The Relationship Between Postural Balance, Posture and Postural Awareness in Patients Diagnosed with Osteoporosis

Abstract

Objective: Osteoporosis, characterized by low bone mass and microarchitectural deterioration, leads to increased fracture risk. Beyond skeletal fragility, it is associated with postural deformities, balance impairments, and potentially diminished postural awareness, which are critical factors for fall prevention. This study aims to investigate the relationship between postural balance, posture, and postural awareness in postmenopausal women diagnosed with osteoporosis compared to those with osteopenia. Materials and Methods: A cross-sectional study was conducted with 32 postmenopausal women (osteoporosis, n=16; osteopenia, n=16). Participants were assessed using the timed up and go (TUG) test for functional mobility, the Berg balance scale (BBS) for balance, the New York posture scale (NYPS) for postural alignment, and the postural awareness scale (PAS) for body awareness. Bone mineral density was determined by lumbar spine T-scores. Statistical analyses included the Mann-Whitney U test for group comparisons and Spearman's correlation to examine relationships between variables. Results: The osteoporosis group demonstrated significantly lower postural awareness (PAS), poorer balance (BBS), longer TUG times, and more postural deviations (NYPS) compared to the osteopenia group (p<0.05), despite similar age and body mass index. Lumbar T-scores were significantly correlated with better PAS, BBS, and NYPS scores (p<0.01), and negatively correlated with TUG times (p<0.01), with stronger correlations observed in the osteoporosis group. A significant proportion of the osteoporosis group was classified as having low awareness, high fall risk, and poor posture. Conclusion: Osteoporosis is associated with significantly impaired postural awareness, poorer postural alignment, and reduced balance compared to osteopenia. The strong correlations between bone mineral density and functional parameters underscore the interconnection between skeletal and neuromuscular health. These findings highlight the necessity of integrating functional assessments and targeted interventions, such as balance training and postural awareness education, into standard osteoporosis management to reduce fall risk and improve quality of life.