Posture Stability and Kinematics While Performing a 180° Turning Step in Elderly Individuals With and Without Vertebral Compression Fracture and in Middle-Aged Adults

Purpose: Older adults with vertebral compression fracture (VCF) have spinal malalignment with large postural sway while standing. The purposes of this study identified the turning strategy of patients with VCF while walking. Methods: The study enrolled 18 adults with VCF (VCF group) and 29 older adults (OA group) and 15 middle-aged adults (MA group) without spinal deformity. The Biodex balance system was employed to assess posture stability. An inertia motion system recorded kinematic data during walking. The 180° turning step before sitting was divided into braking, mid-stance, swing, and terminal loading phases for kinematic analysis. Results: Posture stability score showed that the VCF group achieved the lowest stability. The patients with VCF used slower acceleration and less mobility of the head and spine when turning. However, the VCF group had a larger hip abduction range of motion than the OA group; the OA group exhibited larger thoracic rotation than the MA and VCF groups. The VCF group exhibited less gait stability and coordination between the head and thigh on the sagittal plane than the other groups. Additionally, the VCF group had greater head/lower spine acceleration variability on the frontal plane. Kinematic joint modulations were required, depending on the phase of the turn step. Conclusion: The patients with VCF depend more heavily on a hip strategy to maintain gait stability than do other adult groups. To address gait stability and prevent falls for the patients with VCF, a training program should include balance, trunk mobility, and hip abductor muscle strength training.