Skip to main content
Top
Published in: Osteoporosis International 7/2013

01-07-2013 | Original Article

Correlation of postural balance and knee muscle strength in the sit-to-stand test among women with and without postmenopausal osteoporosis

Authors: G. C. Brech, A. C. Alonso, N. M. S. Luna, J. M. Greve

Published in: Osteoporosis International | Issue 7/2013

Login to get access

Abstract

Summary

The task of standing up from a chair forms a part of daily life for all independent individuals. However, this task becomes more difficult with advancing age. Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up.

Introduction

This study aims to evaluate postural balance during the transition from sitting to standing and its relationship with knee extensor and flexor strength among women with and without postmenopausal osteoporosis.

Methods

Assessments were made on 126 women (aged 55–65 years), divided into osteoporosis and control groups according to lumbar bone density. Their balance during the task of standing up from a chair was evaluated using the Balance Master® device. Knee muscle strength was evaluated using an isokinetic dynamometer (Biodex®), in concentric/concentric mode, at a velocity of 60°/s. Spearman’s correlation between the variables of muscle strength and postural balance was evaluated. Subsequently, to evaluate the association of each balance variable with the group and with muscle strength, multiple linear regression models were fitted. The significance level was set at 0.05.

Results

There was a difference in knee muscle strength between the groups (P < 0.05). However, independent of the muscle strength values, there were no differences in relation to weight transfer times (P = 0.556) or center of gravity sway velocity (P = 0.952). Transfer time diminished with increasing extensor strength (P = 0.025). The center of gravity sway velocity tended to increase with increasing extensor strength (P = 0.013) and was the same in the two groups (P = 0.264).

