Rubin Daniela A, Holmes Skylar C, Ramirez Jacqueline, Garcia Steven A, Shumski Eric J, Pamukoff Derek N
California State University, Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, United States.
University of Massachusetts Amherst, 30 Eastman Lane, Amherst, MA 01003, United States.
Bone Rep. 2023 Jul 17;19:101700. doi: 10.1016/j.bonr.2023.101700. eCollection 2023 Dec.
The incidence of osteopenia and osteoporosis is of concern in adults with Prader-Willi syndrome (PWS). Walking generates reaction forces that could stimulate bone mineralization and is popular in people with PWS. This study compared bone parameters and ground reaction forces (GRF) during gait between young adults with PWS and without PWS and explored associations between bone and GRFs during gait.
10 adults with PWS, 10 controls with obesity (OB) and 10 with normal weight (NW) matched on sex participated. Segmental and full body dual-energy x-ray absorptiometry scans provided femoral neck, spine, total body minus the head bone mineral density (BMD), bone mineral content (BMC). Vertical GRF, vertical impulse, posterior force and negative impulse were measured during 5 walking trials at a self-selected speed along a 10 m runway.
Multivariate analyses of variance showed that adults with PWS ( = 7-8) had hip and body BMD and BMC comparable ( > .050) to NW and lower ( < .050) than OB. Adults with PWS showed slower speed than NW (p < .050) but similar to OB ( > .050). Adults with PWS presented lower absolute vertical GRF, vertical impulse and negative impulse than OB ( < .050). Pearson r correlations ( < .050) in those with PWS (n = 7-8) indicated that femoral neck BMC was associated with vertical GRF ( = 0.716), vertical impulse ( = 0.780), posterior force ( = -0.805), and negative impulse ( = -0.748). Spine BMC was associated with speed ( = 0.829) and body BMD was associated with speed ( = 0.893), and posterior force ( = -0.780).
Increased BMC in the femoral neck and body were associated with larger breaking forces during walking, a phenomenon normally observed at greater gait speeds. Faster walking speed was associated with greater BMC in the spine and body. Our preliminary results suggest that young adults with PWS could potentially benefit from faster walking for bone health; however, larger prospective studies are needed to confirm this.
普拉德-威利综合征（PWS）成人患者中骨质减少和骨质疏松的发病率令人担忧。行走会产生可刺激骨矿化的反作用力，且在PWS患者中很常见。本研究比较了患有PWS和未患PWS的年轻成人在步态期间的骨参数和地面反作用力（GRF），并探讨了步态期间骨与GRF之间的关联。
纳入10名患有PWS的成人、10名肥胖（OB）对照者和10名体重正常（NW）对照者，所有参与者按性别匹配。通过分段和全身双能X线吸收法扫描测量股骨颈、脊柱、去除头部后的全身骨矿物质密度（BMD）、骨矿物质含量（BMC）。在沿着10米跑道以自选速度进行的5次步行试验中，测量垂直GRF、垂直冲量、后向力和负向冲量。
多变量方差分析显示，患有PWS的成人（年龄=7 - 8岁）的髋部和身体BMD及BMC与NW相当（P>0.050），但低于OB（P<0.050）。患有PWS的成人行走速度比NW慢（P<0.050），但与OB相似（P>0.050）。患有PWS的成人的绝对垂直GRF、垂直冲量和负向冲量低于OB（P<0.050）。在患有PWS的成人（n = 7 - 8）中，Pearson相关系数（P<0.050）表明，股骨颈BMC与垂直GRF（r = 0.716）、垂直冲量（r = 0.780）、后向力（r = -0.805）和负向冲量（r = -0.748）相关。脊柱BMC与速度相关（r = 0.829），身体BMD与速度相关（r = 0.893），也与后向力相关（r = -0.780）。
股骨颈和身体中BMC的增加与行走时更大的破断力相关，这一现象通常在更快的步态速度下观察到。更快的行走速度与脊柱和身体中更大的BMC相关。我们的初步结果表明，患有PWS的年轻成人可能会从更快的行走中受益于骨骼健康；然而，需要更大规模的前瞻性研究来证实这一点。
