Skip to main content
Erschienen in: Osteoporosis International 10/2015

01.10.2015 | Original Article

Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture

verfasst von: K. Crockett, C. M. Arnold, J. P. Farthing, P. D. Chilibeck, J. D. Johnston, B. Bath, A. D. G. Baxter-Jones, S. A. Kontulainen

Erschienen in: Osteoporosis International | Ausgabe 10/2015

Einloggen, um Zugang zu erhalten

Abstract

Summary

Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk.

Introduction

The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF.

Methods

One hundred sixty-six postmenopausal women (50–78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6–24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA).

Results

There was a significant group difference (p < 0.05) for the forearm and lower leg, with the Fx group demonstrating 16 and 19 % lower BSIc, 3 and 6 % lower muscle density, and 20 and 21 % lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures.

Conclusions

Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.
Literatur
1.
Zurück zum Zitat Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney RE Jr, McLellan A, Mitchell PJ, Silverman S, Singleton R, Siris E (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27:2039–2046CrossRefPubMed Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney RE Jr, McLellan A, Mitchell PJ, Silverman S, Singleton R, Siris E (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27:2039–2046CrossRefPubMed
5.
Zurück zum Zitat Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936CrossRefPubMed Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936CrossRefPubMed
6.
Zurück zum Zitat Papaioannou A, Morin S, Cheung AM et al (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182:1864–1873PubMedCentralCrossRefPubMed Papaioannou A, Morin S, Cheung AM et al (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182:1864–1873PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Jarvinen TL, Sievanen H, Khan KM, Heinonen A, Kannus P (2008) Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 336:124–126PubMedCentralCrossRefPubMed Jarvinen TL, Sievanen H, Khan KM, Heinonen A, Kannus P (2008) Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 336:124–126PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Stone KL, Seeley DG, Lui LY, Cauley JA, Ensrud K, Browner WS, Nevitt MC, Cummings SR (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res 18:1947–1954CrossRefPubMed Stone KL, Seeley DG, Lui LY, Cauley JA, Ensrud K, Browner WS, Nevitt MC, Cummings SR (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res 18:1947–1954CrossRefPubMed
9.
Zurück zum Zitat Peeters G, van Schoor NM, Lips P (2009) Fall risk: the clinical relevance of falls and how to integrate fall risk with fracture risk. Best Pract Res Clin Rheumatol 23:797–804CrossRefPubMed Peeters G, van Schoor NM, Lips P (2009) Fall risk: the clinical relevance of falls and how to integrate fall risk with fracture risk. Best Pract Res Clin Rheumatol 23:797–804CrossRefPubMed
10.
Zurück zum Zitat Petit MA, Beck TJ, Kontulainen SA (2005) Examining the developing bone: what do we measure and how do we do it? J Musculoskelet Neuronal Interact 5:213–224PubMed Petit MA, Beck TJ, Kontulainen SA (2005) Examining the developing bone: what do we measure and how do we do it? J Musculoskelet Neuronal Interact 5:213–224PubMed
11.
Zurück zum Zitat D’Elia G, Caracchini G, Cavalli L, Innocenti P (2009) Bone fragility and imaging techniques. Clin Cases Miner Bone Metab 6:234–246PubMedCentralPubMed D’Elia G, Caracchini G, Cavalli L, Innocenti P (2009) Bone fragility and imaging techniques. Clin Cases Miner Bone Metab 6:234–246PubMedCentralPubMed
12.
