Sagittal postural alignment in older female fallers: case-control study.
DOI:
https://doi.org/10.11606/issn.1981-4690.2024e38188197Keywords:
Elderly, Falls, Photogrammetry, PostureAbstract
Changes in the spinal curvatures in the sagittal plane have been associated with reduced body balance and falls in elderly adults. By assessing individual vertebral segments, but not the lower limbs, previous studies have left a gap in our understanding regarding compensation that may occur during postural misalignment, as well as other variables related to the projection of the center of gravity (CG). This study aims to compare the physio-functional profile and to investigate to postural alignment in the sagittal plane and its biomechanics implications in healthy elderly fallers and non-fallers women. Eighty women with a mean age of 68.54 years (± 5.96) participated in this case-control study. The case group consisted of 43 female fallers (self-reported falls in the last year), vs. the control group composed of 37 female non-fallers, paired by age and height. The following physical and functional variables were assessed: weight, height, hand grip strength (HGS), Timed up and Go (TUG), and Short Physical Performance Battery (SPPB) to characterization and comparison between the groups. Body posture in the sagittal plane was measured with photogrammetry and Postural Assessment Software PAS/SAPO®. The sample was from elderly with good functional mobility, muscular strength and physical peformance. There were no differences in physical and functional variables between groups of fallers and non-fallers elderly (p > .05). Fallers exhibited greater anteriorization of the body (p = .003), greater knee flexion (p = .022), and greater anterior displacement of the center of gravity (CG) (p = .05). Vertical body alignment and anterior asymmetry of the CG (sagittal plane) were associated with falls. Ankle angle was not associated with falls, but it was found to be negatively correlated with body alignment (r = -0.030), knee angle (r = -0.796) and sagittal asymmetry of the CG (r = -0.314) (p = .009 and p = .006, respectively). Anterior displacement of the body and the projection of centre of gravity (CG) were factors related to falls in the investigated healthy elderly women, with ankle joint responsible for the upward joint compensations in the static posture.
Downloads
References
Roghani T, Khalkhali M, Farideh Z, Manshadi D. Age-related hyperkyphosis: update of its potential causes and clinical impacts - narrative review. Aging Clin Exp Res. 2017;29(4):567-577.
Drzał-Grabiec J, Snela S, Rykała J, Podgórska J, Banaś A. Changes in the body posture of women occurring with age. BMC Geriatr. 2013;13(1):108.
Silveira MM, Pasqualotti A, Colussi EL, Wibelinger LM. Envelhecimento humano e as alterações na postura corporal do idoso. Rev Bras Ciências da Saúde. 2010;8(26):52-58.
Horak F. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(2):7-11.
Kado DM, Huang M-H, Nguyen CB, Barrett-Connor E, Greendale G a. Hyperkyphotic posture and risk of injurious falls in older persons: the Rancho Bernardo Study. J Gerontol A Biol Sci Med Sci. 2007;62(6):652-657.
Imagama S, Ito Z, Wakao N, et al. Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males. Eur Spine J. 2013;22(6):1346-1353.
Groot MH, Willems HC, van Campen JPCM, Lems WF, Beijnen JH, Lamoth CJC. A flexed posture in elderly patients is associated with impairments in postural control during walking. Gait Posture. 2014;39(2):767-772.
Ota S, Goto H, Noda Y, Fujita R, Matsui Y. Relationship between standing postural alignments and physical function among elderly women using day service centers in Japan. J Back Musculoskelet Rehabil. 2015;28(1):111-117.
Fernandes VLS, Ribeiro DM, Caetano L, Menezes RL. Postural changes versus balance control and falls in community-living older adults: a systematic review. Rev Fisioter Mov. 2018;31(3).
Fonseca LCSMES. Relação entre projeção do centro de gravidade e equilíbrio em idosos. Ter Man. 2012;10(14):440-443.
Ishikawa Y, Miyakoshi N, Hongo M, Kasukawa Y, Kudo D, Shimada Y. Relationships among spinal mobility and sagittal alignment of spine and lower extremity to quality of life and risk of falls. Gait Posture. 2017;53:98-103.
Furlanetto TS, Sedrez JA, Candotti CT, Loss JF. Photogrammetry as a tool for the postural evaluation of the spine: A systematic review. World J Orthop. 2016;7(2):136.
Ferreira EAG, Duarte M, Maldonado EP, Burke TN, Marques AP. Postural assessment software (PAS/SAPO): validation and reliability. Clinics. 2010;65(7):675-681.
Ferreira EA, Duarte M, Maldonado EP, Bersanetti AA, Marques AP. Quantitative assessment of postural alignment in young adults based on photographs of anterior, posterior, and lateral views. J Manipulative Physiol Ther. 2011;34(6):371-380.
