Walking and postural balance in adults with severe short stature due to isolated GH deficiency

Abstract

Objectives Walking and postural balance are extremely important to obtain food and to work. Both are critical for quality of life and ability to survive. While walking reflects musculoskeletal and cardiopulmonary systems, postural balance depends on body size, muscle tone, visual, vestibular and nervous systems. Since GH and IGF-I act on all these systems, we decided to study those parameters in a cohort of individuals with severe short stature due to untreated isolated GH deficiency (IGHD) caused by a mutation in the GHRH receptor gene. These IGHD subjects, despite reduction in muscle mass, are very active and have normal longevity. Methods In a cross-sectional study, we assessed walking (by a 6-min walk test), postural balance (by force platform) and fall risk (by the 'Timed Up and Go' test) in 31 IGHD and 40 matched health controls. Results The percentage of the walked distance measured in relation to the predicted one was similar in groups, but higher in IGHD, when corrected by the leg length. Absolute postural balance data showed similar velocity of unipodal support in the two groups, and better values, with open and closed eyes and unipodal support, in IGHD, but these differences became non-significant when corrected for height and lower-limb length. The time in 'Timed Up and Go' test was higher in IGHD cohort, but still below the cut-off value for fall risk. Conclusion IGHD subjects exhibit satisfactory walking and postural balance, without increase in fall risk.

Unveiling the Chaos in Postural Control in Adults with Achondroplasia

“…Sample size was calculated based on power analysis using G*Power software (Franz Faul, Edgar Erdfelder, Axel Buchner, Universität Kiel, Kiel, Germany, version 3.1.9.6) [ 23 ]. With α = 0.05 and a power of 0.90, a minimum sample size of 15 individuals was needed to achieve a large effect size (d = 0.8).…”

“…Postural balance depends on body size and muscle tone as well as the visual, vestibular, somatosensory, and central nervous systems [ 23 , 24 ]. Previous studies in the general population have identified altered integration of somatosensory inputs in sedentary men with a high total fat mass percentage.…”

The state of Sergipe contribution to GH research: from Souza Leite to Itabaianinha syndrome

“…Not surprisingly, there were no reports of spontaneous fractures in this cohort, and the prevalence of vertebral fracture was reduced in older IGHD individuals compared to age-matched controls ( 50 ). They presented satisfactory walking and postural balance with no increased risk of falling ( 51 ), although they had moderate peripheral vestibular impairment ( 52 ) without clinical consequences, as they were quite active in agriculture, horseback riding, and sports.…”

Growth Hormone and Aging: New Findings

“…In addition, one subject who had GH replacement therapy earlier in her life, developed an ependymoma and appears to be tumor-free after surgical treatment. It was also shown that subjects with this syndrome have a reduction in sleep quality with no subjective consequences on the quality of life [ 67 ], deeper periodontal pockets with locally increased levels of several immune mediators [ 68 ], as well as higher prevalence of modest vestibular impairment and abnormal vestibular ocular reflex, likely related to the reported dizziness but without negative effects on postural balance or fall risk [ 69 ]. Furthermore, IGHD subjects had improved insulin sensitivity (ower homeostatic model assessment for insulin resistance [HOMA-IR], reduced creatine phosphokinase [CPK], higher C-reactive protein [CRP], lower sweating, normal vitamin D levels, and normal phosphorus: calcium homeostasis [ 70 ].…”