10 Quality of Live and Muscle Strength in Adults with Low and Moderate to High Risk of Osteoporotic Fracture

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv3-iv3
Author(s):  
Siew Kuan Chua ◽  
Devinder K A Singh ◽  
Bala S Rajaratnam ◽  
Sabarul Afian Mokhtar ◽  
Y W Raymond Lee

Abstract Osteoporotic fracture is known contributor to decline quality of life (QoL) and muscle strength. We aimed to examine the association between quality of life and muscle strength in adults at risk of osteoporotic fracture. A cross-sectional study was conducted among 105 adults aged 50 years and above (69.3 ± 8.5 years) at a spine orthopaedic clinic. Upper and lower limb muscle strength were measured using dominant hand grip strength test (HGS) and 5-sit to stand test (5STS). Quality of life and osteoporotic fracture risk were assessed using EQ5DVAS questionnaire and fracture risk calculator (FRAX®). Approximately 38% of the participants had moderate to high risk of major osteoporotic fracture. Although lower, the total mean score of EQ5DVAS in adults with low (80.54 ± 13.20) and moderate to high (76.88 ± 16.90) risk of osteoporotic fracture was not significantly different (p = 0.77). Adults with risk of osteoporotic fracture had slight to severe problems in EQ5D subdomains (mobility: 30%, self-care:10%, usual activities: 14%, pain discomfort: 60%, anxiety/depression: 46%). After adjusting for femoral neck bone mineral density and education level, higher HGS score (ß = 0.79, 95% C.I: 0.07-1.52, p < 0.05) and shorter time to complete 5STS (ß =-1.02, 95% C.I:-1.86 - -0.19, p < 0.05) were associated with higher QoL scores. Our study results suggest that muscle strength is positively associated with QoL among adults at risk of osteoporotic fracture. Muscle strength training should be emphasised among adults with risk of osteoporotic fracture in view of improving QOL.

2020 ◽  
Author(s):  
Anett Vincze ◽  
Levente Bodoki ◽  
Katalin Szabó ◽  
Melinda Nagy-Vincze ◽  
Orsolya Szalmás ◽  
...  

Abstract Background: The prevalence of osteoporosis and risk of fractures is elevated in rheumatoid arthritis, but we have little information about the bone mineral density and fracture risk in patients with inflammatory myopathies. We intended to ascertain and compare fracture risk, bone mineral density (BMD) and the prevalence of vertebral fractures in patients with inflammatory myositis and rheumatoid arthritis (RA) and to assess the effect of prevalent fractures on the quality of life and functional capacity. Methods: Fifty-two patients with myositis and 43 patients with rheumatoid arthritis were included in the study. Fracture Risk was determined using FRAX® Calculation Tool developed by the University of Sheffield. Dual energy X-ray absorptiometry and bidirectional thoracolumbar radiographs were performed to assess BMD and vertebral fractures. Quality of life was measured with Short Form-36 (SF-36) and physical function assessment was performed using Health Assessment Questionnaire (HAQ). Results: We found a significantly elevated fracture risk in RA compared to myositis patients if the risk assessment was performed without the application of the BMD results. If BMD results and glucocorticoid dose adjustment were taken into account, the differences in fracture risk were no longer significant. The prevalence of osteoporosis was found to be significantly higher in the myositis group (7% vs. 13.5%, p: 0,045), but the fracture prevalence was similar in the two groups (75% vs. 68%). The fractures rates were associated with age in both groups, but not with cumulative dose of steroid and BMD results correlated with fracture prevalence only in the RA patients. The number of prevalent fractures was significantly correlated to poorer physical function in both groups, and poorer health status in the myositis group, but not in the RA group. Conclusions: Our findings suggest that inflammatory myopathies carry significantly elevated risk for osteoporosis and fractures. This higher risk is comparable to one detected with RA in studies and strongly affects the physical function and quality of life of patients. Therefore further efforts are required to make the fracture risk assessment reliable and to facilitate the use early preventive treatments.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Siew Kuan Chua ◽  
Devinder ◽  
KA Singh ◽  
Bala S Rajaratnam ◽  
Sabarul Afian Mokhtar ◽  
...  

