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Gait Variability Detects Women in Early Postmenopause With Low Bone Mineral Density

Kerstin M. Palombaro, Laurita M. Hack, Kathleen Kline Mangione, Ann E. Barr, Roberta A. Newton, Francesca Magri, Theresa Speziale
DOI: 10.2522/ptj.20080401 Published 1 December 2009
Kerstin M. Palombaro
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Laurita M. Hack
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Kathleen Kline Mangione
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Ann E. Barr
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Roberta A. Newton
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Francesca Magri
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Theresa Speziale
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Abstract

Background Women in early postmenopause and with low bone mineral density (BMD) may exhibit early markers for physical frailty as a result of sarcopenia and osteopenia.

Objective The purpose of this study was to determine whether women in early postmenopause and with low BMD exhibit decreased physical performance and differences in gait variability and fall and fracture rates.

Design This study was an observational cohort design with participants assigned to groups on the basis of BMD status.

Methods Fifty-four women, 31 with low BMD and 23 with normal BMD, participated. This study was conducted in a university research facility. Physical performance was measured by assessment of dynamic balance (timed backward tandem walk test), strength (handheld dynamometry of isometric quadriceps muscle force production), and free gait speed. Gait variability was assessed on the basis of the coefficient of variation for temporal-spatial gait characteristics. Falls and fractures were assessed for the year after initial testing.

Results Significant between-group differences were found for step time and stance time variability.

Limitations The limitations of this study included group assignment on the basis of the results of the most recent bone density scan within the preceding 2 years.

Conclusions Women in early postmenopause and with low BMD exhibited increased gait variability in step time and stance time but did not exhibit differences in balance, strength, or gait speed. Gait variability may be more sensitive for detecting differences in women in early postmenopause and with or without low BMD than more typical measures of physical performance.

Footnotes

  • Dr Palombaro, Dr Hack, Dr Mangione, Dr Barr, and Dr Newton provided concept/idea/research design and writing. Dr Palomaro provided data collection, project management, fund procurement, and participants. Dr Palombaro, Dr Hack, Dr Magri, and Dr Speziale provided data analysis. Dr Hack provided facilities/equipment. Dr Hack and Dr Newton provided institutional liaisons. Dr Hack, Dr Mangione, Dr Barr, and Dr Newton provided consultation (including review of manuscript before submission).

  • This study was conducted in partial fulfillment of Dr Palombaro's doctoral degree.

  • The institutional review boards for the protection of human subjects of Arcadia University, Widener University, and Temple University approved the examination procedures before data collection.

  • This study was funded, in part, by grants from the Pennsylvania Physical Therapy Association and the Section on Women's Health of the American Physical Therapy Association.

  • A poster containing the physical performance data was presented at the Pennsylvania Physical Therapy Association Annual Conference; October 26–28, 2007; Pittsburgh, Pennsylvania.

  • Received December 16, 2008.
  • Accepted August 3, 2009.
  • © 2009 American Physical Therapy Association
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Vol 96 Issue 12 Table of Contents
Physical Therapy: 96 (12)

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Gait Variability Detects Women in Early Postmenopause With Low Bone Mineral Density
Kerstin M. Palombaro, Laurita M. Hack, Kathleen Kline Mangione, Ann E. Barr, Roberta A. Newton, Francesca Magri, Theresa Speziale
Physical Therapy Dec 2009, 89 (12) 1315-1326; DOI: 10.2522/ptj.20080401

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Gait Variability Detects Women in Early Postmenopause With Low Bone Mineral Density
Kerstin M. Palombaro, Laurita M. Hack, Kathleen Kline Mangione, Ann E. Barr, Roberta A. Newton, Francesca Magri, Theresa Speziale
Physical Therapy Dec 2009, 89 (12) 1315-1326; DOI: 10.2522/ptj.20080401
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