Institute for Physical Therapy Education, Widener University, Chester, PA 19013, USA.
Phys Ther. 2009 Dec;89(12):1315-26. doi: 10.2522/ptj.20080401. Epub 2009 Oct 15.
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.
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.
This study was an observational cohort design with participants assigned to groups on the basis of BMD status.
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.
Significant between-group differences were found for step time and stance time variability.
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.
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.
处于绝经早期且骨密度(BMD)较低的女性可能会因肌肉减少症和骨质疏松症而出现身体脆弱的早期标志物。
本研究旨在确定绝经早期且 BMD 较低的女性是否表现出身体机能下降,以及在步态变异性、跌倒和骨折率方面的差异。
这是一项观察性队列设计,参与者根据 BMD 状况分组。
共有 54 名女性参与了这项研究,其中 31 名女性的 BMD 较低,23 名女性的 BMD 正常。该研究在一所大学的研究机构进行。身体机能通过动态平衡评估(计时向后并足行走测试)、力量(等长股四头肌力量的手持测力计测量)和自由行走速度来测量。步态变异性是基于时空步态特征的变异系数进行评估的。在初始测试后的一年中评估跌倒和骨折情况。
在步时和站立时间变异性方面发现了显著的组间差异。
本研究的局限性包括基于过去 2 年内最近一次骨密度扫描的结果进行分组。
处于绝经早期且 BMD 较低的女性在步时和站立时间变异性方面表现出更大的步态变异性,但在平衡、力量或行走速度方面没有差异。与更典型的身体机能测量相比,步态变异性可能更敏感,能够检测到绝经早期且 BMD 较低或不较低的女性之间的差异。