Perceived pain, fear of falling and physical function in women with osteoporosis

The aim of this cross-sectional study was to evaluate pain intensity-related differences in physical performance and fear of falling in elderly women with osteoporosis. A sample of 82 osteoporotic women (73.8±8.1 years) with and without vertebral fractures was included. Numeric rating scale (NRS) measures (0=no pain, 10=unbearable) were applied to obtain actual pain intensity and to stratify between patients with mild (0-3), moderate (4-6) and severe (7-10) pain. Activity-related fear of falling was evaluated with the Falls Efficacy Scale-International Version (FES-I). Physical performance measures included maximum voluntary quadriceps strength, postural sway and gait speed measures. Controlling for age, fractures, and history of falls ANCOVA with Scheffe's post hoc test indicated significant slower walking velocities and greater postural sway for patients with severe pain. Furthermore, significant group differences could be detected for muscle strength and fear of falling. Patients with more intense pain (NRS≥5) were 6.4 times (odds ratio; 95%CI: 1.5-26.7) more likely to score below average in fall-related self-efficacy and all physical performance tests. Among women with osteoporosis, heightened back pain intensity increases fear of falling and decreases physical performance irrespective of vertebral fractures and history of falls.