Spinal orthosis, exercise program reduces osteoporotic women’s fall risk

After four weeks, osteoporotic-kyphotic patients significantly improved balance, gait and back extension strength.

Combining the use of a weighted back support device with a special exercise program helps women with osteoporosis-related spinal curvature to improve their balance, according to a study by Mayo Clinic researchers.

The study, published in Mayo Clinic Proceedings, also found that women who participated in the combined program experienced diminished back pain. The results suggest this approach could help to reduce falls among this population of older women, according to a press release.

Mehrsheed Sinaki, MD, and colleagues at the Mayo Clinic in Rochester, Minn., evaluated a weighted kypho-orthosis used in combination with a spinal proprioceptive extension exercise dynamic (SPEED) program. The study included 12 ambulatory women older than 60 years who had osteoporosis-kyphosis. All patients were community dwelling and at risk for suffering falls, according to the study.

“Most studies of falls address the effects of sedatives, weakness of the lower extremity muscles and neuromuscular diseases,” Sinaki, lead author of the study, said in the press release. “What we wanted to see ... were the effects of intervention to shift the center of gravity and improve back strength and gait.”

To establish the risk of falls and the extent of patients” balance disorders, the researchers first compared the 12 kyphotic patients to a control group of 13 healthy women. Kyphotic patients then began using a weighted kypho-orthosis — a special back support device usually weighing 1.75 to 2.5 pounds, which centers its weight on the posterior of the spine. The device helps to better center the body over the legs. Patients also began a four-week SPEED program, which involved two supervised sessions conducted at an outpatient clinic followed by daily home-based training sessions, according to the study.

The researchers found that, at baseline, kyphotic patients had significantly lower scores for balance (P=.002), gait (P<.05) and strength (P<.05) compared to control patients. However, scores for balance (P=.003) and for several gait parameters (P<.05) significantly improved after completing the SPEED program, according to the study.

Kyphotic patients also had significant improvements in back extension strength, the authors noted. At four weeks follow-up, mean back extension strength increased to 198.6 ± 55.2 N from 1.44 ± 46.5 N at baseline (P<.001).

Kyphotic patients additionally reported a significant improvement in back pain (P=.001), according to the study.

For more information:
Sinaki M, Brey RH, Hughes CA, et al. Significant reduction in risk of falls and back pain in osteoporotic-kyphotic women through a spinal proprioceptive extension exercise dynamic (SPEED) program. Mayo Clin Proc. 2005;80:849-855.