Conclusion

Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up.
Literature
1.
go back to reference Hartmann A, Knols R, Murer K, de Bruin ED (2000) Reproducibility of an isokinetic strength-testing protocol of the knee and ankle in older adults. Gerontology 55:259–268CrossRef Hartmann A, Knols R, Murer K, de Bruin ED (2000) Reproducibility of an isokinetic strength-testing protocol of the knee and ankle in older adults. Gerontology 55:259–268CrossRef
2.
go back to reference American College of Sports Medicine (2009) Position stand on exercise and physical activity for older adults. Med Sci Sports Exerc 41:1510–1530CrossRef American College of Sports Medicine (2009) Position stand on exercise and physical activity for older adults. Med Sci Sports Exerc 41:1510–1530CrossRef
3.
go back to reference Frischknecht R (1998) Effect of training on muscle strength and motor function in the elderly. Reprod Nutr Dev 38(2):167–174PubMedCrossRef Frischknecht R (1998) Effect of training on muscle strength and motor function in the elderly. Reprod Nutr Dev 38(2):167–174PubMedCrossRef
4.
go back to reference Stanley SN, Marshall RN, Tilyard MW, Taylor NA (1994) Skeletal muscle mechanics in osteoporotic and nonosteoporotic postmenopausal women. Eur J Appl Physiol Occup Physiol 69(5):450–455PubMedCrossRef Stanley SN, Marshall RN, Tilyard MW, Taylor NA (1994) Skeletal muscle mechanics in osteoporotic and nonosteoporotic postmenopausal women. Eur J Appl Physiol Occup Physiol 69(5):450–455PubMedCrossRef
5.
go back to reference Woollacott MH, Shumway-Cook A, Nashner LM (1986) Aging and posture control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev 23(2):97–114PubMedCrossRef Woollacott MH, Shumway-Cook A, Nashner LM (1986) Aging and posture control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev 23(2):97–114PubMedCrossRef
6.
go back to reference Skelton DA, Greig CA, Davies JM, Young A (1994) Strength, power and related functional ability of healthy people aged 65–89 years. Age Ageing 23:371–377PubMedCrossRef Skelton DA, Greig CA, Davies JM, Young A (1994) Strength, power and related functional ability of healthy people aged 65–89 years. Age Ageing 23:371–377PubMedCrossRef
7.
go back to reference Maki BE, Holliday PJ, Topper AK (1991) Fear of falling and postural performance in the elderly. J Gerontol 46(4):M123–M131PubMedCrossRef Maki BE, Holliday PJ, Topper AK (1991) Fear of falling and postural performance in the elderly. J Gerontol 46(4):M123–M131PubMedCrossRef
8.
go back to reference Rutherford OM, Jones DA (1992) The relationship of muscle and bone loss and activity levels with age in women. Age Ageing 21(4):286–293PubMedCrossRef Rutherford OM, Jones DA (1992) The relationship of muscle and bone loss and activity levels with age in women. Age Ageing 21(4):286–293PubMedCrossRef
9.
go back to reference Hurley MV, Rees J, Newham DJ (1998) Quadriceps function, proprioceptive acuity and functional performance in healthy young, middle-aged and elderly subjects. Age Ageing 27(1):55–62PubMedCrossRef Hurley MV, Rees J, Newham DJ (1998) Quadriceps function, proprioceptive acuity and functional performance in healthy young, middle-aged and elderly subjects. Age Ageing 27(1):55–62PubMedCrossRef
10.
go back to reference Fujita T, Nakamura S, Ohue M, Fujii Y, Miyauchi A, Takagi Y, Tsugeno H (2005) Effect of age on body sway assessed by computerized posturography. J Bone Miner Metab 23(2):152–156PubMedCrossRef Fujita T, Nakamura S, Ohue M, Fujii Y, Miyauchi A, Takagi Y, Tsugeno H (2005) Effect of age on body sway assessed by computerized posturography. J Bone Miner Metab 23(2):152–156PubMedCrossRef
11.
go back to reference Abreu DC, Trevisan DC, Costa GC et al (2010) The association between osteoporosis and static balance in elderly women. Osteoporos Int 21(9):1487–1491PubMedCrossRef Abreu DC, Trevisan DC, Costa GC et al (2010) The association between osteoporosis and static balance in elderly women. Osteoporos Int 21(9):1487–1491PubMedCrossRef
12.
go back to reference World Health Organisation (1994) Assessment of fracture risk and its implication to screening for postmenopausal osteoporosis: technical report series 843. WHO, Geneva World Health Organisation (1994) Assessment of fracture risk and its implication to screening for postmenopausal osteoporosis: technical report series 843. WHO, Geneva
13.
go back to reference Holm L, Olesen JL, Matsumoto K et al (2008) Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength, and bone formation in postmenopausal women. J Appl Physiol 105(1):274–281PubMedCrossRef Holm L, Olesen JL, Matsumoto K et al (2008) Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength, and bone formation in postmenopausal women. J Appl Physiol 105(1):274–281PubMedCrossRef
