Key characteristics of walking correlate with bone density in individuals with chronic stroke

Several recent studies of ambulatory stroke survivors have shown decreased bone mineral density (BMD) in the lower limbs and an elevated risk of hip fracture. Because bone mass is linked to skeletal loading, weight-bearing activities of daily living such as walking are considered critically important for maintenance of femoral BMD in ambulatory individuals. Little is known about the relationships between walking characteristics, skeletal loading, and bone maintenance in individuals who have experienced a stroke. This study determined whether certain gait-related parameters correlate with proximal femoral BMD in ambulatory individuals with poststroke walking deficits. We analyzed data from 33 individuals with chronic stroke and found that a recently introduced metric, the Bone Density Index, which incorporates body weight, number of steps per day, and ground reaction force magnitude, predicted proximal femoral BMD better than other commonly measured demographic and gait-related parameters that we examined.