Relationship between muscle strength, physical performance, quality of life and bone mineral density among postmenopausal women at risk of osteoporotic fractures

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Published: Apr 22, 2020
DOI: https://doi.org/10.14456/sehs.2020.2
Keywords:
muscle strength osteoporotic fracture physical performance postmenopausal women quality of life

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Siew Kuan Chua
Physiotherapy Program and Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia / Center of Physiotherapy, Faculty of Health Sciences, Universiti Teknologi MARA Selangor branch, Puncak Alam Campus, Malaysia
Devinder Kaur Ajit Singh
Physiotherapy Program and Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia. Corresponding author's e-mail: [email protected]
Khairunisa Zubir
Physiotherapy Program and Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
Yin Yian Chua
Physiotherapy Program and Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia / Woodlands Health Campus, 9 Maxwell Road, MND Complex Annex A #03-01, 069112 Singapore
Bala S Rajaratnam
Rehab Services Division, St Lukes Hospital, 659674 Singapore
Sabarul Afian Mokhtar
Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia

Abstract

Information regarding the relationship between muscle strength, physical performance (PP), quality of life (QoL) and bone mineral density (BMD) in adults with osteoporosis is limited. The aim of this study was to determine the relationship between these four parameters and the determinants of lumbar spine BMD in postmenopausal women at risk of osteoporotic fractures. In this cross-sectional study, 50 participants aged 55 and above were recruited from an orthopaedic clinic. A hand dynamometer, a load cell system and short physical performance battery were used to measure hand grip strength (HGS), back extensor muscle strength (BEMS) and PP, respectively. To assess QoL and BMD, European QoL questionnaire and bone densitometry were used, respectively. WHO fracture calculator (FRAX®) results showed that postmenopausal women in this study were at moderate risk of major osteoporotic fractures (13.28 ± 7.10%) and had a high risk of hip fracture (3.35 ± 2.54%). Stepwise regression analysis demonstrated that greater HGS and body mass index (BMI) were determinants of lumbar BMD, accounting for 28.4% of total variance independent of age. Improved muscle strength and having a higher BMI could preserve lumbar BMD and prevent osteoporotic fractures in postmenopausal women.

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Chua, S. K., Singh, D. K. A. ., Zubir, K. ., Chua, Y. Y., Rajaratnam, B. S. ., & Mokhtar, S. A. . (2020). Relationship between muscle strength, physical performance, quality of life and bone mineral density among postmenopausal women at risk of osteoporotic fractures. Science, Engineering and Health Studies, 14(1), 8–21. https://doi.org/10.14456/sehs.2020.2
Issue
Volume 14, Number 1 (January - April), 2020
Section
Research Articles

References

Acree, L. S., Longfors, J., Fjeldstad, A. S., Fjeldstad, C., Schank, B., Nickel, K. J., Montgomery, P. S., and Gardner, A. W. (2006). Physical activity is related to quality of life in older adults. Health Qual Life Outcomes, 4, 37.

Adachi, J. D., Adami, S., Gehlbach, S., Anderson Jr, F. A., Boonen, S., Chapurlat, R. D., Compston, J. E., Cooper, C., Delmas, P., Díez-Pérez, A., and Greenspan, S. L. (2010). Impact of prevalent fractures on quality of life: baseline results from the global longitudinal study of osteoporosis in women. Mayo Clinic Proceedings, 85(9), 806-813.

Arima, K., Abe, Y., Nishimura, T., Okabe, T., Tomita, Y., Mizukami, S., Kanagae, M., and Aoyagi, K. (2017). Association of vertebral compression fractures with physical performance measures among community-dwelling Japanese women aged 40 years and older. BMC Musculoskelet Disord, 18, 176.

Bauer, D. C., Browner, W. S., Cauley, J. A., Orwoll, E. S., Scott, J. C., Black, D. M., Tao, J. L., and Cummings, S. R. (1993). Factors associated with appendicular bone mass in older women. Annals of Internal Medicine, 118(9), 657-665.

