Exercise program, special weighted
back
support
improves balance in elderly
Newswise — By wearing a unique
weighted back support device and participating in a special exercise
program, women over 60 with osteoporosis-caused curvature of the
spine improved their balance and experienced diminished back pain,
giving researchers at Mayo Clinic a promising therapy to reduce
falls among this population.
Falls present a serious risk of
injury in the older population. Falls also can lead to permanent
lifestyle changes, such as hospitalization, long-term rehabilitation
and the inability to function independently, which can cause further
declines in health.
Within four weeks in the study,
the researchers noted significant changes in balance and gait. They
also recorded back extensor strength improvements and significant
decrease in back pain. Mayo Clinic researchers present their
findings in the July 2005 issue of Mayo Clinic Proceedings.
“Most studies of falls address the
effects of sedatives, weakness of the lower extremity muscles and
neuromuscular diseases,” says Mehrsheed Sinaki, M.D., of Mayo
Clinic’s Department of Physical Medicine and Rehabilitation. “What
we wanted to see in this study was the effects of intervention to
shift the center of gravity, and improve back strength and gait.”
The Mayo Clinic researchers
studied women in community-dwelling settings over age 60. Past
studies have shown that community-dwelling people have a higher risk
of falls and fractures than persons whose mobility is severely
restricted. Twelve women in the study suffered from kyphosis, a
progressive curvature of the spine that includes severe, progressive
muscle weakness. Kyphosis causes a stooping posture. Their risk of
falls and balance were studied and compared with a group of 13 women
without this condition.
A fall is a biomechanical event,
in that an external force -- gravity -- destabilizes the body’s
alignment of the torso over the legs. A fall occurs when the center
of gravity of the person’s trunk moves outside the base of support
provided by the feet against the floor. The center of gravity is the
imaginary point at which all the weight of the torso can be
considered concentrated. If the base moves outside the base of
support, a fall will occur.
At the start of the four-week
comparison period, the two groups exhibited significant differences,
but as the women with curvature of the spine continued the program,
they showed improvements in balance, gait and back pain. The women
used a weighted kypho-orthosis (WKO), a specially weighted back
support device that centers its weight on the posterior of the spine
and helps the person center her body better over her legs. It can
weigh between 1.75 and 2.5 pounds, centered below the shoulder
blades. A patient’s doctor determines the best weighting and
placement of the device.
Along with Dr. Sinaki, the
principal investigator, Mayo Clinic researchers contributing to this
study included Robert Brey, Ph.D., Christine Hughes, Dirk Larson and
Kenton Kaufman, Ph.D.
In an editorial in the July
Proceedings, Allan Tencer, Ph.D., of the Department of Orthopedics
at Harborview Medical Center in Seattle, writes that the Mayo Clinic
study “provides an excellent example of how an understanding of
basic biomechanics can serve as a foundation for improving patient
care.”
Further research is now needed to
determine the feasibility of using this intervention in large
populations of patients with kyphosis, says Dr. Tencer.
“The report validates using the
WKO and a dynamic exercise program to improve biomechanics in
persons with kyphosis,” says Dr. Tencer. “This, in turn, can reduce
the possibility of the person falling and prevent the downstream,
potentially life-altering consequences of falling.”
A peer-review journal, Mayo
Clinic Proceedings publishes original articles and reviews dealing
with clinical and laboratory medicine, clinical research, basic
science research and clinical epidemiology. Mayo Clinic Proceedings
is published monthly by Mayo Foundation for Medical Education and
Research as part of its commitment to the medical education of
physicians. The journal has been published for more than 75 years
and has a circulation of 130,000 nationally and internationally.
Copies of the articles are available online at
http://www.mayoclinicproceedings.com.
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