Center of pressure-based postural sway differences on parallel and single leg stance in Olympic deaf basketball and volleyball players

In sports such as basketball and volleyball, loss of balance due to the inability to maintain body stability and lack of postural control adversely affect athletic performance. Deaf athletes appear to struggle with balance and postural stability problems. The purpose of this study was to examine postural sway values in parallel and single leg stance of Olympic deaf basketball and volleyball players and reveal differences between the branches. Twenty-three male athletes from the Turkish national deaf basketball (n=11) and volleyball (n=12) teams participated in the study. After anthropometric measurements, the subjects completed postural sway (PS) tests in parallel/single leg stances with open eyes and closed eyes on a force plate. PS parameters (sway path, velocity, and area) obtained from the device software were used for the statistical analysis. The Mann-Whitney U-test was used to compare differences in PS parameters between basketball and volleyball players, and the alpha value was accepted as 0.05. Volleyball players had significantly better results in parallel stance and dominant leg PS values than basketball players (P<0.05). There was no significant difference between the groups in nondominant leg PS values (P>0.05). We think that proprioceptive and vestibular system enhancing training practices to be performed with stability exercises will be beneficial in terms of both promoting functional stability and interlimb coordination. Trainers and strength coaches should be aware of differences in the postural control mechanism of deaf athletes.

Development of the Home Fall Hazard Checklist

Objective

Home hazard assessment is particularly important following a fracture as a means of preventing subsequent fractures. The purpose of this study was to evaluate current checklists and evidence on home hazard to develop a usable self-administered checklist that could be used by adults to assess home hazards.

Design

Review and observational, prospective study. Setting. Community dwelling. Participants. Nine adults (4 men, 5 women) were asked to review the checklist and provide feedback on whether items were relevant, comprehensive, and easy to understand. Intervention. A search for literature examining the causes of falls that focused on home hazards or behaviours was conducted, and causes were extracted. Using the combined list of home hazards, a draft checklist was created. The participants were asked to pilot the checklist through their home. Primary and Secondary Outcome. An initial iteration of the checklist was modified to reduce redundancy (by grouping certain items together), improve usability (by adding a “not applicable category”), and improve readability (by removing double-barrelled questions or rewriting certain items).

Results

This process resulted in 74 items in 10 areas. On average, it took 10 minutes for the participants to complete the home walk-through while filling out the checklist.

Conclusion

The fall hazard-home checklist is a new checklist designed to identify home fall hazards with the intended use of being either administered by self-report through memory or supported by a walk-about, and that could potentially be completed by a patient who has incurred a fall, fracture, a family member, or caregiver. Given the expense of home hazard assessments that involve a home visit, the validity of this method of detection warrants further investigation.

Audiovestibular functioning of post-menopausal females with osteoporosis and osteopenia

INTRODUCTION

Osteoporosis and osteopenia are progressive disorders characterized by decreased bone mass, especially in postmenopausal women. These can be associated with body pain, fractures, hearing loss and balance disorders. The present study aims to evaluate audio-vestibular function in postmenopausal patients with osteopenia or osteoporosis.

METHODS

The study included 48 postmenopausal women (new subjects) diagnosed with osteoporosis (n = 23) or osteopenia (n = 25) in the age range of 50-66 years, as well as 28 normal women as controls. Audiological testing included pure tone audiometry (conventional and extended high-frequency audiometry), speech audiometry, impedance audiometry and otoacoustic emissions, including both transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs). All subjects also underwent vestibular evoked myogenic potentials testing (both ocular and cervical VEMPs).

RESULTS

In the present study, hearing was worse at all frequencies in the osteoporosis group in comparison with the osteopenia and control groups, with worse speech recognition and discrimination scores and OAEs. Vestibular function was affected in 95.65% of women with osteoporosis and 76% of those with osteopenia.

CONCLUSION

Osteoporosis and osteopenia are risk factors for vestibular dysfunction and hearing deficits in postmenopausal women. Thus, hearing and vestibular function should be monitored by audiological and vestibular testing periodically in these individuals.