Zurück zum Zitat Sheu Y, Zmuda JM, Boudreau RM, Petit MA, Ensrud KE, Bauer DC, Gordon CL, Orwoll ES, Cauley JA (2011) Bone strength measured by peripheral quantitative computed tomography and the risk of nonvertebral fractures: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 26:63–71PubMedCentralCrossRefPubMed Sheu Y, Zmuda JM, Boudreau RM, Petit MA, Ensrud KE, Bauer DC, Gordon CL, Orwoll ES, Cauley JA (2011) Bone strength measured by peripheral quantitative computed tomography and the risk of nonvertebral fractures: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 26:63–71PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Schneider P, Reiners C, Cointry GR, Capozza RF, Ferretti JL (2001) Bone quality parameters of the distal radius as assessed by pQCT in normal and fractured women. Osteoporos Int 12:639–646CrossRefPubMed Schneider P, Reiners C, Cointry GR, Capozza RF, Ferretti JL (2001) Bone quality parameters of the distal radius as assessed by pQCT in normal and fractured women. Osteoporos Int 12:639–646CrossRefPubMed
14.
Zurück zum Zitat Kontulainen SA, Johnston JD, Liu D, Leung C, Oxland TR, McKay HA (2008) Strength indices from pQCT imaging predict up to 85 % of variance in bone failure properties at tibial epiphysis and diaphysis. J Musculoskelet Neuronal Interact 8:401–409PubMed Kontulainen SA, Johnston JD, Liu D, Leung C, Oxland TR, McKay HA (2008) Strength indices from pQCT imaging predict up to 85 % of variance in bone failure properties at tibial epiphysis and diaphysis. J Musculoskelet Neuronal Interact 8:401–409PubMed
15.
Zurück zum Zitat MacDermid JC, Roth JH, Richards RS (2003) Pain and disability reported in the year following a distal radius fracture: a cohort study. BMC Musculoskelet Disord 4:24PubMedCentralCrossRefPubMed MacDermid JC, Roth JH, Richards RS (2003) Pain and disability reported in the year following a distal radius fracture: a cohort study. BMC Musculoskelet Disord 4:24PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Brogren E, Hofer M, Petranek M, Dahlin LB, Atroshi I (2011) Fractures of the distal radius in women aged 50 to 75 years: natural course of patient-reported outcome, wrist motion and grip strength between 1 year and 2–4 years after fracture. J Hand Surg Eur 36:568–576CrossRef Brogren E, Hofer M, Petranek M, Dahlin LB, Atroshi I (2011) Fractures of the distal radius in women aged 50 to 75 years: natural course of patient-reported outcome, wrist motion and grip strength between 1 year and 2–4 years after fracture. J Hand Surg Eur 36:568–576CrossRef
17.
Zurück zum Zitat Kawalilak CE, Lanovaz JL, Johnston JD, Kontulainen SA (2014) Linearity and sex-specificity of impact force prediction during a fall onto the outstretched hand using a single-damper-model. J Musculoskelet Neuronal Interact 14:286–293PubMed Kawalilak CE, Lanovaz JL, Johnston JD, Kontulainen SA (2014) Linearity and sex-specificity of impact force prediction during a fall onto the outstretched hand using a single-damper-model. J Musculoskelet Neuronal Interact 14:286–293PubMed
18.
Zurück zum Zitat Sran MM, Stotz PJ, Normandin SC, Robinovitch SN (2010) Age differences in energy absorption in the upper extremity during a descent movement: implications for arresting a fall. J Gerontol A Biol Sci Med Sci 65:312–317CrossRefPubMed Sran MM, Stotz PJ, Normandin SC, Robinovitch SN (2010) Age differences in energy absorption in the upper extremity during a descent movement: implications for arresting a fall. J Gerontol A Biol Sci Med Sci 65:312–317CrossRefPubMed
19.
Zurück zum Zitat Steenhuis RE, Bryden MP, Schwartz M, Lawson S (1990) Reliability of hand preference items and factors. J Clin Exp Neuropsychol 12:921–930CrossRefPubMed Steenhuis RE, Bryden MP, Schwartz M, Lawson S (1990) Reliability of hand preference items and factors. J Clin Exp Neuropsychol 12:921–930CrossRefPubMed
