Der Orthopäde
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Randomized Controlled Trial
[Influence of spinal orthosis on gait and physical functioning in women with postmenopausal osteoporosis].
Osteoporosis is a widespread chronic bone disease leading to an increased risk of bone fractures. The most common clinical consequences are back pain, hyperkyphosis, limitations of physical functioning and activities of daily living as well as reduced quality of life. Furthermore, osteoporosis is associated with decreased strength and deficits of gait and balance, all together resulting in an increased risk of falls and a subsequent aggravation of fracture risk. Besides pharmaceutical and exercise therapy, back orthoses are increasingly being used in the therapy of osteoporosis and rehabilitation after vertebral fractures. Previous studies have shown that wearing a spinal orthosis results in a reduction of pain as well as improvements of posture and back extensor strength. To date there is no study that has evaluated the effects of a spinal orthosis on gait stability and physical functioning in patients with osteoporosis. Therefore the purpose of the present study was to assess the effects of a spinal orthosis on gait and pain-induced limitations of activities of daily living (ADL) in women with osteoporosis. ⋯ The study demonstrated that wearing a spinal orthosis introduced a reduction in double support time associated with a beneficial impact on gait stability. Furthermore, there was a positive effect on pain-related restrictions of ADL evident in women with a high level of limitations at baseline. Besides previously shown reductions in pain, improvements in back extensor strength and correction of posture, the application of a spinal orthosis may induce advantages for gait stability and physical functioning in women with postmenopausal osteoporosis. Future studies should consider a longer follow-up to evaluate possible effects on the risk of falling and fractures.