Physische Leistungsparameter bei Osteoporose

 

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Zusammenfassung

Einleitung

Ergebnisse physischer Tests sind bei Osteo porosepatienten Grundlage von Diagnostik- und Therapieentscheidungen. Die Zielstellung unserer Arbeit bestand in der Ermittlung der Beziehungen von klinischen Untersuchungen wie z. B. Tandemstand (TS), Ganggeschwindigkeit (GS), Handkraft und Chair- Rising-Test (CRT) im Hinblick auf periphere und/oder vertebrale Frakturen und das Alter bei Patienten mit Osteoporose.

Methoden

Es wurden retrospektiv und monozentrisch Daten von 174 Patienten (122 w., 52 m.) analysiert. Die Zahl peripherer Frakturen wurde anamnestisch, die Zahl von Wirbelfrakturen anhand von Röntgenaufnahmen ermittelt. Diese wurden in Beziehung zu den o. g. Tests und dem Alter der Patienten gesetzt. Drei Gruppen wurden gebildet: < 60 Jahre, 60–70 Jahre und > 70 Jahre.

Ergebnisse

Eine signifikant positive Korrelation fand sich für die Zahl vertebraler Frakturen und den CRT (p < 0,001) und eine negative zur GS (p < 0,001) und zum TS (p < 0,05). Die Handkraft in der Altersgruppe 60- bis 70-Jähriger mit ausschließlich peripheren Frakturen war links (p = 0,001) und rechts (p < 0,001) signifikant vermindert.

Schlussfolgerungen

Durch Anwendung dieser Tests werden erhebliche physische Einschränkungen als Folge früherer Frakturen, aber auch als Ursache möglicher weiterer Frakturen offenbar.

Summary

Background

The strong musculoskeletal relationship plays a major role in generation of fractures and/or muscular weakness. Our aim was to define association between physical function tests like “tandem stand” (TS), “chair rising test” (CRT), “gait speed” (GS) and “hand grip strength” at the right and left side and existent peripheral or vertebral fractures in patients with densitometric verified osteoporosis. We looked further for related differences in different age groups.

Methods

Data from 174 patients with osteoporosis (122 female, 52 male) were collected and retrospectively analysed. The average age of all patients was 67.19 years. Physical parameters were examined and according to the localization of fractures (vertebral and non vertebral) investigated. We also considered patient´s age according to the localization of fractures and divided all patients into three groups: < 60 years, 60–70 years, > 70 years.

Results

A significant positive correlation was demonstrated in patients with vertebral fractures concerning the CRT (p < 0.001) and negative for GS (p < 0.001) as well as for STB (< 0.05). Patients with non-vertebral fractures had less handgrip strength at both arms compared to all other groups. These results are significant in the 60–70 year age group (p = 0.001 for the left and p < 0.001 for the right side).

Conclusion

Functional tests, like CRT, GS and TS, are strongly and significantly associated with the number of vertebral fractures especially in older patients. Patients with non-vertebral fractures have significant reduced hand grip strength. Using these physical performance test an impaired physical status as the result of fractures as well as the risk of further fractures can be detected.

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