Changes in fall risk and functional status in women aged 50 years and older after distal radius fracture: A prospective 1-year follow-up study

STUDY DESIGN

Prospective cohort study.

INTRODUCTION

Few studies have evaluated the course of recovery after distal radius fracture (DRF) when functional decline and fracture risk may be affected.

PURPOSE OF THE STUDY

The purpose of this study was to determine changes in overall functional status over the first year after a DRF in women aged 50 years and older.

METHODS

Seventy-eight women were assessed for balance, balance confidence, lower extremity strength, gait speed, fall history, physical activity levels, and self-reported wrist pain and function (Patient-Rated Wrist Evaluation) at weeks 1, 3, 9, 12, 26, and 52 after DRF. Descriptive data were generated for all variables; a 3-way mixed analysis of variance with repeated measures was used to compare differences between participants aged 50-65 years and 65 years and older.

RESULTS

There was a significant improvement in functional status measures for both age categories except single-leg balance and fast gait speed, from 1 week after fracture extending up to 1 year after fracture (ranging from 6.1% improvement to 25% improvement, P < .05). There was no significant time × age interaction, as both age groups had the same pattern of recovery; however, there was significantly lower functional status in the older group across all time points.

CONCLUSION

Regardless of age, monitoring and addressing functional status including upper limb function, overall strength, balance, confidence, usual gait speed, and physical activity right up to 1 year after fracture is an important consideration for clinicians treating women recovering from DRF. Given the high future fracture risk for these women, identifying functional recovery patterns can help to direct future research and determine preventative strategies.

Eight Weeks of Plyometric Training Improves Ability to Change Direction and Dynamic Postural Control in Female Basketball Players

The aim of this study was to examine the effects of 8 weeks of plyometric training on the ability to change direction and postural control in female basketball players. 25 national level female basketball players aged 18–27 years participated in the study. Volunteers were randomly assigned to an experimental group (n = 13) who replaced a part of their standard regimen by plyometric training twice weekly for 8 weeks, and a control group (n = 12) who continued their usual in-season training program. Before and after the intervention, the ability to change direction and postural control were assessed by force platform under both static and dynamic conditions (with the eyes open and then closed). Isokinetic testing was also performed to calculate the Hamstring/Quadriceps (H/Q) strength ratio. The intervention improved ability to change direction (p ≤ 0.001, d = 1.51) and shortened path length (p = 0.038, d = 0.937) during static balance testing. However, it did not yield significant inter-group differences in postural control in the antero-posterior plane. The stance in the medio-lateral plane seemed the most responsive to the intervention, with reductions in surface area (p = 0.012, d = 0.285), velocity with the eyes closed (p = 0.031, d = 0.968), and path length with the eyes open (p = 0.029, d = 0.968). The intervention did not change the H/Q ratio at the two speeds tested (60° and 120°.s^–1). In summary, the addition of 8 weeks plyometric training to the usual in-season basketball regimen of top-level female basketball players enhanced their ability to change direction and reduced the risk of falls and injuries by improving postural control, but did not increase the H/Q measure of knee stability.

Differences in Function and Fracture Risk in Postmenopausal Women With and Without a Recent Distal Radius Fracture

A distal radius fracture (DRF) is commonly the first fracture to occur in early postmenopausal women. The reasons for sustaining a DRF may be related to fall risk, bone fragility, or both. The objective of this study was to compare functional and fracture risk status in postmenopausal women with and without a recent DRF and explore the relationships between function, grip strength, and fracture risk status. Seventy-seven women a ges 50-78 with (n = 32) and without (n = 45) a history of DRF in the past 2 years participated. Balance, timed up and go (TUG), gait velocity, balance confidence, sit to stand, grip strength, and fracture risk were assessed. There was a significant group difference after controlling for physical activity level (Pillai's Trace, p < .05) where women with DRF had poorer outcomes on sit to stand, gait velocity, TUG, and fracture risk status. Grip strength was associated with functional tests, particularly in women with DRF. Women with a recent DRF demonstrated lower functional status and higher fracture risk compared to women without. Grip strength was associated with measures of function and fracture risk, and may complement screening tools for this population.