14.
go back to reference Kuczyński M, Ostrowska B (2006) Understanding falls in osteoporosis: the viscoelastic modeling perspective. Gait Posture 23(1):51–58PubMedCrossRef Kuczyński M, Ostrowska B (2006) Understanding falls in osteoporosis: the viscoelastic modeling perspective. Gait Posture 23(1):51–58PubMedCrossRef
15.
go back to reference Silva RB, Costa-Paiva L, Morais SS et al (2010) Predictors of falls in women with and without osteoporosis. J Orthop Sports Phys Ther 40(9):582–588PubMed Silva RB, Costa-Paiva L, Morais SS et al (2010) Predictors of falls in women with and without osteoporosis. J Orthop Sports Phys Ther 40(9):582–588PubMed
16.
go back to reference Burke TN, França FJ, Meneses SR et al (2010) Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J 128(4):219–224PubMedCrossRef Burke TN, França FJ, Meneses SR et al (2010) Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J 128(4):219–224PubMedCrossRef
17.
go back to reference Carter ND, Khan KM, Mallinson A et al (2002) Knee extension strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. Gerontology 48(6):360–368PubMedCrossRef Carter ND, Khan KM, Mallinson A et al (2002) Knee extension strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. Gerontology 48(6):360–368PubMedCrossRef
18.
go back to reference Mourex F, Pozzo T, Rouhier-Marcer I, Didier JP (1998) A kinematic comparison between elderly and young subjects standing up from and sitting down in a chair. Age and Ageing 27:137–146CrossRef Mourex F, Pozzo T, Rouhier-Marcer I, Didier JP (1998) A kinematic comparison between elderly and young subjects standing up from and sitting down in a chair. Age and Ageing 27:137–146CrossRef
19.
go back to reference Brech GC, Ciolac EG, Secchi LL, Alonso AC, Greve JMA (2011) The effects of motor learning on clinical isokinetic performance of postmenopausal women. Maturitas 70:379–382PubMedCrossRef Brech GC, Ciolac EG, Secchi LL, Alonso AC, Greve JMA (2011) The effects of motor learning on clinical isokinetic performance of postmenopausal women. Maturitas 70:379–382PubMedCrossRef
20.
go back to reference Neter J, Kutner MH, Nachtsheim CJ, Li W (2005) Applied linear statistical models, 5th edn. Irwin, Chicago Neter J, Kutner MH, Nachtsheim CJ, Li W (2005) Applied linear statistical models, 5th edn. Irwin, Chicago
21.
go back to reference Lynn SG, Sinaki M, Westerlind KC (1997) Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil 78(3):273–277PubMedCrossRef Lynn SG, Sinaki M, Westerlind KC (1997) Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil 78(3):273–277PubMedCrossRef
22.
go back to reference Kado DM, Lui LY, Ensrud KE, Study of Osteoporotic Fractures et al (2009) Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann Intern Med 150(10):681–687PubMedCrossRef Kado DM, Lui LY, Ensrud KE, Study of Osteoporotic Fractures et al (2009) Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann Intern Med 150(10):681–687PubMedCrossRef
23.
go back to reference Roux C, Fechtenbaum J, Kolta S et al (2010) Prospective assessment of thoracic kyphosis in postmenopausal women with osteoporosis. J Bone Miner Res 25(2):362–368PubMedCrossRef Roux C, Fechtenbaum J, Kolta S et al (2010) Prospective assessment of thoracic kyphosis in postmenopausal women with osteoporosis. J Bone Miner Res 25(2):362–368PubMedCrossRef
24.
go back to reference Pijnappels M, van der Burg PJ, Reeves ND, van Dieën JH (2008) Identification of elderly fallers by muscle strength measures. Eur J Appl Physiol 102(5):585–592PubMedCrossRef Pijnappels M, van der Burg PJ, Reeves ND, van Dieën JH (2008) Identification of elderly fallers by muscle strength measures. Eur J Appl Physiol 102(5):585–592PubMedCrossRef
25.
go back to reference Liu-Ambrose T, Eng JJ, Khan KM et al (2002) The influence of back pain on balance and functional mobility in 65- to 75-year-old women with osteoporosis. Osteoporos Int 13(11):868–873PubMedCrossRef Liu-Ambrose T, Eng JJ, Khan KM et al (2002) The influence of back pain on balance and functional mobility in 65- to 75-year-old women with osteoporosis. Osteoporos Int 13(11):868–873PubMedCrossRef
26.
go back to reference Hübscher M, Vogt L, Schmidt K, Fink M, Banzer W (2010) Perceived pain, fear of falling and physical function in women with osteoporosis. Gait Posture 32(3):383–385PubMedCrossRef Hübscher M, Vogt L, Schmidt K, Fink M, Banzer W (2010) Perceived pain, fear of falling and physical function in women with osteoporosis. Gait Posture 32(3):383–385PubMedCrossRef
27.
go back to reference Alexander NB (1994) Postural control in older adults. J Am Geriatr Soc 42(1):93–108PubMed Alexander NB (1994) Postural control in older adults. J Am Geriatr Soc 42(1):93–108PubMed
28.