20.
Zurück zum Zitat Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA (1999) The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol 52:643–651CrossRefPubMed Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA (1999) The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol 52:643–651CrossRefPubMed
21.
Zurück zum Zitat Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A (2000) The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatr 15:1021–1027CrossRef Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A (2000) The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatr 15:1021–1027CrossRef
23.
Zurück zum Zitat Karkkainen M, Rikkonen T, Kroger H, Sirola J, Tuppurainen M, Salovaara K, Arokoski J, Jurvelin J, Honkanen R, Alhava E (2008) Association between functional capacity tests and fractures: an eight-year prospective population-based cohort study. Osteoporos Int 19:1203–1210CrossRefPubMed Karkkainen M, Rikkonen T, Kroger H, Sirola J, Tuppurainen M, Salovaara K, Arokoski J, Jurvelin J, Honkanen R, Alhava E (2008) Association between functional capacity tests and fractures: an eight-year prospective population-based cohort study. Osteoporos Int 19:1203–1210CrossRefPubMed
24.
Zurück zum Zitat Lorbergs AL, Farthing JP, Baxter-Jones AD, Kontulainen SA (2011) Forearm muscle size, strength, force, and power in relation to pQCT-derived bone strength at the radius in adults. Appl Physiol Nutr Metab 36:618–625CrossRefPubMed Lorbergs AL, Farthing JP, Baxter-Jones AD, Kontulainen SA (2011) Forearm muscle size, strength, force, and power in relation to pQCT-derived bone strength at the radius in adults. Appl Physiol Nutr Metab 36:618–625CrossRefPubMed
25.
Zurück zum Zitat McLean RR, Shardell MD, Alley DE et al (2014) Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality: the Foundation for the National Institutes of Health (FNIH) sarcopenia project. J Gerontol A Biol Sci Med Sci 69:576–583PubMedCentralCrossRefPubMed McLean RR, Shardell MD, Alley DE et al (2014) Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality: the Foundation for the National Institutes of Health (FNIH) sarcopenia project. J Gerontol A Biol Sci Med Sci 69:576–583PubMedCentralCrossRefPubMed
26.
Zurück zum Zitat Jones CJ, Rikli RE, Beam WC (1999) A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport 70:113–119CrossRefPubMed Jones CJ, Rikli RE, Beam WC (1999) A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport 70:113–119CrossRefPubMed
27.
Zurück zum Zitat Rikli RE, Jones CJ (2001) Senior fitness test manual. Human Kinetics, Champaign Rikli RE, Jones CJ (2001) Senior fitness test manual. Human Kinetics, Champaign
28.
Zurück zum Zitat Lang T, Streeper T, Cawthon P, Baldwin K, Taaffe DR, Harris TB (2010) Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporos Int 21:543–559PubMedCentralCrossRefPubMed Lang T, Streeper T, Cawthon P, Baldwin K, Taaffe DR, Harris TB (2010) Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporos Int 21:543–559PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat Cousins JM, Petit MA, Paudel ML, Taylor BC, Hughes JM, Cauley JA, Zmuda JM, Cawthon PM, Ensrud KE (2010) Muscle power and physical activity are associated with bone strength in older men: the osteoporotic fractures in men study. Bone 47:205–211PubMedCentralCrossRefPubMed Cousins JM, Petit MA, Paudel ML, Taylor BC, Hughes JM, Cauley JA, Zmuda JM, Cawthon PM, Ensrud KE (2010) Muscle power and physical activity are associated with bone strength in older men: the osteoporotic fractures in men study. Bone 47:205–211PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Crockett K, Ardell K, Hermanson M, Penner A, Lanovaz J, Farthing J, Arnold C (2013) The relationship of knee-extensor strength and rate of torque development to sit-to-stand performance in older adults. Physiother Can 65:229–235PubMedCentralCrossRefPubMed Crockett K, Ardell K, Hermanson M, Penner A, Lanovaz J, Farthing J, Arnold C (2013) The relationship of knee-extensor strength and rate of torque development to sit-to-stand performance in older adults. Physiother Can 65:229–235PubMedCentralCrossRefPubMed
