Are osteoporotic vertebral fractures or forward head posture associated with performance-based measures of balance and mobility?

Summary The main objective of this study was to explore whether vertebral fracture characteristics or posture is independently associated with physical performance. Posture was significantly associated with physical performance but fracture characteristics were not, suggesting posture should be the focus of physical performance variance. Purpose The main objective of this study was to explore whether vertebral fracture characteristics (number, severity, location) or occiput-to-wall distance (OWD) is independently associated with physical performance. Methods This was a secondary data analysis using baseline data from a randomized controlled trial, of community-dwelling women aged 65 years and older with a suspected vertebral fragility fracture. Lateral thoracic and lumbar spine radiographs were used to determine the number, location, and severity of fracture. The dependent variables were timed up and go (TUG), five times sit-to-stand, four-meter walk, and step test. The independent variables were number, severity, location of fracture, and OWD. Pain during movement and age were covariates. Multivariable regression analyses determined the association between each of the dependent and independent variables. Results Participants’ ( n = 158) mean (standard deviation [SD]) age was 75.9 (6.5) years. They had a mean (SD) BMI, OWD, and number of fractures of 26.7 (5.3) kg/m 2 , 5.7 (4.6) cm, and 2.2 (1.8), respectively. OWD was independently associated with TUG (estimated coefficient [ B ] = 0.29, 95% confidence interval [CI] = 0.16, 0.42), five times sit-to-stand ( B = 0.33, 95% CI = 0.12, 0.55), four-meter walk ( B = 0.09, 95% CI = 0.05, 0.13), and step test ( B = − 0.36, 95% CI = − 0.50, − 0.23) in the unadjusted model. OWD was independently associated with TUG ( B = 0.25, 95% CI = 0.12, 0.38), five times sit-to-stand ( B = 0.29, 95% CI = 0.07, 0.50), four-meter walk ( B = 0.08, 95% CI = 0.03, 0.12), and step test ( B = − 0.22, 95% CI = − 0.47, − 0.19) in the adjusted model. Conclusion OWD was significantly associated with physical performance but fracture characteristics were not. These analyses were exploratory and require replication in future studies.