Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study

Background: Low bone mineral density (BMD) and falls are common problems encountered in the postmenopausal women. The purpose was to evaluate the association between postural balance and BMD in postmenopausal women and its relation to risk for falls.Methods: In this cross-sectional study, 225 women in amenorrhea > 12 months and age >= 45 years were included and divided, according to BMD, in T-score values > -2.0 SD (n = 140) and <= -2 SD (n = 85). Those with neurological or musculoskeletal disorders, history of vestibulopathies, uncorrected visual deficit or drug use that could affect balance were excluded. History of falls (last 24 months), clinical and anthropometric characteristics were evaluated. Postural balance was assessed by stabilometry (force platform). For statistical analysis were used Wilcoxon's Test, Chi-Square Test and logistic regression method for fall risk (Odds Ratio-OR).Results: Patients with BMD > -2.0 SD were younger, with shorter time since menopause, and showed higher BMI as compared to those with low BMD (<= -2 SD) (p < 0.05). It was observed that 57.8% of the participants reported fall episodes without significant difference distribution between the groups (p = 0.055). No differences were found from the comparison between the groups (p > 0.05) for stabilometric parameters. Risk for falls increased with age (OR 1.07; CI 95% 1.01-1.13), current smoking (OR 2.19; CI 95% 1.22-3.21) and corrected visual deficit (OR 9.06; CI 95% 1.14-4.09). In contrast, hormone therapy (HT) use was significantly associated with reduced risk for falls (OR 0.48; CI 95% 0.26-0.88).Conclusions: In postmenopausal women, BMD did not show association with postural balance or risk for falls. Age, smoking and corrected visual deficit were clinical indicators of risk for falls whereas HT use showed to be a protective factor

Effect of hormone therapy on postural balance in postmenopausal women

Objective: The aim of this study was to analyze the effects of hormone therapy (HT) on postural balance in postmenopausal women and its association with risk of falls.Methods: In this cross-sectional study, a total of 225 Brazilian postmenopausal women aged 45 to 75 years were included and divided into two groups: HT users (n = 102) and nonusers (n = 123). HT users were women who had continuously taken HT throughout the preceding 6 months, whereas nonusers received no such therapy during the same period. Women with amenorrhea for more than 12 months and aged 45 years or older were included. Those with neurological or musculoskeletal disorders, vestibulopathies, uncorrected visual deficit, or drug use that could affect balance were excluded. Histories of falls (previous 24 mo) as well as clinical and anthropometric characteristics were analyzed. Postural balance was assessed through stabilometry (computerized force platform), Romberg test, and crouching test. Statistical analysis included the median test, chi(2) test, Spearman correlation coefficient, and logistic regression method (odds ratio).Results: Women users of HT were younger (53.0 vs 57.0 y) and with a shorter time since menopause (5.5 vs 10.0 y) than nonusers (P 0.05). In the crouching test, 47.1% of the participants showed an adequate level of muscle strength in lower limbs without differences between the groups (P > 0.05).Conclusions: Postmenopausal women using HT showed lower frequency of falls and a better performance in stabilometric parameters than did nonusers.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Fatores de risco para osteoporose em mulheres na pós-menopausa do sudeste brasileiro

OBJETIVO: Avaliar a densidade mineral óssea (DMO) e os fatores de risco associados à osteoporose na pós-menopausa. MÉTODOS: Estudo clínico transversal com 431 mulheres (idade 40 - 75 anos). Foram incluídas mulheres com: amenorréia >12 meses e idade >45 anos ou, ooforectomia bilateral >40 anos, com DMO (escore T de coluna lombar/colo de fêmur) pelo DEXA dos últimos 12 meses. Fatores de risco avaliados: idade, idade e tempo de menopausa, tabagismo, atividade física (30 min/5 vezes/ semana), artrite reumatoide (AR), uso de corticoterapia e de terapia hormonal (TH), fratura prévia, fratura materna de quadril e índice de massa corpórea (IMC=peso/altura²). Foram empregodos teste do χ² e método de regressão logística no risco (Odds Ratio - OR) para osteoporose. RESULTADOS: Pelos critérios da Organização Mundial da Saúde, 106 (24,6%) mulheres apresentavam osteoporose (escore T -1,0DP). Foi detectada osteoporose em 12% das mulheres com idade entre 40 e 49anos, em 21,8% no grupo de 50 a 59 anos e 45,7% nas mulheres com idade >60anos (p10anos (p12 months and age >45 years or, bilateral oophorectomy >40 years with BMD values (T-score of lumbar spine/femur neck) by DXA of the last 12 months. Risk factors evaluated: age, age and time of menopause, smoking, physical activity (30 min/5 times/week), rheumatoid arthritis (RA), use of corticotherapy and hormone therapy (HT), previous fracture, maternal hip fracture and body mass index (BMI=weight/height²). The χ2 test and the logistic regression method (Odds Ratio - OR) were used to determine osteoporosis risk. RESULTS: According to WHO criteria, 106 (24.6%) women showed osteoporosis (T-score -1.0 DP). Osteoporosis was detected in 12% of women aged 40 - 49 years, in 21.8% of women aged 50 - 59 years and in 45.7% of women aged >60 years (p10 years (p<0.001). of the women with early menopause, 80% showed osteopenia/osteoporosis (p=0.03), and of those with BMI <20 kg/m², 50% were osteoporotic (p<0.001). The risk for osteoporosis detection increased with age (OR=1.1; CI95%=1.0-1.1), time of menopause (OR=1.1; CI95%=1.0-1.1), smoking (OR=1.9; CI95%=1.2-3.2), RA (OR=3.6; CI95%=1.3-9.6) and maternal fracture history (OR=2.1; CI95%=1.1-3.0) (p<0.05). In contrast, HT use (OR=0.3; 95%CI=0.2-0.6) and high BMI (OR=0.9; 95%CI=0.8-0.9) reduced the risk (p<0.05). CONCLUSION: In postmenopausal women, age, time of menopause, smoking and maternal history of fracture were clinical indicators of risk for osteoporosis, whereas HT use and high BMI proved to be protective factors.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP