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Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study.

van der Jagt-Willems HC, de Groot MH, van Campen JP, Lamoth CJ, Lems WF - BMC Geriatr (2015)

Bottom Line: An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51).A flexed posture was not significantly associated with future falls.We suggest clinical attention for underlying causes.

View Article: PubMed Central - PubMed

Affiliation: Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. hannavanderjagt@hotmail.com.

ABSTRACT

Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the next year.

Methods: Patients were recruited at a geriatric outpatient clinic. Vertebral fractures were evaluated on lateral radiographs of the spine with the semi-quantitative method of Genant; the degree of thoracic kyphosis was assessed with the Cobb angle. The occiput-to-wall distance was used to determine a flexed posture. Self-reported falls were prospectively registered by monthly phone contact for the duration of 12 months.

Results: Fifty-one older adults were included; mean age was 79 years (SD = 4.8). An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51). Prevalent vertebral fractures had a trend towards significancy (OR 3.67; 95% CI 0.85-15.9). A flexed posture was not significantly associated with future falls.

Conclusion: Older adults with an increased thoracic kyphosis are more likely to fall within the next year. We suggest clinical attention for underlying causes. Because patients with increased thoracic curvature of the spine might have underlying osteoporotic vertebral fractures, clinicians should be aware of the risk of a new fracture.

No MeSH data available.


Related in: MedlinePlus

Various postures among geriatric patients. (A) Normal posture; (B) Hyperkyphosis, defined as a Cobb angle ≥50 ° between T2 and T12 as measured on the X-ray of the vertebral column; (C) Flexed posture, defined as an occiput-to-wall distance >5.0 cm.
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Fig1: Various postures among geriatric patients. (A) Normal posture; (B) Hyperkyphosis, defined as a Cobb angle ≥50 ° between T2 and T12 as measured on the X-ray of the vertebral column; (C) Flexed posture, defined as an occiput-to-wall distance >5.0 cm.

Mentions: The severity of flexed posture was evaluated by measuring the occiput-to-wall distance (OWD), see Figure 1. While subjects stood with their head in a natural position, their heels and back touching the wall and their knees as extended as possible, the distance between their occiput and the wall was measured [12]. A flexed posture was defined as an OWD >5.0 cm.Figure 1


Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study.

van der Jagt-Willems HC, de Groot MH, van Campen JP, Lamoth CJ, Lems WF - BMC Geriatr (2015)

Various postures among geriatric patients. (A) Normal posture; (B) Hyperkyphosis, defined as a Cobb angle ≥50 ° between T2 and T12 as measured on the X-ray of the vertebral column; (C) Flexed posture, defined as an occiput-to-wall distance >5.0 cm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4414293&req=5

Fig1: Various postures among geriatric patients. (A) Normal posture; (B) Hyperkyphosis, defined as a Cobb angle ≥50 ° between T2 and T12 as measured on the X-ray of the vertebral column; (C) Flexed posture, defined as an occiput-to-wall distance >5.0 cm.
Mentions: The severity of flexed posture was evaluated by measuring the occiput-to-wall distance (OWD), see Figure 1. While subjects stood with their head in a natural position, their heels and back touching the wall and their knees as extended as possible, the distance between their occiput and the wall was measured [12]. A flexed posture was defined as an OWD >5.0 cm.Figure 1

Bottom Line: An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51).A flexed posture was not significantly associated with future falls.We suggest clinical attention for underlying causes.

View Article: PubMed Central - PubMed

Affiliation: Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. hannavanderjagt@hotmail.com.

ABSTRACT

Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the next year.

Methods: Patients were recruited at a geriatric outpatient clinic. Vertebral fractures were evaluated on lateral radiographs of the spine with the semi-quantitative method of Genant; the degree of thoracic kyphosis was assessed with the Cobb angle. The occiput-to-wall distance was used to determine a flexed posture. Self-reported falls were prospectively registered by monthly phone contact for the duration of 12 months.

Results: Fifty-one older adults were included; mean age was 79 years (SD = 4.8). An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51). Prevalent vertebral fractures had a trend towards significancy (OR 3.67; 95% CI 0.85-15.9). A flexed posture was not significantly associated with future falls.

Conclusion: Older adults with an increased thoracic kyphosis are more likely to fall within the next year. We suggest clinical attention for underlying causes. Because patients with increased thoracic curvature of the spine might have underlying osteoporotic vertebral fractures, clinicians should be aware of the risk of a new fracture.

No MeSH data available.


Related in: MedlinePlus