Implementation of a fall screening program in a high risk of fracture population

Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling.

PURPOSE

Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care.

METHODS

The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise.

RESULTS

Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs.

CONCLUSIONS

Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people with osteoporosis screened positive for being at risk of falling, justifying integration of fall prevention into routine osteoporosis care.

An investigation of the use of the Kinect system as a measure of dynamic balance and forward reach in the elderly

OBJECTIVE

To investigate the reliability and correlations of Kinect-derived valuables of forward reach distance and velocity with the traditional functional reach distance, scores on posturography, and other measures of physical fitness.

DESIGN

Observational study.

SETTING

Community hospital.

SUBJECTS

Individuals >65 years who attended a geriatric health examination were enrolled.

MAIN MEASURES

The Kinect system was used to record the reach distance and velocity of the forward reach test. Center of pressure displacement was measured by posturography. Physical fitness performance was assessed using the 2-Minute Step Test, the 30-Second Chair Stand Test, the Sit-and-Reach Test, grip strength, and walking speed.

RESULTS

A total of 442 individuals were enrolled (mean age: 73.3 ± 5.2 years). Forward reach tracking using the Kinect system showed good repeatability and correlated with traditional functional reach ( r = 0.719, P < 0.001); the reaching velocity correlated with scores on posturography ( r = -0.257, P = 0.047). Reach distances were significantly decreased in the older group (≥75 years) than in the younger group (<75 years) ( P < 0.001).

CONCLUSION

The Kinect system provides a simple, reliable, and age-sensitive assessment of balance in older adults. The valuables correlate with the traditional functional reach, scores on posturography, and physical fitness performance. It provides alternative representation of both static and dynamic balance function.

Balance Training Programs in Athletes - a Systematic Review

It has become almost routine practice to incorporate balance exercises into training programs for athletes from different sports. However, the type of training that is most efficient remains unclear, as well as the frequency, intensity and duration of the exercise that would be most beneficial have not yet been determined. The following review is based on papers that were found through computerized searches of PubMed and SportDiscus from 2000 to 2016. Articles related to balance training, testing, and injury prevention in young healthy athletes were considered. Based on a Boolean search strategy the independent researchers performed a literature review. A total of 2395 articles were evaluated, yet only 50 studies met the inclusion criteria. In most of the reviewed articles, balance training has proven to be an effective tool for the improvement of postural control. It is difficult to establish one model of training that would be appropriate for each sport discipline, including its characteristics and demands. The main aim of this review was to identify a training protocol based on most commonly used interventions that led to improvements in balance. Our choice was specifically established on the assessment of the effects of balance training on postural control and injury prevention as well as balance training methods. The analyses including papers in which training protocols demonstrated positive effects on balance performance suggest that an efficient training protocol should last for 8 weeks, with a frequency of two training sessions per week, and a single training session of 45 min. This standard was established based on 36 reviewed studies.

Risk factors for hospital re-presentation among older adults following fragility fractures: a systematic review and meta-analysis

BACKGROUND

Older adults hospitalized with fragility fractures are at high risk of negative events that can culminate in re-presentations to hospital emergency departments or readmissions to hospital. This systematic review aimed to identify patient, clinical, or hospital-related factors that are identifiable at the index admission and that may be associated with re-presentations to hospital emergency departments or hospital readmissions in older adults following fragility fractures.

METHODS

Four electronic databases (PubMed, CINAHL, Embase, and Scopus) were searched. A suite of search terms identified peer-reviewed English-language articles that examined potential correlates of hospital re-presentation in older adults (mean age ≥ 65 years) who were discharged from hospital following treatment for fragility fractures. A three-stage screening process (titles, abstracts, full text) was conducted by two researchers independently. Participant characteristics, study design, potential correlates examined, analyses, and findings were extracted for studies included in the review. Quality and risk of bias were assessed with the Effective Public Health Practice Project Quality Assessment Tool. The strength of evidence was incorporated into a best evidence synthesis, and meta-analysis was conducted where effect pooling was possible.

