Matheus Machado Gomes

The association between osteoporosis and static balance in elderly women

SummaryThis study aimed at answering the question: do people with high bone loss have greater postural instability? Groups were separated into group 1: women with normal bone mineral density, group 2: women with osteopenia, and group 3: women with osteoporosis. The balance was evaluated in four upright postural situations. Osteoporosis group had greater oscillation in the anteroposterior displacement in all situations compared to control group and the greatest mediolateral displacement in all situations compared to other groups.IntroductionIt is not known whether the presence of osteoporosis can be considered a factor aggravating the postural control. This study aimed at answering the question: do people with high bone loss have greater postural instability?MethodsThis study was divided into three groups: group 1 (n = 20) consisting of women with normal bone mineral density, group 2 (n = 20) women with osteopenia, and group 3 (n = 20) women with osteoporosis. All the participants were submitted to evaluation of the balance using the Polhemus system in four upright postural situations.ResultsOsteoporosis group had greater oscillation in the anteroposterior displacement in all situations compared to control group. The osteoporosis group also showed the greatest mediolateral displacement in all situations compared to other groups.ConclusionThe results suggest that osteoporotic women had the worst balance, possibly due to the more pronounced body changes compared to non-osteoporotic women.

Postural control parameters in elderly female fallers and non-fallers diagnosed or not with knee osteoarthritis.

OBJECTIVES To compare stabilometric parameters of elderly female fallers and non-fallers associated or not with knee osteoarthritis (OA). METHODS Fifty-six elderly female fallers and non-fallers diagnosed or not with unilateral or bilateral knee OA were divided into the following groups: FOA (n = 10), elderly female fallers with knee OA; FNOA (n = 11), elderly female fallers without knee OA; NFOA (n = 14), elderly female non-fallers with knee OA; and NFNOA (n = 21), elderly female non-fallers without knee OA. For analyzing semi-static balance on a force platform with the elderly females standing, the following parameters were assessed in four conditions: center of pressure (COP), anterior-posterior and mediolateral displacements (APD and MLD, respectively); and COP anterior-posterior and mediolateral displacement velocities (APV and MLV, respectively). The following conditions were assessed: 1) standing on a firm wooden surface with eyes open (WSEO); 2) standing on a firm wooden surface with eyes closed (WSEC); 3) standing on a foam surface with eyes open (FSEO); 4) standing on a foam surface with eyes closed (FSEC). RESULTS The elderly females with knee OA showed greater APD in all four conditions assessed (P < 0.05), while the elderly female fallers showed greater MLD (P < 0.05). No difference between the groups was observed for APV and MLV (P > 0.05). CONCLUSIONS Knee OA per se increases APD of the COP, while the history of falls, regardless of the presence of knee OA, hinders postural control in the ML direction.

What is the influence of surgical treatment of adolescent idiopathic scoliosis on postural control

PURPOSE To evaluate the effect of surgical treatment on the control of upright balance in adolescent idiopathic scoliosis (AIS). METHODS Thirty adolescents were divided into two groups: Group C (n=15) consisted of individuals without scoliosis (control), and Group S (n=15) consisted of individuals with scoliosis. The mean amplitude and velocity of the center of pressure (COP) evaluations in the anterior-posterior and medial-lateral directions were obtained before surgery and at 7, 30, 60 and 90-days after surgery, in an upright position, using a force platform. RESULTS Group S showed larger oscillation than Group C before surgery. The COP oscillation in Group S after surgery was larger than that in the pre-surgery period. The oscillation diminished over the post-surgery period, but individuals in the 90-day post-surgery period still had larger oscillation compared with the oscillation in the pre-surgery period. CONCLUSION Group S had larger AP and ML mean amplitude and mean velocity before and after surgery compared with Group C, which suggests that a sensorimotor impairment or sensory integration problem could explain the balance control alterations more than biomechanical factors in the AIS.

Body balance evaluation in osteoporotic elderly women.