Beyazal, M. S., Devrimsel, G., Türkyılmaz, A. K., and Yıldırım, M. (2016). The relationship of hand grip strength with bone mineral density and vitamin D in postmenopausal women. Turkish Journal of Osteoporosis, 22, 1-6.

Bianchi, M. L., Orsini, M. R., Saraifoger, S., Ortolani, S., Radaelli, G., and Betti, S. (2005). Quality of life in post-menopausal osteoporosis. Health Qual Life Outcomes, 3, 78.

Bottai, V., Giannotti, S., Raffaetà, G., Mazzantini, M., Casella, F., De Paola, G., Menconi, A., Falossi, F., and Guido, G. (2016). Underdiagnosis of osteoporotic vertebral fractures in patients with fragility fractures: retrospective analysis of over 300 patients. Clinical Cases in Mineral and Bone Metabolism, 13(2), 119-122.

Cawthon, P. M., Blackwell, T. L., Marshall, L. M., Fink, H. A., Kado, D. M., Ensrud, K. E., Cauley, J. A., Black, D., Orwoll, E. S., Cummings, S. R., and Schousboe, J. T. (2014). Physical performance and radiographic and clinical vertebral fractures in older men. Journal of Bone and Mineral Research, 29(9), 2101-2108.

Chan, C. Y., Subramaniam, S., Mohamed, N., Ima-Nirwana, S., Muhammad, N., Fairus, A., Ng, P. Y., Jamil, N. A., Abd Aziz, N., and Chin, K. Y. (2020). Determinants of bone health status in a multi-ethnic population in Klang Valley, Malaysia. International Journal of Environmental Research and Public Health, 17(2), 384.

Cheung, E. Y., Tan, K. C., Cheung, C. L., and Kung, A. W. (2016). Osteoporosis in East Asia: Current issues in assessment and management. Osteoporos Sarcopenia, 2(3), 118-133.

Cheung, C. L., Ang, S. B., Chadha, M., Chow, E. S. L., Chung, Y. S., Hew, F. L., Jaisamrarn, U., Ng, H., Takeuchi, Y., Wu, C. H., and Xia, W. (2018). An updated hip fracture projection in Asia: the Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia, 4(1), 16-21.

Chin, K. Y., Low, N. Y., Dewiputri, W. I., and Ima-Nirwanaa, S. (2017). Factors associated with bone health in Malaysian middle-aged and elderly women assessed via quantitative ultrasound. International Journal of Environmental Research and Public Health, 14(7), 736.

Chua, S. K., Singh, D. K., Rajaratnam, B. S., Mokhtar, S. A., Sridharan, R., Gan, K. B., Chin, K. Y., and Lee, R. Y. W. (2017). A study protocol: spinal morphology, physical performance, quality of life and biochemical markers in adults at risk of osteoporotic fractures. Pertanika Journal of Science and Technology, 25(4), 1123-1134.

Crepaldi, G., Romanato, G., Tonin, P., and Maggi, S. (2007). Osteoporosis and body composition. Journal of Endocrinological Investigation, 30(suppl 6), 42-47.

Daoud, J. I. (2017). Multicollinearity and regression analysis. Journal of Physics: Conference Series, 949(1), 012009.

Delmas, P. D., van de Langerijt, L., Watts, N. B., Eastell, R., Genant, H., Grauer, A., and Cahall, D. L. (2005). Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. Journal of Bone and Mineral Research, 20(4), 557-563.

Demoulin, C., Grosdent, S., Smeets, R., Verbunt, J., Jidovtseff, B., Mahieu, G., Crielaard, J. M., and Vanderthommen, M. (2012). Muscular performance assessment of trunk extensors: A critical appraisal of the literature. In Low Back Pain (Ali Asghar Norasteh., ed). pp. 141-165. [OnlineURL: www.intechopen.com/books/low-back-pain/muscular-performance-assessment-of-trunk-extensors-a-critical-appraisal-of-the-literature] accessed on April 15, 2018.

Dhillon, V., Hurst, N., Hannan, J., and Nuki, G. (2005). Association of low general health status measured prospectively by Euroqol EQ5D, with osteoporosis, independent of a history of prior fracture. Osteoporosis International, 16(5), 483-489.

