Abstract
ABSTRACT The purpose of the study was to explore differences in the coronal biomechanics of the trunk, pelvis, hip, and knee joints, and gluteus medius muscle activity (GMed) during walking and step down from two riser heights. Joint kinematics and kinetics from 20 healthy participants were recorded using a 10-camera Qualisys system and force plates, and GMed EMG was recorded using a Delsys Trigno system. Hip abductor strength was measured using a hand-held dynamometer. Pelvic obliquity and lateral trunk bending excursions were significantly higher in walking than in step-down tasks. Significantly greater knee adduction moments were seen during both step-down tasks compared to level walking with significantly greater GMed activity. However, a significant interaction between side and task was seen for hip adduction moment, with step-down tasks showing lower hip moments than during walking, with greater peak hip moments being more apparent in the dominant limb. This suggests the GMed has a greater stabilizing role during the step-down tasks, although walking required a greater mechanical demand. Health professionals should expect to find less excursion of lateral trunk bending in step-down tasks compared to level walking and consider that GMed has different roles in these two tasks.
Highlights
Walking and step tasks are commonly used in activities of daily living and during rehabilitative programs
To have baseline data of the coronal plane movements and hip abductor strength in healthy adults, this study explored differences exist in the clinical assessment of hip strength, gluteus medius muscle activity (GMed) muscle activity, and coronal plane biomechanics of the trunk, pelvis, hip, and knee and whether differences exist between three clinical assessment tasks; walking, a 20 cm step down and 30 cm step down
The patterns of lateral trunk bending, pelvic obliquity, knee adduction moment, and GMed muscle activity were all similar between sides; this study showed no asymmetries in the measurements taken between the non-dominant limb (NDL) and dominant limb (DL)
Summary
Walking and step tasks are commonly used in activities of daily living and during rehabilitative programs. Powers (2003) identified that compensation of ipsilateral trunk bending in PFP contributed to an increase in knee abduction moment and greater stress on the patellar femoral joint. Asymmetries and greater movements are often noted and associated with clinical impairment, such as lateral trunk bending, pelvic drop, and knee valgus, and have been identified as a risk factor of injury development (Zhang et al 2008). Such trunk compensations have been identified in people with knee OA (Tanaka et al 2008), with greater knee adduction moments being linked to greater loading on the medial compartment of the knee
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