Gait in patients with symptomatic osteoporotic vertebral compression fractures over 6 months of recovery

Eva Jacobs; Christopher McCrum; Rachel Senden; Lodewijk W van Rhijn; K Meijer; Paul C Willems

doi:10.1007/s40520-019-01203-9

Gait in patients with symptomatic osteoporotic vertebral compression fractures over 6 months of recovery

Eva Jacobs^*, Christopher McCrum, Rachel Senden, Lodewijk W van Rhijn, K Meijer, Paul C Willems

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: One factor related to disability in people with spinal deformity is decreased postural control and increased risk of falling. However, little is known about the effect of osteoporotic vertebral compression fractures (OVCFs) and their recovery on gait and stability. Walking characteristics of older adults with and without vertebral fractures have not yet been compared.

AIMS: The purpose of the current study was to examine the spatiotemporal gait parameters and their variability in patients with an OVCF and healthy participants during treadmill walking at baseline and after 6 months of recovery.

METHODS: Twelve female patients suffering a symptomatic OVCF were compared to 11 matched controls. Gait analysis was performed with a dual-belt instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment). Results of patients with an OVCF and healthy participants were compared. Furthermore, spatiotemporal gait parameters were assessed over 6 months following the fracture.

RESULTS: Patients suffering from an OVCF appeared to walk with significantly shorter, faster and wider strides compared to their healthy counterparts. Although stride time and length improved over time, the majority of the parameters analysed remained unchanged after 6 months of conservative treatment.

DISCUSSION: Since patients do not fully recover to their previous level of mobility after 6 months of conservative treatment for OVCF, it appears of high clinical importance to add balance and gait training to the treatment algorithm of OVCFs.

CONCLUSIONS: Patients suffering from an OVCF walk with shorter, faster and wider strides compared to their healthy counterparts adopt a less stable body configuration in the anterior direction, potentially increasing their risk of forward falls if perturbed. Although stride time and stride length improve over time even reaching healthy levels again, patients significantly deviate from normal gait patterns (e.g. in stability and step width) after 6 months of conservative treatment.

Original language	English
Pages (from-to)	239-246
Number of pages	8
Journal	Aging Clinical and Experimental Research
Volume	32
Issue number	2
DOIs	https://doi.org/10.1007/s40520-019-01203-9
Publication status	Published - Feb 2020

Keywords

AGE
Ageing spine
BALANCE
Gait analysis
OUTCOMES
OVCF
PAIN
RISK
STABILITY
STANCE
Spatiotemporal gait parameters
VARIABILITY
Vertebral fracture

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Cite this

@article{db4a6a17a6c04f26a8afd350a9dbd554,

title = "Gait in patients with symptomatic osteoporotic vertebral compression fractures over 6 months of recovery",

abstract = "BACKGROUND: One factor related to disability in people with spinal deformity is decreased postural control and increased risk of falling. However, little is known about the effect of osteoporotic vertebral compression fractures (OVCFs) and their recovery on gait and stability. Walking characteristics of older adults with and without vertebral fractures have not yet been compared.AIMS: The purpose of the current study was to examine the spatiotemporal gait parameters and their variability in patients with an OVCF and healthy participants during treadmill walking at baseline and after 6 months of recovery.METHODS: Twelve female patients suffering a symptomatic OVCF were compared to 11 matched controls. Gait analysis was performed with a dual-belt instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment). Results of patients with an OVCF and healthy participants were compared. Furthermore, spatiotemporal gait parameters were assessed over 6 months following the fracture.RESULTS: Patients suffering from an OVCF appeared to walk with significantly shorter, faster and wider strides compared to their healthy counterparts. Although stride time and length improved over time, the majority of the parameters analysed remained unchanged after 6 months of conservative treatment.DISCUSSION: Since patients do not fully recover to their previous level of mobility after 6 months of conservative treatment for OVCF, it appears of high clinical importance to add balance and gait training to the treatment algorithm of OVCFs.CONCLUSIONS: Patients suffering from an OVCF walk with shorter, faster and wider strides compared to their healthy counterparts adopt a less stable body configuration in the anterior direction, potentially increasing their risk of forward falls if perturbed. Although stride time and stride length improve over time even reaching healthy levels again, patients significantly deviate from normal gait patterns (e.g. in stability and step width) after 6 months of conservative treatment.",

keywords = "AGE, Ageing spine, BALANCE, Gait analysis, OUTCOMES, OVCF, PAIN, RISK, STABILITY, STANCE, Spatiotemporal gait parameters, VARIABILITY, Vertebral fracture",

author = "Eva Jacobs and Christopher McCrum and Rachel Senden and {van Rhijn}, {Lodewijk W} and K Meijer and Willems, {Paul C}",

note = "Funding Information: Acknowledgements The authors thank Liesbeth J{\"u}tten and Mieke Van-dewall, Department of Orthopaedic Surgery, Paul Willems, Department of Nutrition and Movement Science, and Rik Marcellis, Department of Physical Therapy for their valuable contribution to the execution of this study. The authors also thank Julia Agmon for assistance with the marker set measurements. CM was funded by the Kootstra Talent Fellowship awarded by the Centre for Research Innovation, Support and Policy (CRISP) and by the NUTRIM Graduate Programme, both of Maastricht University Medical Center+. Funding Information: The authors thank Liesbeth J?tten and Mieke Vandewall, Department of Orthopaedic Surgery, Paul Willems, Department of Nutrition and Movement Science, and Rik Marcellis, Department of Physical Therapy for their valuable contribution to the execution of this study. The authors also thank Julia Agmon for assistance with the marker set measurements. CM was funded by the Kootstra Talent Fellowship awarded by the Centre for Research Innovation, Support and Policy (CRISP) and by the NUTRIM Graduate Programme, both of Maastricht University Medical Center+. Publisher Copyright: {\textcopyright} 2019, The Author(s).",

year = "2020",

month = feb,

doi = "10.1007/s40520-019-01203-9",

language = "English",

volume = "32",

pages = "239--246",

journal = "Aging Clinical and Experimental Research",

issn = "1594-0667",

publisher = "Springer, Cham",

number = "2",

}

TY - JOUR

T1 - Gait in patients with symptomatic osteoporotic vertebral compression fractures over 6 months of recovery