Dixon, W. G., Lunt, M., Pye, S. R., Reeve, J., Felsenberg, D., Silman, A. J., and O'neill, T. W. (2005). Low grip strength is associated with bone mineral density and vertebral fracture in women. Rheumatology, 44(5), 642-646.

Dyer, S. M., Crotty, M., Fairhall, N., Magaziner, J., Beaupre, L. A., Cameron, I. D., and Sherrington, C. (2016). A critical review of the long-term disability outcomes following hip fracture. BMC Geriatrics, 16, 158.

Fess, E. E. (1992). Grip strength. In Clinical Assessment Recommendations (Casanova J. S. ed.), 2nd, pp. 41-45, Chicago: American Society of Hand Therapists.

Field, A. (2011). Discovering Statistics using SPSS, 3rd, SAGE Publications Ltd., pp. 13.

Gomez-Cabello, A., Ara, I., González-Agüero, A., Casajus, J. A., and Vicente-Rodriguez, G. (2012). Effects of training on bone mass in older adults. Sports Medicine, 42(4), 301-325.

Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., and Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), M85-M94.

Guralnik, J. M., Ferrucci, L., Pieper, C. F., Leveille, S. G., Markides, K. S., Ostir, G. V., Studenski, S., Berkman, L. F., and Wallace, R. B. (2000). Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. Journal of Gerontology: Medical Sciences, 55(4), M221-M231.

Hallberg, I., Rosenqvist, A. M., Kartous, L., Löfman, O., Wahlström, O., and Toss, G. (2004). Health-related quality of life after osteoporotic fractures. Osteoporosis International, 15(10), 834-841.

Hongo, M., Miyakoshi, N., Shimada, Y., and Sinaki, M. (2012). Association of spinal curve deformity and back extensor strength in elderly women with osteoporosis in Japan and the United States. Osteoporosis International, 23(3), 1029-1034.

Huang, C. Y., Liao, L. C., Tong, K. M., Lai, H. L., Chen, W. K., Chen, C. I., Lu, C.Y., and Chen, F. J. (2015). Mediating effects on health-related quality of life in adults with osteoporosis: a structural equation modelling. Osteoporosis International, 26(3), 875-883.

Iki, M., Saito, Y., Kajita, E., Nishino, H., and Kusaka, Y. (2006). Trunk muscle strength is a strong predictor of bone loss in postmenopausal women. Clinical Orthopaedics and Related Research, 443, 66-72.

Imagama, S., Matsuyama, Y., Hasegawa, Y., Sakai, Y., Ito, Z., Ishiguro, N., and Hamajima, N. (2011). Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males. European Spine Journal, 20(6), 954-961.

Innes, E. (1999). Handgrip strength testing: A review of the literature. Australian Occupational Therapy Journal, 46(3), 120-140.

Jun, H. J., Kim, K. J., Lee, J. S., and Yang, S. H. (2015). Association between osteoporotic fractures and quality of life based on the Korean Community Health Survey of 2010. Journal of Physical Therapy Science, 27(10), 3325-3328.

Jung, H. J., Park, Y. S., Seo, H. Y., Lee, J. C., An, K. C., Kim, J. H., Sin, B. J., Kang, T. W., and Park, S. Y. (2017). Quality of life in patients with osteoporotic vertebral compression fractures. Journal of Bone Metabolism, 24(3), 187-196.

Kanis, J. A., Johnell, O., Odén, A., Johansson, H., and McCloskey, E. (2008). FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporosis International, 19(4), 385-397.

Kärkkäinen, M., Rikkonen, T., Kröger, H., Sirola, J., Tuppurainen, M., Salovaara, K., Arokoski, J., Jurvelin, J., Honkanen, R., and Alhava, E. (2009). Physical tests for patient selection for bone mineral density measurements in postmenopausal women. Bone, 44(4), 660-665.

