functional status of the patient. However this triangle among vertebral fractures, kyphosis and balance has not been well documented in the literature.

The vertebral fracture cascade phenomena raises the possibility that multiple factors, such as spinal characteristics, vertebral alignment, spinal curvature, and spinal loads, as well as low bone mineral density, may have an impact on falls and fractures. Vertebral fracture may cause sagittal imbalance which leading to postural instability and becomes a possible risk factor for falls. Especially in osteoporotic elderly; falls are associated with high morbidity and mortality. However the effect of a vertebral fracture, as a preventable risk factor on balance impairment has not been studied sufficiently. In this study, we aimed to assess the effect of the presence of a vertebral fracture on balance and physical performance and its additional contribution to fall and fracture risk in patients with postmenopausal osteoporosis.

Conditions

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Postmenopausal Osteoporosis Vertebral Fracture Fracture of Vertebra Fall

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Postmenopausal women with vertebral fractures

Thoracolumbar radiograph, computed static posturography, fracture risk assessment tool (FRAX) scores, Dual-energy x-ray absorptiometry (DXA) measurements, serum 25(OH)D values, tandem test, timed up and go test (TUG), Berg balance scale (BBS) were performed.

Cross-sectional study

Intervention Type OTHER

This is not intervention study.

Postmenopausal women without vertebral fractures

Thoracolumbar radiograph, computed static posturography, fracture risk assessment tool (FRAX) scores, Dual-energy x-ray absorptiometry (DXA) measurements, serum 25(OH)D values, tandem test, timed up and go test (TUG), Berg balance scale (BBS) were performed.

Cross-sectional study

Intervention Type OTHER

This is not intervention study.

Interventions

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Cross-sectional study

This is not intervention study.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Patients aged 50 years or older
2. Diagnosis of postmenopausal osteoporosis according to WHO (World Health Organization) criteria and/or osteoporotic vertebral fractures

Exclusion Criteria

1. A history of neurological and/or vestibular system disease
2. Using a medication that may affect balance and proprioception
3. The presence of a psychotic disorder
4. A history of lower extremity surgery in the last 6 months
Minimum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Istanbul University - Cerrahpasa

OTHER

Sponsor Role lead

Responsible Party

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Dilara Okutan Kuzu

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sansin Tuzun

Role: STUDY_DIRECTOR

Istanbul University - Cerrahpasa

Dilara Okutan Kuzu

Role: PRINCIPAL_INVESTIGATOR

Istanbul University - Cerrahpasa

Rana Kaynar Terlemez

Role: STUDY_CHAIR

Istanbul University - Cerrahpasa

Deniz Palamar Kadioglu

Role: STUDY_CHAIR

Istanbul University - Cerrahpasa

Locations

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Istanbul University-Cerrahpasa

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R; National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014 Oct;25(10):2359-81. doi: 10.1007/s00198-014-2794-2. Epub 2014 Aug 15.

Reference Type BACKGROUND
PMID: 25182228 (View on PubMed)

Sozen T, Ozisik L, Basaran NC. An overview and management of osteoporosis. Eur J Rheumatol. 2017 Mar;4(1):46-56. doi: 10.5152/eurjrheum.2016.048. Epub 2016 Dec 30.

Reference Type BACKGROUND
PMID: 28293453 (View on PubMed)

Wang LY, Liaw MY, Huang YC, Lau YC, Leong CP, Pong YP, Chen CL. Static and dynamic balance performance in patients with osteoporotic vertebral compression fracture. J Back Musculoskelet Rehabil. 2013;26(2):199-205. doi: 10.3233/BMR-130369.

Reference Type BACKGROUND
PMID: 23640322 (View on PubMed)

Lems WF. Clinical relevance of vertebral fractures. Ann Rheum Dis. 2007 Jan;66(1):2-4. doi: 10.1136/ard.2006.058313.

Reference Type BACKGROUND
PMID: 17178757 (View on PubMed)

Lynn SG, Sinaki M, Westerlind KC. Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil. 1997 Mar;78(3):273-7. doi: 10.1016/s0003-9993(97)90033-2.

Reference Type BACKGROUND
PMID: 9084349 (View on PubMed)

Katzman WB, Vittinghoff E, Kado DM, Lane NE, Ensrud KE, Shipp K. Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial. Osteoporos Int. 2016 Mar;27(3):899-903. doi: 10.1007/s00198-015-3478-2. Epub 2016 Jan 18.

Reference Type BACKGROUND
PMID: 26782685 (View on PubMed)

Huang MH, Barrett-Connor E, Greendale GA, Kado DM. Hyperkyphotic posture and risk of future osteoporotic fractures: the Rancho Bernardo study. J Bone Miner Res. 2006 Mar;21(3):419-23. doi: 10.1359/JBMR.051201. Epub 2005 Dec 5.

Reference Type BACKGROUND
PMID: 16491290 (View on PubMed)

Huang C, Ross PD, Wasnich RD. Vertebral fracture and other predictors of physical impairment and health care utilization. Arch Intern Med. 1996 Nov 25;156(21):2469-75.

Reference Type BACKGROUND
PMID: 8944740 (View on PubMed)

Briggs AM, Greig AM, Wark JD. The vertebral fracture cascade in osteoporosis: a review of aetiopathogenesis. Osteoporos Int. 2007 May;18(5):575-84. doi: 10.1007/s00198-006-0304-x. Epub 2007 Jan 6.

Reference Type BACKGROUND
PMID: 17206492 (View on PubMed)

Other Identifiers

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89403766-604.01.02-136365

Identifier Type: -

Identifier Source: org_study_id

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