SummaryOsteoporotic Brazilian women balance was evaluated by timed up and go test (TUG) and to the Berg balance scale (BBS). In the BBS, women with and without osteoporosis had normal range scores, even with history of fall. In the TUG test, women with osteoporosis were slower, but in the normal parameter. Results suggest that the references values of these tests are not appropriate for Brazilians.PurposesThe purposes of this study were to evaluate balance and functional mobility in women with osteoporosis and without osteoporosis and to verify if the history of falls has association to the TUG and to the BBS, both largely used in the clinical practice.Materials and methodsForty-five women were divided into three groups: group 1, young women with normal body mineral density (BMD); group 2, elderly with normal BMD; and group 3, elderly with osteoporosis. BBS and TUG were performed, and the history of falls was collected.ResultsBBS and TUG showed differences in the scores obtained for young women compared with both elderly with and without osteoporosis. In the TUG test, there were differences between elderly with and without osteoporosis. The fall’s history did not present correlations either for TUG or BBS.ConclusionsAlthough the results showed that all women were within the normal range for BBS and TUG, the results suggest that the reference values for TUG and BBS are not appropriate for Brazilian population.

Evaluation of postural control and quality of life in elderly women with knee osteoarthritis

OBJECTIVE To assess the balance in dynamic tasks and in the quality of life in elderly women with and without knee osteoarthritis. METHODS Elderly women were divided into Group 1 (n = 12), consisting of participants with bilateral knee osteoarthritis (Kellgreen-Lawrence grade 1 and 2), and Group 2 (n = 12), consisting of controls. A force plate (EMG System do Brazil) was used to assess postural sway in dynamic tasks, whereas the quality of life was assessed by using the WHOQOL-Bref questionnaire. RESULTS Students t-test showed no statistical difference during sitting down and standing up from the chair (p > 0.05). However, stair ascent revealed difference in displacement speed (p < 0.05), whereas stair descent showed differences in both displacement speed and amplitude (p < 0.05). In the questionnaire, Group 1 showed values lower than those in the control group regarding physical domain (p < 0.05). CONCLUSION Elderly women with knee osteoarthritis seemed to have more difficulty on stair descent task and had perception of worst physical domain. These findings were observed in OA group, even in the early stages of the disease, which shows the importance of even earlier interventions.

The influence of vision and support base on balance during quiet standing in patients with adolescent idiopathic scoliosis before and after posterior spinal fusion

BACKGROUND CONTEXT Scoliosis is the most common postural alteration in adolescence and is characterized by deviations of the spine in three planes. Surgical treatment based on arthrodesis has been developed, but the effects of such restructuring on the systems involved in postural control need to be better understood. PURPOSE To assess the influence of vision and the support base on balance in the quiet standing position in adolescents awaiting surgical treatment for idiopathic scoliosis. STUDY DESIGN/SETTING Longitudinal study/Ribeirão Preto Clinics Hospital (HC-FMRP-USP) and Laboratory of Assessment and Rehabilitation of Equilibrium at the FMRP-USP. PATIENT SAMPLE Adolescent idiopathic scoliosis patients and controls. OUTCOME MEASURES Center of pressure (CoP) sway area of the 95% confidence ellipse. METHODS Thirty female adolescents were divided into two groups according to their spinal alignment: control (n=15) and scoliosis groups (SGs) (n=15). The subjects with scoliosis were evaluated before and 7, 30, 60, and 90 days after surgery; the controls were evaluated once. The area of CoP oscillation was measured with the eyes open and closed and with two different support bases (feet apart or together). The force platform was purchased with funding support (US

Analysis of postural control and muscular performance in young and elderly women in different age groups

8,375.00) provided by the Research Foundation of São Paulo (FAPESP). The study sponsors had no involvement in the study. Data were collected from the force platform and then statistically assessed through a linear model analysis of mixed effects. RESULTS Data reveal that subjects in the SG oscillated more than controls, and postsurgery subjects had more oscillation than presurgery subjects. The results also indicated that both groups (control and scoliosis) showed more oscillation among those subjects with feet apart and eyes closed, but subjects with scoliosis were more affected by vision deprivation than by a reduced support base. CONCLUSIONS Our results indicate that adolescents with idiopathic scoliosis are more dependent on visual information and that surgical correction does not change this relationship.