Kasukawa, Y., Miyakoshi, N., Hongo, M., Ishikawa, Y., Kudo, D., Suzuki, M., Mizutani, T., Kimura, R., Ono, Y., and Shimada, Y. (2017). Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population. Clinical Interventions in Aging, 12, 413-420.

Katzman, W. B., Vittinghoff, E., Kado, D. M., Lane, N. E., Ensrud, K. E., and Shipp, K. (2016). Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial. Osteoporosis International, 27(3), 899-903.

Kim, S. W., Lee, H. A., and Cho, E. H. (2012). Low handgrip strength is associated with low bone mineral density and fragility fractures in postmenopausal healthy Korean women. Journal of Korean Medical Science, 27(7), 744-747.

Korkmaz, N., Tutoğlu, A., Korkmaz, I., and Boyacı, A. (2014). The relationships among vitamin D level, balance, muscle strength, and quality of life in postmenopausal patients with osteoporosis. Journal of Physical Therapy Science, 26(10), 1521-1526.

Bartlett, J. E., Kotrlik, J. W., and Higgins, C. C. (2001). Organizational research: Determining appropriate sample size in survey research. Information Technology, Learning, and Performance Journal, 19(1), 43-50.

Lam, N. W., Goh, H. T., Kamaruzzaman, S. B., Chin, A. V., Poi, P. J. H., and Tan, M. P. (2016). Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population. Singapore Medical Journal, 57(10), 578-584.

Landi, F., Calvani, R., Tosato, M., Martone, A. M., Fusco, D., Sisto, A., Ortolani, E., Savera, G., Salini, S., and Marzetti, E. (2017). Age-related variations of muscle mass, strength, and physical performance in community-dwellers: results from the Milan EXPO survey. Journal of the American Medical Directors Association, 18(1), 88.e17-88.e24

Li, W. C., Chen, Y. C., Yang, R. S., and Tsauo, J. Y. (2009). Effects of exercise programmes on quality of life in osteoporotic and osteopenic postmenopausal women: a systematic review and meta-analysis. Clinical Rehabilitation, 23(10), 888-896.

Lim, S., Joung, H., Shin, C. S., Lee, H. K., Kim, K. S., Shin, E. K., Kim, H. Y., Lim, M. K., and Cho, S. I. (2004). Body composition changes with age have gender-specific impacts on bone mineral density. Bone, 35(3), 792-798.

Lim, P. S., Ong, F. B., Adeeb, N., Seri, S. S., Noor-Aini, M. Y., Shamsuddin, K., Hapizah, N., Mohamed, A. L., Mokhtar, A., and Wan, H. W. H. (2005). Bone health in urban midlife Malaysian women: risk factors and prevention. Osteoporosis International, 16(12), 2069-2079.

Lindsey, C., Brownbill, R. A., Bohannon, R. A., and Ilich, J. Z. (2005). Association of physical performance measures with bone mineral density in postmenopausal women. Archives of Physical Medicine and Rehabilitation, 86(6), 1102-1107.

Mika, A., Unnithan, V. B., and Mika, P. (2005). Differences in thoracic kyphosis and in back muscle strength in women with bone loss due to osteoporosis. Spine, 30(2), 241-246.

Müller, R., Strässle, K., and Wirth, B. (2010). Isometric back muscle endurance: an EMG study on the criterion validity of the Ito test. Journal of Electromyography and Kinesiology, 20(5), 845-850.

Morin, S., Tsang, J. F., and Leslie, W. D. (2009). Weight and body mass index predict bone mineral density and fractures in women aged 40 to 59 years. Osteoporosis International, 20(3), 363-370.

Orwoll, E. S., Bauer, D. C., Vogt, T. M., and Fox, K. M. (1996). Axial bone mass in older women. Annals of Internal Medicine, 124(2), 187-196.

Rexhepi, S., Bahtiri, E., Rexhepi, M., Sahatciu-Meka, V., and Rexhepi, B. (2015). Association of body weight and body mass index with bone mineral density in women and men from Kosovo. Mater Sociomed, 27(4), 259-262.

Riggs, B. L., and Melton, L. J. (1986). Involutional osteoporosis. New England Journal of Medicine, 314, 1676-1686.