RESULTS

Eleven of 35 eligible studies were categorized as high quality studies. These studies reported that age, higher Cumulative Illness Rating scores, American Society of Anesthesiologists scores > 3, longer length of stay, male sex, cardiovascular disease, low post-operative hemoglobin, kidney disease, dementia and cancer were factors identified at the index admission that were predictive of subsequent re-presentation to hospital. Age was the only predictor for which pooling of effects across studies was possible: pooling was conducted for re-presentation ≤ 30 days (pooled OR, 1.27; 95 % CI, 1.14-1.43) and > 30 days (pooled OR, 1.23; 95 % CI, 1.01-1.50).

CONCLUSIONS

The best-evidence synthesis, in addition to the meta-analysis, identified a range of factors that may have utility in guiding clinical practice and policy guidelines for targeted interventions to reduce the need for re-presentation to hospital among this frail clinical population. The paucity of studies investigating re-presentations to hospital emergency departments without admission was an important gap in the literature identified in this review. Key limitations were exclusion of non-English language studies and grey literature.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42015019379 .

Application of the health belief model and social cognitive theory for osteoporosis preventive nutritional behaviors in a sample of Iranian women

BACKGROUND

Osteoporosis is the most common metabolic bone disease. The purpose of this study is to investigate the health belief model (HBM) and social cognitive theory (SCT) for osteoporosis preventive nutritional behaviors in women.

MATERIALS AND METHODS

In this quasi-experimental study, 120 patients who were women and registered under the health centers in Fasa City, Fars Province, Iran were selected. A questionnaire consisting of HBM constructs and the constructs of self-regulation and social support from SCT was used to measure nutrition performance. Bone mineral density was recorded at the lumbar spine and femur. The intervention for the experimental group included 10 educational sessions of 55-60 min of speech, group discussion, questions and answers, as well as posters and educational pamphlets, film screenings, and PowerPoint displays. Data were analyzed using SPSS 19 via Chi-square test, independent t-test, and repeated measures analysis of variance (ANOVA) at a significance level of 0.05.

RESULTS

After intervention, the experimental group showed a significant increase in the HBM constructs, self-regulation, social support, and nutrition performance, compared to the control group. Six months after the intervention, the value of lumbar spine bone mineral density (BMD) T-score increased to 0.127 in the experimental group, while it reduced to -0.043 in the control group. The value of the hip BMD T-score increased to 0.125 in the intervention group, but it decreased to -0.028 in the control group.

CONCLUSIONS

This study showed the effectiveness of HBM and constructs of self-regulation and social support on adoption of nutrition behaviors and increase in the bone density to prevent osteoporosis.

Risk factors for hospital re-presentation among older adults following fragility fractures: protocol for a systematic review

BACKGROUND

After being discharged from hospital following the acute management of a fragility fracture, older adults may re-present to hospital emergency departments in the post-discharge period. Early re-presentation to hospital, which includes hospital readmissions, and emergency department presentations without admission may be considered undesirable for individuals, hospital institutions and society. The identification of modifiable risk factors for hospital re-representation following initial fracture management may prove useful for informing policy or practice initiatives that seek to minimise the need for older adults to re-present to hospital early after they have been discharged from their initial inpatient care. The purpose of this systematic review is to identify correlates of hospital re-presentation in older patients who have been discharged from hospital following clinical management of fragility fractures.

METHODS/DESIGN

The review will follow the PRISMA-P reporting guidelines for systematic reviews. Four electronic databases (PubMed, CINAHL, Embase, and Scopus) will be searched. A suite of search terms will identify peer-reviewed articles that have examined the correlates of hospital re-presentation in older adults (mean age of 65 years or older) who have been discharged from hospital following treatment for fragility fractures. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies will be used to assess the quality of the studies. The strength of evidence will be assessed through best evidence synthesis. Clinical and methodological heterogeneity across studies is likely to impede meta-analyses.