Abstract Osteoporotic related fractures (OF) are associated with functional impairments and declined quality of life. Low bone mineral density is one of the main risk factor for OF. However, there is limited information regarding the association of spinal morphology, muscle strength and physical performance with OF. The aim of the study was to examine association between risk of osteoporotic fractures with spinal morphology (thoracolumbar curvature and back extensors muscle strength), muscle strength and physical performance. 105 adults aged 50 years and above (69.3+ 8.5 years) were recruited for this cross-sectional study from a spine orthopaedic clinic. Thoracolumbar curvature, back extensors (BEMS) and handgrip (HGS) muscle strength were measured using an electromagnetic tracking system, a load-cell system and hand-held dynamometer respectively. Physical performance was assessed using Short Physical Performance Battery (SPPB). Participants were categorised for major osteoporotic fracture risk (major OF) with cut-point 10% using fracture risk calculator (FRAX®) with BMD. Student t-test analysis demonstrated that there is a significant (p<0.05) difference between participants with low risk and moderate to high risk of major OF for BEMS, HGS, and SPPB. Adjusted logistic models (forward and backward), showed that lower HGS and physical performance were associated with increased risk of major OF (HGS: OR = 0.18 [95% CI, 0.07–0.48]; SPPB: OR = 0.32[95% CI, 0.13–0.80]). Our study results suggest that declined muscle strength and physical performance is associated with higher risk of OF. It is important to promote optimum muscle strength and physical performance among older adults in the prevention of OF.


2018 ◽  
Vol 16 (si) ◽  
pp. 217-218
Author(s):  
Siew Kuan Chua ◽  
Devinder Kaur Ajit Singh ◽  
Bala S Rajaratnam ◽  
Sabarul Afian Mokhtar

2020 ◽  
Author(s):  
Anett Vincze ◽  
Levente Bodoki ◽  
Katalin Szabó ◽  
Melinda Nagy-Vincze ◽  
Orsolya Szalmás ◽  
...  

Abstract Background: The prevalence of osteoporosis and risk of fractures is elevated in rheumatoid arthritis, but we have limited information about the bone mineral density and fracture risk in patients with inflammatory myopathies. We intended to ascertain and compare fracture risk, bone mineral density (BMD) and the prevalence of vertebral fractures in patients with inflammatory myositis and rheumatoid arthritis (RA) and to assess the effect of prevalent fractures on the quality of life and functional capacity.Methods: Fifty-two patients with myositis and 43 patients with rheumatoid arthritis were included in the study. Fracture Risk was determined using FRAX® Calculation Tool developed by the University of Sheffield. Dual energy X-ray absorptiometry and bidirectional thoracolumbar radiographs were performed to assess BMD and vertebral fractures. Quality of life was measured with Short Form-36 (SF-36) and physical function assessment was performed using Health Assessment Questionnaire (HAQ). Results: We found a significantly elevated fracture risk in RA as compared to myositis patients if the risk assessment was performed without the inclusion of the BMD results. If BMD results and glucocorticoid dose adjustment were taken into account, the differences in fracture risk were no longer significant. The prevalence of osteoporosis was found to be significantly higher in the myositis group (7% vs. 13.5%, p: 0.045), but the fracture prevalence was similar in the two groups (75% vs. 68%). The fracture rates were independently associated with age in the myositis group, and with lower BMD results in the RA patients. The number of prevalent fractures was significantly correlated to poorer physical function in both groups, and poorer health status in the myositis group, but not in the RA group.Conclusions: Our findings suggest that inflammatory myopathies carry significantly elevated risks for osteoporosis and fractures. These higher risks are comparable to ones detected with RA in studies and strongly affect the physical function and quality of life of patients. Therefore further efforts are required to make the fracture risk assessment reliable and to facilitate the use of early preventive treatments.