Almeida CWL, Castro CHM, Pedreira PG, Heymann RE, Szejnfeld VL. Percentage height of center of mass is associated with the risk of falls among elderly women: A case-control study. Gait Posture. 2011;34(2):208-212.
Lourenço RA, Veras RP. Mini-Exame do Estado Mental: características psicométricas em idosos ambulatoriais. Rev Saude Publica. 2006;40(4):712-719.
Gomes GAO, Cintra FA, Diogo MJD, Neri AL, Guariento ME, Sousa MLR. Comparação entre idosos que sofreram quedas segundo desempenho físico e número de ocorrências. Rev Bras Fisioter. 2009;13(5):430-437.
Avin KG, Hanke TA, Kirk-Sanchez N, McDonough CM, Shubert TE, Hardage J, Hartley G. Management of falls in community-dwelling older adults: Clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815-834.
Souza JA, Pasinato F, Basso D, Corrêa ECR, Silva AMT. Biofotogrametria confiabilidade das medidas do protocolo do software para avaliação postural (SAPO). Rev Bras Cineantropometria e Desempenho Hum. 2011;13(4):299-305.
De Leva P. Adjustments to zatsiorsky-seluyanov’s segment inertia parameters. J Biomech. 1996;29(9):1223-1230.
Lusardi MM, Fritz S, Middleton A, et al. Systematic reviews determining risk of falls in community dwelling older adults: a systematic review and meta-analysis using posttest Probability; 2017.
Reis MM, Arantes PMM. Medida da força de preensão manual- validade e confiabilidade do dinamômetro saehan. Fisioter e Pesqui; 2011.
Freire AN, Guerra RO, Alvarado B, Guralnik JM, Zunzunegui MV. Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil, J. Aging Health. 2012;24:863-878.
Van Der Jagt-Willems HC, De Groot MH, Van Campen JPCM, Lamoth CJC, Lems WF. Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: A prospective cohort study. BMC Geriatr. 2015;15(1):1-7.
Ishikawa Y, Miyakoshi N, Kasukawa Y, Hongo M, Shimada Y. Spinal sagittal contour affecting falls: cut-off value of the lumbar spine for falls. Gait Posture. 2013;38(2):260-263.
Drzał-Grabiec J, Rachwał M, Podgórska-Bednarz J, et al. The effect of spinal curvature on the photogrammetric assessment on static balance in elderly women. BMC Musculoskelet Disord. 2014;15(1):186.
Morasso PG, Sanguineti V. Ankle muscle stiffness alone cannot stabilize balance during quiet standing. J Neurophysiol. 2002;88(4):2157-2162.
Hall LA, McCloskey DI. Detections of movements imposed on finger, elbow and shoulder joints. J Physiol. 1983;335(1):519-533.
Lafage V, Schwab F, Skalli W, et al. Standing balance and sagittal plane spinal deformity. Spine (Phila Pa 1976). 2008;33(14):1572-1578.
Ihira H, Makizako H, Mizumoto A, Makino K, Matsuyama K, Furuna T. Age-related differences in postural control and attentional cost during tasks performed in a one-legged standing posture. J Geriatr Phys Ther. 2016;39(4):159-164.
Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture. 2002;16(1):1-14.
Bueno GAS, Ribeiro DM, Gervasio FM, Martins AC, Menezes RL. Gait profile score identifies changes in gait kinematics in nonfaller, faller and recurrent faller elderly women. Gait Posture. 2019;76-81.
Cattagni T, Scaglioni G, Laroche D, Gremeaux V, Martin A. The involvement of ankle muscles in maintaining balance in the upright posture is higher in elderly fallers. Exp Gerontol. 2016;77:38-45.
Spink MJ, Fotoohabadi MR, Wee E, Hill KD, Lord SR, Menz HB. Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older adults. Arch Phys Med Rehabil. 2011;92(1):68-75.
Katzman WB, Vittinghoff E, Ensrud K, Black DM, Kado DM. Increasing kyphosis predicts worsening mobility in older community-dwelling women: A prospective cohort study. J Am Geriatr Soc. 2011;59(1):96-100.
Eum R, Leveille SG, Kiely DK, Kiel DP, Samelson EJ, Bean JF. Is kyphosis related to mobility, balance, and disability? Am J Phys Med Rehabil. 2013;92(11):980-989.
Horak FB. Clinical assessment of balance disorders. Gait Posture. 1997;6(1):76-84.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Brazilian journal of physical education and sport
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Todo o conteúdo da revista, exceto onde está identificado, está licenciado sob uma Licença Creative Commons (CC-BY)
