Skip to main content
Top
Published in: Osteoporosis International 10/2018

01-10-2018 | Original Article

Postural control is associated with muscle power in post-menopausal women with low bone mass

Authors: N. Stolzenberg, D. Felsenberg, D. L. Belavy

Published in: Osteoporosis International | Issue 10/2018

Login to get access

Abstract

Summary

Older women with low bone mass are at higher risk of fracture and there is limited data on what is associated with risk of falls. We found explosive jumping to relate most strongly to postural control. It may be beneficial to include power or speed training into falls prevention programs.

Introduction

Post-menopausal women with low bone mass are at higher risk of bone fractures subsequent to falls. Understanding the correlates of postural control in this collective informs intervention design for falls prevention.

Methods

We examined postural control in single-leg stance on stable and unstable surfaces in 63 community-dwelling post-menopausal women with osteopenia or osteoporosis but without diagnosed neuromuscular, vestibular or arthritic diseases. Postural measures were compared to countermovement jump performance (height, force and power), leg-press strength (10 repetition maximum), calf muscle area and density (via peripheral quantitative computed tomography), body mass, height and age.

Results

On step-wise regression, peak countermovement jump power and jump height (p ≤ 0.014), but not jump force, leg-press strength or calf muscle size, were related to postural control in single-leg stance on, respectively, an unstable surface (eyes open) and standing on a stable surface (eyes open). None of the parameters measured were significantly related to the postural control parameters in single-leg stance on a stable surface with eyes closed. With testing on the stable surface, body mass was associated with slow mean centre of pressure movement speed (p ≤ 0.030).