DISCUSSION

The best evidence synthesis will outline correlates of hospital re-presentations in this clinical group. This synthesis will take into account potential risks of bias for each study, while permitting inclusion of findings from a range of quantitative study designs. It is anticipated that findings from the review will be useful in identifying potentially modifiable risk factors that have relevance in policy, practice and research priorities to improve the management of patients with fragility fractures.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42015019379.

The Development and Validation of the Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia

OBJECTIVES

To develop and validate Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia.

METHODS

The OPAAT was modified from the Malaysian Osteoporosis Knowledge Tool and developed from an exploratory study on patients. Face and content validity was established by an expert panel. The OPAAT consists of 30 items, categorized into three domains. A higher score indicates higher knowledge level. English speaking non-osteoporotic postmenopausal women ≥ 50 years of age and pharmacists were included in the study.

RESULTS

A total of 203 patients and 31 pharmacists were recruited. Factor analysis extracted three domains. Flesch reading ease was 59.2. The mean ± SD accuracy rate was 0.60 ± 0.22 (range: 0.26-0.94). The Cronbach's α for each domain ranged from 0.286-0.748. All items were highly correlated (Spearman's rho: 0.761-0.990, p < 0.05), with no significant change in the overall test-retest scores, indicating that OPAAT has achieved stable reliability. Pharmacists had higher knowledge score than patients (80.9 ± 8.7 vs 63.6 ± 17.4, p < 0.001), indicating that the OPAAT was able to discriminate between the knowledge levels of pharmacists and patients.

CONCLUSION

The OPAAT was found to be a valid and reliable instrument for assessing patient's knowledge about osteoporosis and its prevention in Malaysia. The OPAAT can be used to identify individuals in need of osteoporosis educational intervention.

The impact of osteoporosis, falls, fear of falling, and efficacy expectations on exercise among community-dwelling older adults

PURPOSE

The purpose of this study was to test a model delineating the factors known to influence fear of falling and exercise behavior among older adults.

DESIGN AND METHODS

This was a secondary data analysis using baseline data from the Bone Health study. A total of 866 individuals from two online communities participated in the study: 161 (18.6%) were from SeniorNet and 683 (78.9%) were from MyHealtheVet. More than half (63%) of the participants were male with a mean age of 62.8 (SD = 8.5) years. The majority was White (89%) and married (53%) and had some college education (87%).

RESULTS

Knowledge about osteoporosis and awareness one has a diagnosis of osteoporosis directly influenced fear of falling, and knowledge of osteoporosis directly and indirectly influenced exercise behavior. A diagnosis of osteoporosis indirectly influenced exercise behavior. Taken together, the hypothesized model explained 13% of the variance in exercise behavior.

IMPLICATIONS

Improving knowledge of osteoporosis and awareness of having a diagnosis of osteoporosis, decreasing fear of falling, and strengthening self-efficacy and outcome expectations for exercise may help improve exercise behavior among older adults.

Low bone mineral density is associated with balance and hearing impairments

PURPOSE

Bone demineralization affects the skeletal system, including the temporal bone, which contains the cochlea and the vestibular labyrinth. However, research on the association of bone mineral density (BMD) with balance and hearing sensitivity is limited with conflicting results. Therefore, we examined the relationship in a population representative sample.

METHODS

We analyzed 8863 participants to the National Health and Nutrition Examination Survey (1999-2004) aged 40 years and older. Total and head BMD were measured by dual energy x-ray absorptiometry. Balance was evaluated using the Romberg Test of Standing Balance on Firm and Compliant Support Surfaces condition 4, also indicative of vestibular dysfunction. Hearing condition was self-reported. The associations of total and head BMD with balance and hearing were assessed using multiple and multinomial logistic regressions adjusting for covariates.

RESULTS

On multiple logistic regression, low total BMD was associated with balance impairment (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.43-4.75), especially in older adults (≥65 years old; OR, 3.72; 95% CI, 1.07-12.85). In multinomial regression, low total BMD was associated with report of significant hearing impairment in older adults (OR, 5.30; 95% CI, 1.20-23.26).

