Assessment of Gait Symmetry in Elderly Women with Low Bone Mineral Density Using a Portable Trunk Accelerometer: A Pilot Study

Abstract

BackgroundConvincing evidence regarding gait and balance function in elderly women with low bone mineral density (BMD) and/or osteoporosis is limited. In the present study, we aimed to compare the gait characteristics in elderly women with and without low BMD and to analyze plausible parameter(s) for predicting low BMD.Material/MethodsWe retrospectively analyzed prospectively collected data of 26 consecutive postmenopausal women aged >65 years who were admitted to our geriatric outpatient service. They were assigned to 2 groups, with (n=14) and without (n=12) low BMD based on T-score (<−1 standard deviation of the mean for healthy adults) of dual-energy X-ray absorptiometry. We compared gait parameters derived from a portable Tri-Axial trunk accelerometer that included cadence, walking speed, average acceleration, horizontal/vertical displacement ratio, and symmetry index of the Lissajous figure (LI) during a 5-meter walk test at comfortably fast speed between groups.ResultsWomen with low BMD tended to show increased LI compared with healthy subjects (P=0.04). No statistically significant differences were noted in cadence, walking speed, average acceleration, and ratio of horizontal and vertical displacement (P>0.05). Receiver operating characteristic curve analysis demonstrated that LI can predict low BMD in the femur neck with moderate accuracy (area under the curve=0.75, 95% confidence interval 0.55–0.95; P=0.031). The optimal cut-off value was 17%, with 67% specificity and 86% sensitivity.ConclusionsThese results suggest that elderly women with low BMD may walk with asymmetrical trunk movement, but they are able to generate gait patterns similar to healthy peers. The LI may provide valuable quantitative information for preventing fractures in subjects with osteoporosis.

Hypoperfusion in the posterior cingulate cortex is associated with lower bone mass density in elderly women with osteopenia and Alzheimer’s disease

“…Bone mineral density was measured the year prior to entry into the study using whole‐body DXA (QDR 4500a, Hologic) performed at the Tohoku University Hospital as part of the routine clinical examination. The same protocol was used in all cases . DXA can provide both total and regional body composition through a three‐compartment method that distinguishes total bone mineral content from soft tissue.…”

“…Postmenopausal women are more susceptible to osteoporosis because of reduced estrogen levels . As they age, women tend to show greater changes in muscle strength and mass than men, which affects gait patterns and increases the risk of falls and fractures . Moreover, lower BMD in postmenopausal women is significantly associated with cognitive impairment …”

Voxel-Based Morphometry Reveals a Correlation Between Bone Mineral Density Loss and Reduced Cortical Gray Matter Volume in Alzheimer’s Disease

“…BMD and Skeletal Muscle Index (SMI) Measurements With DXA BMD and skeletal muscle index (SMI) were measured from a single protocol on a whole-body DXA machine (QDR 4500a, Hologic Inc., Bedford, MA, USA; Kunitoki et al, 2019;Takano et al, 2019Takano et al, , 2020. DXA can provide both total and regional body composition through a three-compartment method that distinguishes total bone mineral content from soft tissue.…”