Conclusions

Our findings show that, in post-menopausal women with low bone mass, neuromuscular power is a more important determinant of postural control than muscle strength or size. Our findings provide evidence to support the integration of power or speed training into falls prevention and balance training programs in post-menopausal women with osteopenia and osteoporosis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Abreu DC, Trevisan DC, Costa GC, Vasconcelos FM, Gomes MM, Carneiro AA (2010) The association between osteoporosis and static balance in elderly women. Osteoporos Int 21:1487–1491CrossRef Abreu DC, Trevisan DC, Costa GC, Vasconcelos FM, Gomes MM, Carneiro AA (2010) The association between osteoporosis and static balance in elderly women. Osteoporos Int 21:1487–1491CrossRef
2.
go back to reference Burke TN, França FJR, Meneses SRF, Cardoso VI, Pereira RMR, Danilevicius CF, Marques AP (2010) Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J 128:219–224CrossRef Burke TN, França FJR, Meneses SRF, Cardoso VI, Pereira RMR, Danilevicius CF, Marques AP (2010) Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J 128:219–224CrossRef
3.
go back to reference Hue O, Simoneau M, Marcotte J, Berrigan F, Doré J, Marceau P, Marceau S, Tremblay A, Teasdale N (2007) Body weight is a strong predictor of postural stability. Gait Posture 26:32–38CrossRef Hue O, Simoneau M, Marcotte J, Berrigan F, Doré J, Marceau P, Marceau S, Tremblay A, Teasdale N (2007) Body weight is a strong predictor of postural stability. Gait Posture 26:32–38CrossRef
4.
go back to reference Binda SM, Culham EG, Brouwer B (2003) Balance, muscle strength, and fear of falling in older adults. Exp Aging Res 29:205–219CrossRef Binda SM, Culham EG, Brouwer B (2003) Balance, muscle strength, and fear of falling in older adults. Exp Aging Res 29:205–219CrossRef
5.
go back to reference Carter ND, Khan KM, Mallinson A, Janssen PA, Heinonen A, Petit MA, McKay H, Fall-Free BC Research Group (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 48:360–368CrossRef Carter ND, Khan KM, Mallinson A, Janssen PA, Heinonen A, Petit MA, McKay H, Fall-Free BC Research Group (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 48:360–368CrossRef
6.
go back to reference Hassan BS, Mockett S, Doherty M (2001) Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis 60:612–618CrossRef Hassan BS, Mockett S, Doherty M (2001) Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis 60:612–618CrossRef
7.
go back to reference Jadelis K, Miller ME, Ettinger WH, Messier SP (2001) Strength, balance, and the modifying effects of obesity and knee pain: results from the Observational Arthritis Study in Seniors (oasis). J Am Geriatr Soc 49:884–891CrossRef Jadelis K, Miller ME, Ettinger WH, Messier SP (2001) Strength, balance, and the modifying effects of obesity and knee pain: results from the Observational Arthritis Study in Seniors (oasis). J Am Geriatr Soc 49:884–891CrossRef
8.
go back to reference Lord SR, Murray SM, Chapman K, Munro B, Tiedemann A (2002) Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci 57:M539–M543CrossRef Lord SR, Murray SM, Chapman K, Munro B, Tiedemann A (2002) Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci 57:M539–M543CrossRef
9.
go back to reference Lord SR, Clark RD, Webster IW (1991) Postural stability and associated physiological factors in a population of aged persons. J Gerontol 46:M69–M76CrossRef Lord SR, Clark RD, Webster IW (1991) Postural stability and associated physiological factors in a population of aged persons. J Gerontol 46:M69–M76CrossRef
10.
go back to reference Ringsberg K, Gerdhem P, Johansson J, Obrant KJ (1999) Is there a relationship between balance, gait performance and muscular strength in 75-year-old women? Age Ageing 28:289–293CrossRef Ringsberg K, Gerdhem P, Johansson J, Obrant KJ (1999) Is there a relationship between balance, gait performance and muscular strength in 75-year-old women? Age Ageing 28:289–293CrossRef
11.
go back to reference Bohannon RW (1995) Standing balance, lower extremity muscle strength, and walking performance of patients referred for physical therapy. Percept Mot Skills 80:379–385CrossRef Bohannon RW (1995) Standing balance, lower extremity muscle strength, and walking performance of patients referred for physical therapy. Percept Mot Skills 80:379–385CrossRef
12.
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 23:371–377CrossRef Skelton DA, Greig CA, Davies JM, Young A (1994) Strength, power and related functional ability of healthy people aged 65-89 years. Age Ageing 23:371–377CrossRef
13.
go back to reference Stolzenberg N, Belavý DL, Rawer R, Felsenberg D (2013) Vibration or balance training on neuromuscular performance in osteopenic women. Int J Sports Med 34:956–962CrossRef Stolzenberg N, Belavý DL, Rawer R, Felsenberg D (2013) Vibration or balance training on neuromuscular performance in osteopenic women. Int J Sports Med 34:956–962CrossRef
14.
go back to reference Stolzenberg N, Belavý DL, Beller G, Armbrecht G, Semler J, Felsenberg D (2013) Bone strength and density via pQCT in post-menopausal osteopenic women after 9 months resistive exercise with whole body vibration or proprioceptive exercise. J Musculoskelet Neuronal Interact 13:66–76PubMed Stolzenberg N, Belavý DL, Beller G, Armbrecht G, Semler J, Felsenberg D (2013) Bone strength and density via pQCT in post-menopausal osteopenic women after 9 months resistive exercise with whole body vibration or proprioceptive exercise. J Musculoskelet Neuronal Interact 13:66–76PubMed
15.
go back to reference Stolzenberg N, Belavý DL, Rawer R, Felsenberg D (2013) Whole-body vibration versus proprioceptive training on postural control in post-menopausal osteopenic women. Gait Posture 38:416–420CrossRef Stolzenberg N, Belavý DL, Rawer R, Felsenberg D (2013) Whole-body vibration versus proprioceptive training on postural control in post-menopausal osteopenic women. Gait Posture 38:416–420CrossRef
16.
go back to reference Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R (2000) Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol Bethesda Md 1985(89):104–110 Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R (2000) Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol Bethesda Md 1985(89):104–110
17.
go back to reference Farr JN, Funk JL, Chen Z, Lisse JR, Blew RM, Lee VR, Laudermilk M, Lohman TG, Going SB (2011) Skeletal muscle fat content is inversely associated with bone strength in young girls. J Bone Miner Res 26:2217–2225CrossRef Farr JN, Funk JL, Chen Z, Lisse JR, Blew RM, Lee VR, Laudermilk M, Lohman TG, Going SB (2011) Skeletal muscle fat content is inversely associated with bone strength in young girls. J Bone Miner Res 26:2217–2225CrossRef
18.
go back to reference Le Pellec A, Maton B (2002) Initiation of a vertical jump: the human body’s upward propulsion depends on control of forward equilibrium. Neurosci Lett 323:183–186CrossRef Le Pellec A, Maton B (2002) Initiation of a vertical jump: the human body’s upward propulsion depends on control of forward equilibrium. Neurosci Lett 323:183–186CrossRef
19.
go back to reference Horak FB (2006) Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 35(Suppl 2):ii7–ii11CrossRef Horak FB (2006) Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 35(Suppl 2):ii7–ii11CrossRef
20.
go back to reference Preventive Services Task Force US et al (2018) Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA 319:1696–1704CrossRef Preventive Services Task Force US et al (2018) Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA 319:1696–1704CrossRef
21.
go back to reference Orr R, Raymond J, Fiatarone Singh M (2008) Efficacy of progressive resistance training on balance performance in older adults: a systematic review of randomized controlled trials. Sports Med 38:317–343CrossRef Orr R, Raymond J, Fiatarone Singh M (2008) Efficacy of progressive resistance training on balance performance in older adults: a systematic review of randomized controlled trials. Sports Med 38:317–343CrossRef
22.
go back to reference Orr R, de Vos NJ, Singh NA, Ross DA, Stavrinos TM, Fiatarone-Singh MA (2006) Power training improves balance in healthy older adults. J Gerontol A Biol Sci Med Sci 61:78–85CrossRef Orr R, de Vos NJ, Singh NA, Ross DA, Stavrinos TM, Fiatarone-Singh MA (2006) Power training improves balance in healthy older adults. J Gerontol A Biol Sci Med Sci 61:78–85CrossRef
23.
go back to reference Maki BE, McIlroy WE (2006) Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Ageing 35(Suppl 2):ii12–ii18CrossRef Maki BE, McIlroy WE (2006) Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Ageing 35(Suppl 2):ii12–ii18CrossRef
24.
go back to reference Gianoudis J, Bailey CA, Ebeling PR, Nowson CA, Sanders KM, Hill K, Daly RM (2014) Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. J Bone Miner Res 29:182–191CrossRef Gianoudis J, Bailey CA, Ebeling PR, Nowson CA, Sanders KM, Hill K, Daly RM (2014) Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. J Bone Miner Res 29:182–191CrossRef
Metadata
Title
Postural control is associated with muscle power in post-menopausal women with low bone mass
Authors
N. Stolzenberg
D. Felsenberg
D. L. Belavy
Publication date
01-10-2018
Publisher
Springer London
Published in
Osteoporosis International / Issue 10/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-018-4599-1

Other articles of this Issue 10/2018

Osteoporosis International 10/2018 Go to the issue