Gait in Patients with Symptomatic Osteoporotic Vertebral Compression Fractures over 6 months of Recovery

Overview

Journal Aging Clin Exp Res

Publisher Springer

Specialty Geriatrics

Date 2019 Apr 29

PMID 31030421

Citations 5

Authors

Eva Jacobs

Christopher McCrum

Rachel Senden

Lodewijk W van Rhijn

K Meijer

Paul C Willems

Affiliations

Soon will be listed here.

Abstract

Background: One factor related to disability in people with spinal deformity is decreased postural control and increased risk of falling. However, little is known about the effect of osteoporotic vertebral compression fractures (OVCFs) and their recovery on gait and stability. Walking characteristics of older adults with and without vertebral fractures have not yet been compared.

Aims: The purpose of the current study was to examine the spatiotemporal gait parameters and their variability in patients with an OVCF and healthy participants during treadmill walking at baseline and after 6 months of recovery.

Methods: Twelve female patients suffering a symptomatic OVCF were compared to 11 matched controls. Gait analysis was performed with a dual-belt instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment). Results of patients with an OVCF and healthy participants were compared. Furthermore, spatiotemporal gait parameters were assessed over 6 months following the fracture.

Results: Patients suffering from an OVCF appeared to walk with significantly shorter, faster and wider strides compared to their healthy counterparts. Although stride time and length improved over time, the majority of the parameters analysed remained unchanged after 6 months of conservative treatment.

Discussion: Since patients do not fully recover to their previous level of mobility after 6 months of conservative treatment for OVCF, it appears of high clinical importance to add balance and gait training to the treatment algorithm of OVCFs.

Conclusions: Patients suffering from an OVCF walk with shorter, faster and wider strides compared to their healthy counterparts adopt a less stable body configuration in the anterior direction, potentially increasing their risk of forward falls if perturbed. Although stride time and stride length improve over time even reaching healthy levels again, patients significantly deviate from normal gait patterns (e.g. in stability and step width) after 6 months of conservative treatment.

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Gait alterations in patients with adult spinal deformity.

Huysmans S, Senden R, Jacobs E, Willems P, Marcellis R, Boogaart M N Am Spine Soc J. 2024; 17:100306.

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References

Gabell A, NAYAK U . The effect of age on variability in gait. J Gerontol. 1984; 39(6):662-6. DOI: 10.1093/geronj/39.6.662. View

Abellan van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M . Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009; 13(10):881-9. DOI: 10.1007/s12603-009-0246-z. View

Luthman S, Widen J, Borgstrom F . Appropriateness criteria for treatment of osteoporotic vertebral compression fractures. Osteoporos Int. 2017; 29(4):793-804. DOI: 10.1007/s00198-017-4348-x. View

de Kruijf M, Verlinden V, Huygen F, Hofman A, van der Geest J, Uitterlinden A . Chronic joint pain in the lower body is associated with gait differences independent from radiographic osteoarthritis. Gait Posture. 2015; 42(3):354-9. DOI: 10.1016/j.gaitpost.2015.06.193. View

Hafer J, Boyer K . Age related differences in segment coordination and its variability during gait. Gait Posture. 2018; 62:92-98. DOI: 10.1016/j.gaitpost.2018.02.021. View

McCrum C, Eysel-Gosepath K, Epro G, Meijer K, Savelberg H, Bruggemann G . Associations Between Bipedal Stance Stability and Locomotor Stability Following a Trip in Unilateral Vestibulopathy. J Appl Biomech. 2016; 33(2):112-117. DOI: 10.1123/jab.2016-0004. View

Yang F, Pai Y . Adaptive control of center of mass (global) motion and its joint (local) origin in gait. J Biomech. 2014; 47(11):2797-800. PMC: 4184911. DOI: 10.1016/j.jbiomech.2014.06.001. View

Zeni Jr J, Higginson J . Gait parameters and stride-to-stride variability during familiarization to walking on a split-belt treadmill. Clin Biomech (Bristol). 2009; 25(4):383-6. PMC: 2847055. DOI: 10.1016/j.clinbiomech.2009.11.002. View

Muratore M, Ferrera A, Masse A, Bistolfi A . Osteoporotic vertebral fractures: predictive factors for conservative treatment failure. A systematic review. Eur Spine J. 2017; 27(10):2565-2576. DOI: 10.1007/s00586-017-5340-z. View

10.

Glassman S, Bridwell K, Dimar J, Horton W, Berven S, Schwab F . The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976). 2005; 30(18):2024-9. DOI: 10.1097/01.brs.0000179086.30449.96. View

11.

Owings T, Pavol M, Foley K, Grabiner M . Measures of postural stability are not predictors of recovery from large postural disturbances in healthy older adults. J Am Geriatr Soc. 2000; 48(1):42-50. DOI: 10.1111/j.1532-5415.2000.tb03027.x. View

12.

Verghese J, Holtzer R, Lipton R, Wang C . Quantitative gait markers and incident fall risk in older adults. J Gerontol A Biol Sci Med Sci. 2009; 64(8):896-901. PMC: 2709543. DOI: 10.1093/gerona/glp033. View

13.

Johnell O, Kanis J . An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006; 17(12):1726-33. DOI: 10.1007/s00198-006-0172-4. View

14.

Hausdorff J . Gait variability: methods, modeling and meaning. J Neuroeng Rehabil. 2005; 2:19. PMC: 1185560. DOI: 10.1186/1743-0003-2-19. View

15.

Talbot L, Musiol R, Witham E, Metter E . Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health. 2005; 5:86. PMC: 1208908. DOI: 10.1186/1471-2458-5-86. View

16.

Ismail A, Cooper C, Felsenberg D, Varlow J, Kanis J, Silman A . Number and type of vertebral deformities: epidemiological characteristics and relation to back pain and height loss. European Vertebral Osteoporosis Study Group. Osteoporos Int. 1999; 9(3):206-13. DOI: 10.1007/s001980050138. View

17.

Mackey D, Robinovitch S . Postural steadiness during quiet stance does not associate with ability to recover balance in older women. Clin Biomech (Bristol). 2005; 20(8):776-83. DOI: 10.1016/j.clinbiomech.2005.05.002. View

18.

Lindsay R, Silverman S, Cooper C, Hanley D, Barton I, Broy S . Risk of new vertebral fracture in the year following a fracture. JAMA. 2001; 285(3):320-3. DOI: 10.1001/jama.285.3.320. View

19.

Hof A, Gazendam M, Sinke W . The condition for dynamic stability. J Biomech. 2004; 38(1):1-8. DOI: 10.1016/j.jbiomech.2004.03.025. View

20.

Venmans A, Klazen C, Lohle P, Mali W, van Rooij W . Natural history of pain in patients with conservatively treated osteoporotic vertebral compression fractures: results from VERTOS II. AJNR Am J Neuroradiol. 2011; 33(3):519-21. PMC: 7966424. DOI: 10.3174/ajnr.A2817. View