Is the History of Falls an Indicative of Greater Decline in Quadriceps Muscle Function and Postural Sway

BACKGROUND: muscle strength and power are two factors affecting balance. The impact of muscle strength and power on postural control has not been fully explored among different age strata over sixty. OBJECTIVES: the aim of the present study was to assess the muscle strength and power of elderly women in different age groups and determine their correlation with postural control. METHOD: eighty women were divided into four groups: the young 18-30 age group (n=20); the 60-64 age group (n=20); the 65-69 age group (n=20); and the 70-74 age group (n=20). The participants underwent maximum strength (one repetition maximum or 1-RM) and muscle power tests to assess the knee extensor and flexor muscles at 40%, 70%, and 90% 1-RM intensity. The time required by participants to recover their balance after disturbing their base of support was also assessed. RESULTS: the elderly women in the 60-64, 65-69, and 70-74 age groups exhibited similar muscle strength, power, and postural control (p>0.05); however, these values were lower than those of the young group (p<0.05) as expected. There was a correlation between muscle strength and power and the postural control performance (p<0.05). CONCLUSION: despite the age difference, elderly women aged 60 to 74 years exhibited similar abilities to generate strength and power with their lower limbs, and this ability could be one factor that explains the similar postural control shown by these women.

PADRÃO DE MARCHA, PREVALÊNCIA DE QUEDAS E MEDO DE CAIR EM IDOSAS ATIVAS E SEDENTÁRIAS

To evaluate whether a history of falls is directly related to the quadriceps muscular function and body sway, 26 elderly women were divided on the basis of the presence or absence of a history of falls. Evaluation of muscular power and anteroposterior and mediolateral displacements of center of pressure during consecutive stand and sit 5 times were performed. Fallers exhibited higher mediolateral displacement than nonfallers. No differences were observed for quadriceps power and for sit-to-stand time between groups (P < .05). The fall history was not related to the quadriceps muscular function or to the anteroposterior displacement during sit to stand.

The effect of supervised and home based exercises on balance in elderly subjects: a randomized controlled trial to prevent falls

Introducao: O envelhecimento desencadeia alteracoes da marcha e aumenta o risco de quedas e o medo de cair, comprometendo a saude e a capacidade funcional do idoso. Estudos anteriores investigaram a pratica de exercicio fisico como possivel fator de reducao desses problemas, porem os resultados encontrados ate o momento sao inconclusivos. Objetivo: Analisar os parâmetros da marcha, a prevalencia de quedas e o medo de cair em idosas ativas e sedentarias. Metodos: Trinta e cinco mulheres com idades entre 60 e 75 anos foram divididas em dois grupos: grupo sedentarias (GS), que nao praticavam exercicios fisicos regularmente no ultimo ano e grupo ativas (GA), que praticavam exercicio fisico em um projeto de extensao de uma universidade publica, ha pelo menos seis meses. Os dados referentes aos parâmetros espaco-temporais da marcha foram coletados por meio de um tapete (4,88 m) com sensores de pressao. As idosas caminharam sobre o tapete em duas condicoes experimentais: velocidade preferida e maior velocidade possivel. Foram realizadas tres tentativas em cada condicao de forma aleatoria, totalizando seis tentativas. As voluntarias tambem responderam dois questionarios: questionario de Baecke, para avaliar a aptidao fisica, e questionario de quedas para avaliar a ocorrencia e consequencias das quedas. Resultados: A velocidade da marcha, a cadencia, e o comprimento da passada foram significativamente maiores nas idosas ativas, enquanto o tempo em duplo suporte foi significativamente maior nas idosas sedentarias em ambas as condicoes analisadas. Alem disso, as idosas ativas apresentaram menor prevalencia de quedas (22%) e de medo de cair (22%) comparadas as idosas sedentarias (58% e 70%, respectivamente). Conclusao: A pratica de exercicios fisicos realizados de forma sistematica em programas de educacao fisica para idosos parece ser uma estrategia interessante para minimizar os efeitos do processo de envelhecimento na marcha, no risco de quedas e no medo de cair em mulheres idosas.