31.
Zurück zum Zitat Duckham RL, Frank AW, Johnston JD, Olszynski WP, Kontulainen SA (2013) Monitoring time interval for pQCT-derived bone outcomes in postmenopausal women. Osteoporos Int 24:1917–1922CrossRefPubMed Duckham RL, Frank AW, Johnston JD, Olszynski WP, Kontulainen SA (2013) Monitoring time interval for pQCT-derived bone outcomes in postmenopausal women. Osteoporos Int 24:1917–1922CrossRefPubMed
33.
Zurück zum Zitat Carter DR, Hayes WC (1977) The compressive behavior of bone as a two-phase porous structure. J Bone Joint Surg Am 59:954–962PubMed Carter DR, Hayes WC (1977) The compressive behavior of bone as a two-phase porous structure. J Bone Joint Surg Am 59:954–962PubMed
34.
Zurück zum Zitat Frank-Wilson AW, Johnston JD, Olszynski WP, Kontulainen SA (2015) Measurement of muscle and fat in postmenopausal women: precision of previously reported pQCT imaging methods. Bone 75:49–54CrossRefPubMed Frank-Wilson AW, Johnston JD, Olszynski WP, Kontulainen SA (2015) Measurement of muscle and fat in postmenopausal women: precision of previously reported pQCT imaging methods. Bone 75:49–54CrossRefPubMed
35.
Zurück zum Zitat Chilibeck PD, Vatanparast H, Pierson R, Case A, Olatunbosun O, Whiting SJ, Beck TJ, Pahwa P, Biem HJ (2013) Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: a randomized clinical trial. J Bone Miner Res 28:780–793CrossRefPubMed Chilibeck PD, Vatanparast H, Pierson R, Case A, Olatunbosun O, Whiting SJ, Beck TJ, Pahwa P, Biem HJ (2013) Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: a randomized clinical trial. J Bone Miner Res 28:780–793CrossRefPubMed
36.
Zurück zum Zitat Sievanen H, Oja P, Vuori I (1992) Precision of dual-energy x-ray absorptiometry in determining bone mineral density and content of various skeletal sites. J Nucl Med 33:1137–1142PubMed Sievanen H, Oja P, Vuori I (1992) Precision of dual-energy x-ray absorptiometry in determining bone mineral density and content of various skeletal sites. J Nucl Med 33:1137–1142PubMed
37.
Zurück zum Zitat Uusi-Rasi K, Sievanen H, Pasanen M, Kannus P (2007) Age-related decline in trabecular and cortical density: a 5-year peripheral quantitative computed tomography follow-up study of pre- and postmenopausal women. Calcif Tissue Int 81:249–253CrossRefPubMed Uusi-Rasi K, Sievanen H, Pasanen M, Kannus P (2007) Age-related decline in trabecular and cortical density: a 5-year peripheral quantitative computed tomography follow-up study of pre- and postmenopausal women. Calcif Tissue Int 81:249–253CrossRefPubMed
38.
Zurück zum Zitat Marcell TJ (2003) Sarcopenia: causes, consequences, and preventions. J Gerontol A Biol Sci Med Sci 58:M911–M916CrossRefPubMed Marcell TJ (2003) Sarcopenia: causes, consequences, and preventions. J Gerontol A Biol Sci Med Sci 58:M911–M916CrossRefPubMed
39.
Zurück zum Zitat Narici MV, Maffulli N (2010) Sarcopenia: characteristics, mechanisms and functional significance. Br Med Bull 95:139–159CrossRefPubMed Narici MV, Maffulli N (2010) Sarcopenia: characteristics, mechanisms and functional significance. Br Med Bull 95:139–159CrossRefPubMed
40.
Zurück zum Zitat Ashe MC, Liu-Ambrose TY, Cooper DM, Khan KM, McKay HA (2008) Muscle power is related to tibial bone strength in older women. Osteoporos Int 19:1725–1732CrossRefPubMed Ashe MC, Liu-Ambrose TY, Cooper DM, Khan KM, McKay HA (2008) Muscle power is related to tibial bone strength in older women. Osteoporos Int 19:1725–1732CrossRefPubMed
