Vertical ground reaction force during standing and walking: Are they related to bone mineral density left-right asymmetries?
Osteoporosis is a systemic skeletal disease that is characterized by reduced bone mass, deterioration of bone tissue and skeletal fragility. The purpose of the current study was to determine whether asymmetrical femur bone mineral density (BMD) is associated with asymmetrical gait and standing. We compared measures of gait and standing asymmetry in subjects with (n=38) and without (n=11) significant left-right differences in BMD. Participants walked for 72m at their comfortable speed and stood quietly for 60s while outfitted with pressure-sensitive insoles. Based on the pressure measurements, indices of standing and gait asymmetry were determined. Gait Asymmetry (GA) indices of maximum ground reaction force (GRF) and stance time were significantly higher in the asymmetrical BMD group, compared to the symmetrical group (p<0.03). During quiet standing, maximal GRF was twice as high in those with BMD asymmetry, compared to those without, although this difference was not statistically significant (p=0.10). These preliminary findings indicate that femur BMD asymmetry and gait asymmetry are interrelated in otherwise healthy adults. Nutrition, metabolism and lifestyle are known contributors to BMD; typically, they affect bone health symmetrically. We suggest, therefore, that the BMD asymmetry may be due to previous changes in the loading pattern during walking that might have led to asymmetric bone deterioration. Future larger scale and prospective studies are needed to identify the mechanisms underlying the relationship between standing, gait and BMD and to explore whether gait training and exercises that target gait symmetry might help to reduce BMD asymmetry.
Center for the study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Israel. Electronic address: marinab@tlvmc.gov.il.
Marina
M
Brozgol
Unit of Clinical Nutrition, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Mira
M
Arbiv
Center for the study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel.
Anat
A
Mirelman
Center for the study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Israel.
Talia
T
Herman
Center for the study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Physical Therapy, Sackler School of Medicine, Tel Aviv University, Israel.
Jeffrey M
JM
Hausdorff
Unit of Clinical Nutrition, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Nachum
N
Vaisman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena / Q000502:physiology*; D015519:Bone Density / Q000502:physiology*; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000503:physiopathology; D010865:Pilot Projects; D011187:Posture / Q000502:physiology*; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology*
Asymmetry; Bone mineral density; Femoral bone; Gait