Sakazaki, T., Koike, T., Yanagimoto, Y., and Oshida, Y. (2012). Association between gait speed and bone strength in community-dwelling postmenopausal Japanese women. Environmental Health and Preventive Medicine, 17, 394-400.

Shafie, A. A., Thakumar, A. V., Lim, C. J., and Luo, N. (2019). Psychometric performance assessment of Malay and Malaysian English version of EQ-5D-5L in the Malaysian population. Quality of Life Research, 28(1), 153-162.

Shum, G. L. K., Crosbie, J., and Lee, R. Y. W. (2010). Back pain is associated with changes in loading pattern throughout forward and backward bending. Spine, 35(25), E1472-E1478.

Singh, D. K. A., Bailey, M., and Lee, R. (2010). Biplanar measurement of thoracolumbar curvature in older adults using an electromagnetic tracking device. Archives of Physical Medicine and Rehabilitation, 91(1), 137-142.

Singh, D. K. A., Bailey, M., and Lee, R. Y. W. (2011a). Strength and fatigue of lumbar extensor muscles in older adults. Muscle Nerve, 44(1), 74-79.

Singh, D. K. A., Bailey, M., and Lee, R.Y. (2011b). Ageing modifies the fibre angle and biomechanical function of the lumbar extensor muscles. Clinical Biomechanics, 26(6), 543-547.

Singh, D. K. A., Bailey, M., and Lee, R. (2013). Decline in lumbar extensor muscle strength in older adults: correlation with age, gender and spine morphology. BMC Musculoskeletal Disorders, 14, Article number: 215.

Sirola, J., Rikkonen, T., Tuppurainen, M., Jurvelin, J. S., and Kröger, H. (2006). Association of grip strength change with menopausal bone loss and related fractures: a population-based follow-up study. Calcified Tissue International, 78(4), 218-226.

Solimeo, S. L., Silverman, S. L., Calderon, A. D., Nguyen, A., and Gold, D. T. (2012). Measuring health-related quality of life (HRQOL) in osteoporotic males using the Male OPAQ. Osteoporosis International, 23(3), 841-852.

Subramaniam, S., Chan, C. Y., Soelaiman, I. N., Mohamed, N., Muhammad, N., Ahmad, F., Manaf, M. R. A., Ng, P. Y., Jamil, N. A., and Chin, K. Y. (2019). Prevalence and predictors of osteoporosis among the Chinese population in Klang Valley, Malaysia. Applied Sciences, 9(9), 1820.

Tosteson, A. N. A., Melton, L. J., Dawson-Hughes, B., Baim, S., Favus, M. J., Khosla, S., and Lindsay, R. L. (2008). Cost-effective osteoporosis treatment thresholds: The United States perspective. Osteoporosis International, 19(4), 437-447.

Varatharajan, S., and Chen, W. S. (2012). Reliability and validity of EQ-5D in Malaysian population. Applied Research Quality Life, 7(2), 209-221.

Vermeulen, J., Neyens, J. C. L., Spreeuwenberg, M. D., van Rossum, E., Hewson, D. J., and de Witte, L. P. (2015). Measuring grip strength in older adults: comparing the grip-ball with the Jamar dynamometer. Journal of Geriatric Physical Therapy, 38(3), 148-153.

Werle, S., Goldhahn, J., Drerup, S., Simmen, B. R., Sprott, H., and Herren, D. B. (2009). Age-and gender-specific normative data of grip and pinch strength in a healthy adult Swiss population. Journal of Hand Surgery (European Volume), 34(1), 76-84.

Zehnacker C. H., and Bemis-Dougherty, A. (2007). Effect of weighted exercises on bone mineral density in post- menopausal women a systematic review. Journal of Geriatric Physical Therapy, 30(2), 79-88.

Zhou, Z., Zheng, L., Wei, D., Ye, M., and Li, X. (2013). Muscular strength measurements indicate bone mineral density loss in postmenopausal women. Clinical Interventions in Aging, 8, 1451-1459.