Key characteristics of walking correlate with bone density in individuals with chronic stroke

Abstract

Abstract-Several recent studies of ambulatory stroke survivors have shown decreased bone mineral density (BMD) in the lower limbs and an elevated risk of hip fracture. Because bone mass is linked to skeletal loading, weight-bearing activities of daily living such as walking are considered critically important for maintenance of femoral BMD in ambulatory individuals. Little is known about the relationships between walking characteristics, skeletal loading, and bone maintenance in individuals who have experienced a stroke. This study determined whether certain gait-related parameters correlate with proximal femoral BMD in ambulatory individuals with poststroke walking deficits. We analyzed data from 33 individuals with chronic stroke and found that a recently introduced metric, the Bone Density Index, which incorporates body weight, number of steps per day, and ground reaction force magnitude, predicted proximal femoral BMD better than other commonly measured demographic and gait-related parameters that we examined.

Balance, falls, and bone health: Role of exercise in reducing fracture risk after stroke

“…This is consistent with the findings by Worthen et al, who developed the Bone Density Index to quantify gait-related skeletal loading [48]. The computation of the Bone Density Index incorporates ground reaction force magnitude as well as the number of loading cycles per day.…”

“…Following a stroke, individuals can have a multitude of impairments that result in compromised functional status, low physical activity, reduced use of the paretic arm and leg, and consequently bone loss overall that is greater on the paretic side. In persons with stroke, BMD on the paretic side has been correlated with muscle strength [38][39], muscle atrophy [38,40], degree of motor recovery [41][42][43][44], cardiovascular fitness [40], ability to perform functional activities [42,[44][45], walking ability [46], weight-bearing ability [47], and amount of skeletal loading [48]. The nonparetic side may also sustain a certain degree of bone loss that is less pronounced when compared with the paretic side [46][47]49].…”

“…The nonparetic side may also sustain a certain degree of bone loss that is less pronounced when compared with the paretic side [46][47]49]. Such bone changes on the nonparetic side may be due to changes in patterns of habitual use [48,50]. The clinical implication is that one may be able to enhance bone health by changing these associated factors, which primarily involve activity and limb use.…”

“…A large proportion of people living with stroke (>60%) are able to regain standing and some walking function [20]. The ground reaction force produced during walking and transfers thus provides a source of mechanical loading to the paretic leg [48]. In contrast, patients with stroke often use their nonparetic arm to compensate and develop "learned non-use" of the paretic upper limb despite recovery of motor ability [56][57].…”

Ground Reaction Force and Foot Pressure Analysis During Golf Iron Swing by Gender

“…운동역학적인 측면에서 골프와 같은 치기 운동에 서 좌-우 양발간의 체중의 이동은 각 분절의 순차적인 움직임 에 대한 결과로 해석되어져야 하지만 (Okuda, Armstrong, Tsunezumi & Yoshiiko, 2002), 좋은 스윙의 필요충분조건인 것 처럼 잘못 해석되어지는 경우도 있다 (Barrentine, Fleisig & Johnson, 1994;Koenig, Tamres & Mann, 1994;Wallace, Grimshaw & Asford, 1994). 운동역학적인 측면에서 지면반력(ground reaction force)은 인체의 움직임에 큰 역할을 함으로서, 지면반 력을 이용한 연구로서는 스포츠 동작 (Ball & Best, 2006;Parker, 2001), 자세제어 (Doyle, Hsiao-Wecksler, Ragan & Rosengren, 2006;Onell, 2000), 보행 (Veltink, Liedtke & van der Kooji, 2005), 신발 (Aguinaldo & Mahar, 2003), 재활의학 (Worthen et al, 2005), 무중력 상태의 움직임 (Schaffner et al, 2005) …”