2012 ◽  
Vol 10 (3) ◽  
pp. 427-435 ◽  
Author(s):  
D. Marchese ◽  
M. D'Andrea ◽  
V. Ventura ◽  
T. Montalcini ◽  
D. Foti ◽  
...  

This study was designed to evaluate whether a weight-bearing exercise training played 3 times a week can have benefits on bone mineral density and neuromuscular function in women with a diagnosis of osteopenia. The study enrolled 22 women aged between 45 and 65, with densitometric diagnosis of osteopenia. The participants were randomly assigned to a group of exercise (n=11) and a control group (n=11). The exercise program lasted for 45 min and consisted of a combination of strength exercises that seek to cause a mechanical osteoblastic stimulus by use of gravity, body weight, fall with antigravity reaction, in combination with exercises for the improvement of balance and coordination. The outcome measures used to assess the result on bone mass are the bone Mineralometric DEXA method for femoral head-neck region and lumbar spine and biochemical markers of bone turnover (resorption and neoformation) and for the evaluation of neuromuscular function was chosen to use surface electromyography (sEMG) as an indicator of overall activity and speed activation of lumbar paravertebral muscles and of the lower limbs antigravity muscles, stabilometric analysis and 6' Walk Test. In addition each person enrolled was given EuroQol and ICF core set of osteoporosis, respectively, to assess the quality of life, as well as activity limitations and participation restrictions associated. In the exercise group, mean values and changes in average rates for the balance, muscle strength, walking ability and quality of life, mean bone mineral content and bone turnover markers, corresponding to the assessments made at 0 (before rehabilitation intervention) and Time 1 (program ended), showed a statistically significant improvement. The results of this study demonstrate that a group rehabilitation program of exercises based on gravitational load, aimed to improve muscle strength and trophism, coordination and balance, can provide advantages of unquestionable importance, not only on the slope of increase bone mass of neuromuscular function and reducing risk of falling, but on health in general.


2020 ◽  
Author(s):  
Anett Vincze ◽  
Levente Bodoki ◽  
Katalin Szabó ◽  
Melinda Nagy-Vincze ◽  
Orsolya Szalmás ◽  
...  

Abstract Background: The prevalence of osteoporosis and risk of fractures is elevated in rheumatoid arthritis, but we have little information about the bone mineral density and fracture risk in patients with inflammatory myopathies. We intended to ascertain and compare fracture risk, bone mineral density (BMD) and the prevalence of vertebral fractures in patients with inflammatory myositis and rheumatoid arthritis (RA) and to assess the effect of prevalent fractures on the quality of life and functional capacity. Methods: Fifty-two patients with myositis and 43 patients with rheumatoid arthritis were included in the study. Fracture Risk was determined using FRAX® Calculation Tool developed by the University of Sheffield. Dual energy X-ray absorptiometry and bidirectional thoracolumbar radiographs were performed to assess BMD and vertebral fractures. Quality of life was measured with Short Form-36 (SF-36) and physical function assessment was performed using Health Assessment Questionnaire (HAQ). Results: We found a significantly elevated fracture risk in RA compared to myositis patients if the risk assessment was performed without the application of the BMD results. If BMD results and glucocorticoid dose adjustment were taken into account, the differences in fracture risk were no longer significant. The prevalence of osteoporosis was found to be significantly higher in the myositis group (7% vs. 13.5%, p: 0,045), but the fracture prevalence was similar in the two groups (75% vs. 68%). The fractures rates were independently associated with age in the myositis group, and with lower BMD results in the RA patients. The number of prevalent fractures was significantly correlated to poorer physical function in both groups, and poorer health status in the myositis group, but not in the RA group. Conclusions: Our findings suggest that inflammatory myopathies carry significantly elevated risk for osteoporosis and fractures. This higher risk is comparable to one detected with RA in studies and strongly affects the physical function and quality of life of patients. Therefore further efforts are required to make the fracture risk assessment reliable and to facilitate the use early preventive treatments.


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