go back to reference Ciolac EG, Brech GC, Greve JMD (2010) Age does not affect exercise intensity progression among women. J Strength Cond Res 24:3023–3031PubMedCrossRef Ciolac EG, Brech GC, Greve JMD (2010) Age does not affect exercise intensity progression among women. J Strength Cond Res 24:3023–3031PubMedCrossRef
29.
go back to reference Burke TN, França FJ, Ferreira de Meneses SR, Cardoso VI, Marques AP (2010) Postural control in elderly persons with osteoporosis: efficacy of an intervention program to improve balance and muscle strength: a randomized controlled trial. Am J Phys Med Rehabil 89(7):549–556PubMedCrossRef Burke TN, França FJ, Ferreira de Meneses SR, Cardoso VI, Marques AP (2010) Postural control in elderly persons with osteoporosis: efficacy of an intervention program to improve balance and muscle strength: a randomized controlled trial. Am J Phys Med Rehabil 89(7):549–556PubMedCrossRef
30.
go back to reference MacIntyre NJ, Stavness CL, Adachi JD (2010) The Safe Functional Motion test is reliable for assessment of functional movements in individuals at risk for osteoporotic fracture. Clin Rheumatol 29(2):143–150PubMedCrossRef MacIntyre NJ, Stavness CL, Adachi JD (2010) The Safe Functional Motion test is reliable for assessment of functional movements in individuals at risk for osteoporotic fracture. Clin Rheumatol 29(2):143–150PubMedCrossRef
31.
go back to reference Katzman WB, Vittinghoff E, Kado DM (2011) Age-related hyperkyphosis, independent of spinal osteoporosis, is associated with impaired mobility in older community-dwelling women. Osteoporos Int 22(1):85–90PubMedCrossRef Katzman WB, Vittinghoff E, Kado DM (2011) Age-related hyperkyphosis, independent of spinal osteoporosis, is associated with impaired mobility in older community-dwelling women. Osteoporos Int 22(1):85–90PubMedCrossRef
32.
go back to reference Schacht E, Ringe JD (2012) Alfacalcidol improves muscle power, muscle function and balance in elderly patients with reduced bone mass. Rheumatol Int 32(1):207–215PubMedCrossRef Schacht E, Ringe JD (2012) Alfacalcidol improves muscle power, muscle function and balance in elderly patients with reduced bone mass. Rheumatol Int 32(1):207–215PubMedCrossRef
33.
go back to reference NeuroCom® International, Inc (2003) Balance Master® System Operator’s Manual, version 8.1. NeuroCom® International, Inc, Clackamas NeuroCom® International, Inc (2003) Balance Master® System Operator’s Manual, version 8.1. NeuroCom® International, Inc, Clackamas
34.
go back to reference Wolfson L, Whipple R, Judge J et al (1993) Training balance and strength in the elderly to improve function. J Am Geriatr Soc 41(3):341–343PubMed Wolfson L, Whipple R, Judge J et al (1993) Training balance and strength in the elderly to improve function. J Am Geriatr Soc 41(3):341–343PubMed
35.
go back to reference Rose DJ, McKillop J (1998) Assessment of balance and mobility functions: a reference study based on the Balance Master 6.0. NeuroCom® International, Inc, Clackamas Rose DJ, McKillop J (1998) Assessment of balance and mobility functions: a reference study based on the Balance Master 6.0. NeuroCom® International, Inc, Clackamas
36.
go back to reference Blain H, Jaussent A, Thomas E et al (2009) Low sit-to-stand performance is associated with low femoral neck bone mineral density in healthy women. Calcif Tissue Int 84(4):266–275PubMedCrossRef Blain H, Jaussent A, Thomas E et al (2009) Low sit-to-stand performance is associated with low femoral neck bone mineral density in healthy women. Calcif Tissue Int 84(4):266–275PubMedCrossRef
37.
go back to reference Lindsey C, Brownbill RA, Bohannon RA, Ilich JZ (2005) Association of physical performance measures with bone mineral density in postmenopausal women. Arch Phys Med Rehabil 86(6):1102–1107PubMedCrossRef Lindsey C, Brownbill RA, Bohannon RA, Ilich JZ (2005) Association of physical performance measures with bone mineral density in postmenopausal women. Arch Phys Med Rehabil 86(6):1102–1107PubMedCrossRef
38.
go back to reference Alp A, Kanat E, Yurtkuran M (2007) Efficacy of a self-management program for osteoporotic subjects. Am J Phys Med Rehabil 86(8):633–640PubMedCrossRef Alp A, Kanat E, Yurtkuran M (2007) Efficacy of a self-management program for osteoporotic subjects. Am J Phys Med Rehabil 86(8):633–640PubMedCrossRef
Metadata
Title
Correlation of postural balance and knee muscle strength in the sit-to-stand test among women with and without postmenopausal osteoporosis
Authors
G. C. Brech
A. C. Alonso
N. M. S. Luna
J. M. Greve
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 7/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-013-2285-x

Other articles of this Issue 7/2013

Osteoporosis International 7/2013 Go to the issue