41.
Zurück zum Zitat Hardy R, Cooper R, Shah I, Harridge S, Guralnik J, Kuh D (2010) Is chair rise performance a useful measure of leg power? Aging Clin Exp Res 22:412–418PubMedCentralCrossRefPubMed Hardy R, Cooper R, Shah I, Harridge S, Guralnik J, Kuh D (2010) Is chair rise performance a useful measure of leg power? Aging Clin Exp Res 22:412–418PubMedCentralCrossRefPubMed
42.
Zurück zum Zitat Nikander R, Sievanen H, Heinonen A, Daly RM, Uusi-Rasi K, Kannus P (2010) Targeted exercise against osteoporosis: a systematic review and meta-analysis for optimising bone strength throughout life. BMC Med 8:47PubMedCentralCrossRefPubMed Nikander R, Sievanen H, Heinonen A, Daly RM, Uusi-Rasi K, Kannus P (2010) Targeted exercise against osteoporosis: a systematic review and meta-analysis for optimising bone strength throughout life. BMC Med 8:47PubMedCentralCrossRefPubMed
43.
Zurück zum Zitat Rozental TD, Deschamps LN, Taylor A, Earp B, Zurakowski D, Day CS, Bouxsein ML (2013) Premenopausal women with a distal radial fracture have deteriorated trabecular bone density and morphology compared with controls without a fracture. J Bone Joint Surg Am 95:633–642PubMedCentralCrossRefPubMed Rozental TD, Deschamps LN, Taylor A, Earp B, Zurakowski D, Day CS, Bouxsein ML (2013) Premenopausal women with a distal radial fracture have deteriorated trabecular bone density and morphology compared with controls without a fracture. J Bone Joint Surg Am 95:633–642PubMedCentralCrossRefPubMed
44.
Zurück zum Zitat Engelke K, Libanati C, Fuerst T, Zysset P, Genant HK (2013) Advanced CT based in vivo methods for the assessment of bone density, structure, and strength. Curr Osteoporos Rep 11:246–255CrossRefPubMed Engelke K, Libanati C, Fuerst T, Zysset P, Genant HK (2013) Advanced CT based in vivo methods for the assessment of bone density, structure, and strength. Curr Osteoporos Rep 11:246–255CrossRefPubMed
45.
Zurück zum Zitat Felsenberg D, Boonen S (2005) The bone quality framework: determinants of bone strength and their interrelationships, and implications for osteoporosis management. Clin Ther 27:1–11CrossRefPubMed Felsenberg D, Boonen S (2005) The bone quality framework: determinants of bone strength and their interrelationships, and implications for osteoporosis management. Clin Ther 27:1–11CrossRefPubMed
46.
Zurück zum Zitat Vico L, Zouch M, Amirouche A, Frere D, Laroche N, Koller B, Laib A, Thomas T, Alexandre C (2008) High-resolution pQCT analysis at the distal radius and tibia discriminates patients with recent wrist and femoral neck fractures. J Bone Miner Res 23:1741–1750CrossRefPubMed Vico L, Zouch M, Amirouche A, Frere D, Laroche N, Koller B, Laib A, Thomas T, Alexandre C (2008) High-resolution pQCT analysis at the distal radius and tibia discriminates patients with recent wrist and femoral neck fractures. J Bone Miner Res 23:1741–1750CrossRefPubMed
47.
Zurück zum Zitat Kontulainen S, Sievanen H, Kannus P, Pasanen M, Vuori I (2002) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 17:2281–2289CrossRefPubMed Kontulainen S, Sievanen H, Kannus P, Pasanen M, Vuori I (2002) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 17:2281–2289CrossRefPubMed
Metadaten
Titel
Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture
verfasst von
K. Crockett
C. M. Arnold
J. P. Farthing
P. D. Chilibeck
J. D. Johnston
B. Bath
A. D. G. Baxter-Jones
S. A. Kontulainen
Publikationsdatum
01.10.2015
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 10/2015
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3160-8

Weitere Artikel der Ausgabe 10/2015

Osteoporosis International 10/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.