Sarcopenia and Balance in Community-dwelling Women with Postmenopausal Osteoporosis

Objective:Sarcopenia and osteoporosis share common risk factors and biological pathways. In the present study, patients with postmenopausal osteoporosis were screened for sarcopenia using the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and balance impairment was investigated in sarcopenic patients.Method:Fifty three postmenopausal osteoporotic patients were evaluated for sarcopenia as per the algorithm proposed by the EWGSOP. Among the parameters included in the algorithm, gait speed was assessed using the timed up&go test (TUG), Jamar hand dynamometer was used to measure grip strength and calf circumference (an anthropometric method) was used for the measurement of muscle mass. Balance was assessed using the Berg balance scale and functional abilities using the TUG.Results:Fifty three postmenopausal patients with osteoporosis with a mean age of 65.48±9.12 years (range 47-84) were enrolled in the study. Sixteen patients (30.2%) reported a fall within the previous year, 22 patients (41.5%) had a history of fracture and 17 patients (32.1%) had maternal history of hip fracture. Sarcopenia was present in 8 (15.1%) patients. There was no significant difference between balance measurements of sarcopenic and non-sarcopenic patients (p>0.05). Only muscle mass showed a positive weak correlation and a significant association with balance (r=0.28, p<0.05).Conclusion:Despite low rate of balance impairment, most of our patients had a history of fracture. Balance is not the only risk factor for falls in postmenopausal patients. The use of anthropometry as a screening tool and usage of more objective methods for definitive diagnosis provide more accurate data for the measurement of muscle mass

The Effect of Back Pain on Quality of Life, Sleep Quality and Depression in Patients with Postmenopausal Osteoporosis

Objective: This study aimed to assess the effects of back pain on the quality of sleep, quality of life and depression in patients with postmenopausal osteoporosis. We also evaluated the relationship between bone mineral density (BMD) and these parameters. Materials and Methods: One hundred and five patients diagnosed with postmenopausal osteoporosis were included in this study. The patients were evaluated on the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI). The intensity of back pain was evaluated using the visual analog scale (VAS). Results: Patients ranged in age from 46 to 75, with a mean age of 61.16±7.59. As pain scores increased, depression scores increased and sleep quality and quality of life were impaired (p<0.01). There were strong positive correlations among depression, sleep quality and quality of life (p<0.01), but we did not find significant correlations among lumbar spine (L1-L4) T-scores, L1-L4 BMD values, VAS, PSQI total scores, QUALEFFO-41 total scores and BDI scores. Conclusion: High pain scores in postmenopausal patients may be related to low quality of sleep and of life, and depression. Depression, sleep disorder and low quality of life may affect each other. Treating back pain, a frequent symptom in postmenopausal osteoporosis patients, may produce favorable effects on quality of sleep and life and on depression, as well as basic management. (Turkish Journal of Osteoporosis 2014;20: 6-9

Consensus recommendations for botulinum toxin injections in the spasticity management of children with cerebral palsy during COVID-19 outbreak

Spasticity is the most common motor disturbance in cerebral palsy (CP). Lockdown in the COVID-19 outbreak has profoundly changed daily routines, and similarly caused the suspension of spasticity treatment plans. Besides, the delay in botulinum toxin (BoNT) injection, which is important in the management of focal spasticity, led to some problems in children. This consensus report includes BoNT injection recommendations in the management of spasticity during the COVID-19 pandemic in children with CP. In order to develop the consensus report, physical medicine and rehabilitation (PMR) specialists experienced in the field of pediatric rehabilitation and BoNT injections were invited by Pediatric Rehabilitation Association. Items were prepared and adapted to the Delphi technique by PMR specialists. Then they were asked to the physicians experienced in BoNT injections (PMR specialist, pediatric orthopedists, and pediatric neurologists) or COVID-19 (pediatric infectious disease, adult infectious disease). In conclusion, the experts agree that conservative management approaches for spasticity may be the initial steps before BoNT injections. BoNT injections can be administered to children with CP with appropriate indications and with necessary precautions during the pandemic