Relationship between stair ascent gait speed, bone density and gait characteristics of postmenopausal women.

Abstract

Stair ascent is a biomechanically challenging task for older women. Bone health may affect gait stability during stair walking. This study investigated the gait biomechanics associated with stair ascent in a group of postmenopausal women in relation to walking speed and bone health, quantified by T-score. Forty-five healthy women (mean (SD) age: 67 (14) years), with bone density ranging from healthy to osteoporotic (T-score range +1 to -3), ascended a custom-made five-step staircase with two embedded force plates, surrounded by 10 motion capture cameras, at their self-selected speed. Multivariate regression analyses investigated the explained variance in gait parameters in relation to stair ascent speed and T-score of each individual. Stair ascent speed was 0.65 (0.1) m·s-1 and explained the variance (R2 = 9 to 47%, P ≤ 0.05) in most gait parameters. T-score explained additional variance in stride width (R2 = 20%, P = 0.014), pelvic hike (R2 = 19%, P = 0.011), pelvic drop (R2 = 21%, P = 0.007) and hip adduction (R2 = 7%, P = 0.054). Increased stride width, and thereby a wider base of support, accompanied by increased frontal plane hip kinematics, could be important strategies to improve dynamic stability during stair ascent among this group of women. These findings suggest that targeted exercises of the hip abductors and adductors, including core trunk musculature, could improve dynamic stability during more challenging locomotor tasks. Balance exercises that challenge base of support could also benefit older women with low bone mineral density who may be at risk of falls.