CONCLUSIONS

Low BMD is associated with balance and hearing impairments, especially in older adults.

Falls, osteoporosis, and hip fractures

Osteoporosis and falls are distinct conditions that share the potential clinical endpoint of fracture. This article explores the associations between osteoporosis and falls by examining the epidemiology, risk factors, risk prevention, and treatments. It outlines the evidence on falls prevention, osteoporosis diagnosis, and fracture risk assessment. It includes several studies that challenge the common view on the use of fall prevention tools, dual energy X-ray absorptiometry testing, and postfracture bisphosphonate treatment. By understanding the evidence, it becomes clearer how to target populations at risk, interpret screening methods, and promote disease prevention and treatment.

Integrated injury prevention program improves balance and vertical jump height in children

Implementing an injury prevention program to athletes under age 12 years may reduce injury rates. There is limited knowledge regarding whether these young athletes will be able to modify balance and performance measures after completing a traditional program that has been effective with older athletes or whether they require a specialized program for their age. The purpose of this study was to compare the effects of a pediatric program, which was designed specifically for young athletes, and a traditional program with no program in the ability to change balance and performance measures in youth athletes. We used a cluster-randomized controlled trial to evaluate the effects of the programs before and after a 9-week intervention period. Sixty-five youth soccer athletes (males: n = 37 mass = 34.16 +/- 5.36 kg, height = 143.07 +/- 6.27 cm, age = 10 +/- 1 yr; females: n = 28 mass = 33.82 +/- 5.37 kg, height = 141.02 +/- 6.59 cm) volunteered to participate and attended 2 testing sessions in a research laboratory. Teams were cluster-randomized to either a pediatric or traditional injury prevention program or a control group. Change scores for anterior-posterior and medial-lateral time-to-stabilization measures and maximum vertical jump height and power were calculated from pretest and post-test sessions. Contrary with our original hypotheses, the traditional program resulted in positive changes, whereas the pediatric program did not result in any improvements. Anterior-posterior time-to-stabilization decreased after the traditional program (mean change +/- SD = -0.92 +/- 0.49 s) compared with the control group (-0.49 +/- 0.59 s) (p = 0.003). The traditional program also increased vertical jump height (1.70 +/- 2.80 cm) compared with the control group (0.20 +/- 0.20 cm) (p = 0.04). There were no significant differences between control and pediatric programs. Youth athletes can improve balance ability and vertical jump height after completing an injury prevention program. Training specificity appears to affect improvements and should be considered with future program design.

Bone T-scores and functional status: a cross-sectional study on German elderly

Background

We explore the association between bone T-scores, used in osteoporosis diagnosis, and functional status since we hypothesized that bone health can impact elderly functional status and indirectly independence.

Methods

In a cross-sectional study (2005–2006) on community dwelling elderly (> = 75 years) from Herne, Germany we measured bone T-scores with Dual-energy X-ray Absorptiometry, and functional status indexed by five geriatric tests: activities of daily living, instrumental activities of daily living, test of dementia, geriatric depression score and the timed-up-and-go test, and two pooled indexes: raw and standardized. Generalized linear regression was used to determine the relationship between T-scores and functional status.

Results

From 3243 addresses, only 632 (19%) completed a clinical visit, of which only 440 (male∶female, 243∶197) could be included in analysis. T-scores (−0.99, 95% confidence interval [CI], −1.1–0.9) predicted activities of daily living (95.3 CI, 94.5–96.2), instrumental activities of daily living (7.3 CI, 94.5–96.2), and timed-up-and-go test (10.7 CI, 10.0–11.3) (P< = 0.05). Pooled data showed that a unit improvement in T-score improved standardized pooled functional status (15 CI, 14.7–15.3) by 0.41 and the raw (99.4 CI, 97.8–101.0) by 2.27 units. These results were limited due to pooling of different scoring directions, selection bias, and a need to follow-up with evidence testing.

Conclusions

T-scores associated with lower functional status in community-dwelling elderly. Regular screening of osteoporosis as a preventive strategy might help maintain life quality with aging.