Three-dimensional analysis of gait in postmenopausal women with low bone mineral density

Abstract

BackgroundThere's lack in the literature respecting changes in the trunk and hip angles, and power profile of the lower extremities in postmenopausal women with low bone mineral density (BMD). Therefore, this study aimed to examine gait characteristics of that population, and find out which characteristics may be predictors to BMD. This may provide suitable interventions for subjects with osteoporosis.MethodsSeventeen healthy postmenopausal women and seventeen with low BMD engaged in this study. Dual X-ray Absorbiometry measured BMD at lumber (L2–4) and femoral neck. Qualysis gait analysis system assessed the gait pattern of each subject.ResultsCompared to healthy peers, women with low BMD showed less trunk rotation (p = 0.02), hip adduction (p = 0.005) and extension moments (p = 0.008). They showed less hip power generation during early stance (H1S) (p = 0.000), and swing phase (H3S) (p = 0.005), and less hip power absorption (H2S) (p = 0.005). They also, showed less knee power absorption during terminal swing (K4S) (p = 0.002), and ankle power generation at push off (A2S) (p = 0.000). The ability of the gait variables to discriminate between subjects with or without osteopenia was (0.72%, p = 0.016) for trunk rotation, (78%, p = 0.0004) for hip adductor moment, (76%, p = 0.0013) for hip extensor moment, (87%, p < 0.0001) for H1S, (79%, p = 0.0001) for H2S, (77%, p = 0.0008) H3S, (81%, p = 0.0001) for K4S, and (93%, p < 0.0001) for A2S.ConclusionLess power generation at the hip and ankle as well as, less power absorption at the hip and knee, may suggest that postmenopausal women with low BMD showed less propulsion, and stability during walking. Trunk rotation, hip adduction and extension moments, H1S, H2S, H3S, K4S, and A2S are significant predictors for low bone mass in the postmenopausal women.

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

“…In that research, the authors asserted that reduced hip extension moment and related eccentric hip work may reduce stress on the lumbar region, thus resulting in bone loss. Also, elderly women with low BMD reportedly preserve trunk rotation in the sagittal and coronal planes, and hip angles in three-dimensional planes [5,15]. This is consistent with the lack of significant difference in conventional gait parameters such as cadence and walking speed between low BMD and normal BMD subjects.…”

“…Using kinetic analysis, previous research has characterized postmenopausal women with low BMD with reduced external hip extension and adduction moments, power generation at the hip and ankle, and power absorption at the hip and knee [5]. In that research, the authors asserted that reduced hip extension moment and related eccentric hip work may reduce stress on the lumbar region, thus resulting in bone loss.…”

“…Such elderly women tend to show reductions in muscle mass and strength, which may affect gait patterns [3,4]. A recent kinetic study demonstrated decreased external hip extension and adduction moments, power generation at the hip and ankle, or hip and knee in postmenopausal women with low BMD compared to normal BMD subjects [5]. These findings support the idea of strengthening these muscle groups for improving gait patterns of elderly women to prevent them from falling [6].…”

Effects of short-term Nordic walking training on sarcopenia-related parameters in women with low bone mass: a preliminary study

“…It is generally known that elderly women with low bone mineral density show changes in gait,48 greater postural imbalance, and a greater predisposition to falls 49. Therefore, exercises aimed at strengthening muscles, tai chi, and general walking are recommended to increase balance and functional mobility.…”

Relationships between walking speed, T-score and age with gait parameters in older post-menopausal women with low bone mineral density

“…Temporal-spatial data do not examine the complex interactions between joint movements and mechanical power outputs by the muscles acting about the hip, knee and ankle joints during walking [14]. There is limited evidence of altered gait profiles for older women with low BMD including less hip extension, reduced power generation at the hip in early stance (termed H1 power burst [15]) and pre-swing (H3), less knee power absorption during terminal swing (K4) and smaller ankle power generation at push-off (A2) in comparison with women with normal BMD [16]. Nevertheless, there is a dearth of knowledge on the gait biomechanics of older women with low BMD and osteoporosis.…”