AU - Jacobs, Eva

AU - McCrum, Christopher

AU - Senden, Rachel

AU - van Rhijn, Lodewijk W

AU - Meijer, K

AU - Willems, Paul C

N1 - Funding Information: Acknowledgements The authors thank Liesbeth Jütten and Mieke Van-dewall, Department of Orthopaedic Surgery, Paul Willems, Department of Nutrition and Movement Science, and Rik Marcellis, Department of Physical Therapy for their valuable contribution to the execution of this study. The authors also thank Julia Agmon for assistance with the marker set measurements. CM was funded by the Kootstra Talent Fellowship awarded by the Centre for Research Innovation, Support and Policy (CRISP) and by the NUTRIM Graduate Programme, both of Maastricht University Medical Center+. Funding Information: The authors thank Liesbeth J?tten and Mieke Vandewall, Department of Orthopaedic Surgery, Paul Willems, Department of Nutrition and Movement Science, and Rik Marcellis, Department of Physical Therapy for their valuable contribution to the execution of this study. The authors also thank Julia Agmon for assistance with the marker set measurements. CM was funded by the Kootstra Talent Fellowship awarded by the Centre for Research Innovation, Support and Policy (CRISP) and by the NUTRIM Graduate Programme, both of Maastricht University Medical Center+. Publisher Copyright: © 2019, The Author(s).

PY - 2020/2

Y1 - 2020/2

N2 - BACKGROUND: One factor related to disability in people with spinal deformity is decreased postural control and increased risk of falling. However, little is known about the effect of osteoporotic vertebral compression fractures (OVCFs) and their recovery on gait and stability. Walking characteristics of older adults with and without vertebral fractures have not yet been compared.AIMS: The purpose of the current study was to examine the spatiotemporal gait parameters and their variability in patients with an OVCF and healthy participants during treadmill walking at baseline and after 6 months of recovery.METHODS: Twelve female patients suffering a symptomatic OVCF were compared to 11 matched controls. Gait analysis was performed with a dual-belt instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment). Results of patients with an OVCF and healthy participants were compared. Furthermore, spatiotemporal gait parameters were assessed over 6 months following the fracture.RESULTS: Patients suffering from an OVCF appeared to walk with significantly shorter, faster and wider strides compared to their healthy counterparts. Although stride time and length improved over time, the majority of the parameters analysed remained unchanged after 6 months of conservative treatment.DISCUSSION: Since patients do not fully recover to their previous level of mobility after 6 months of conservative treatment for OVCF, it appears of high clinical importance to add balance and gait training to the treatment algorithm of OVCFs.CONCLUSIONS: Patients suffering from an OVCF walk with shorter, faster and wider strides compared to their healthy counterparts adopt a less stable body configuration in the anterior direction, potentially increasing their risk of forward falls if perturbed. Although stride time and stride length improve over time even reaching healthy levels again, patients significantly deviate from normal gait patterns (e.g. in stability and step width) after 6 months of conservative treatment.

AB - BACKGROUND: One factor related to disability in people with spinal deformity is decreased postural control and increased risk of falling. However, little is known about the effect of osteoporotic vertebral compression fractures (OVCFs) and their recovery on gait and stability. Walking characteristics of older adults with and without vertebral fractures have not yet been compared.AIMS: The purpose of the current study was to examine the spatiotemporal gait parameters and their variability in patients with an OVCF and healthy participants during treadmill walking at baseline and after 6 months of recovery.METHODS: Twelve female patients suffering a symptomatic OVCF were compared to 11 matched controls. Gait analysis was performed with a dual-belt instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment). Results of patients with an OVCF and healthy participants were compared. Furthermore, spatiotemporal gait parameters were assessed over 6 months following the fracture.RESULTS: Patients suffering from an OVCF appeared to walk with significantly shorter, faster and wider strides compared to their healthy counterparts. Although stride time and length improved over time, the majority of the parameters analysed remained unchanged after 6 months of conservative treatment.DISCUSSION: Since patients do not fully recover to their previous level of mobility after 6 months of conservative treatment for OVCF, it appears of high clinical importance to add balance and gait training to the treatment algorithm of OVCFs.CONCLUSIONS: Patients suffering from an OVCF walk with shorter, faster and wider strides compared to their healthy counterparts adopt a less stable body configuration in the anterior direction, potentially increasing their risk of forward falls if perturbed. Although stride time and stride length improve over time even reaching healthy levels again, patients significantly deviate from normal gait patterns (e.g. in stability and step width) after 6 months of conservative treatment.

KW - AGE

KW - Ageing spine

KW - BALANCE

KW - Gait analysis

KW - OUTCOMES

KW - OVCF

KW - PAIN

KW - RISK

KW - STABILITY

KW - STANCE

KW - Spatiotemporal gait parameters

KW - VARIABILITY

KW - Vertebral fracture

U2 - 10.1007/s40520-019-01203-9

DO - 10.1007/s40520-019-01203-9

M3 - Article

C2 - 31030421

SN - 1594-0667

VL - 32

SP - 239

EP - 246

JO - Aging Clinical and Experimental Research

JF - Aging Clinical and Experimental Research

IS - 2

ER -