Differences in Walking Kinematics Between Genders During Disturbed Walking

Abstract

1065 Gender differences in lower extremity kinematic patterns that put the anterior cruciate ligament (ACL) at risk have been identified during jump landing and cutting, as well as lower level activities such as walking and jogging. Recent reports have suggested that both hip and knee motions may play significant roles in these at risk movement patterns. PURPOSE: To investigate differences in hip and knee movement patterns between genders during level walking with and without the application of an expected perturbation. METHODS: Twenty subjects (10 males, 10 females) who were regular participants in level I or II (e.g., jumping, cutting, and pivoting sports) sports underwent motion analysis while performing self-paced walking trials. Five trials were undisturbed, and five each with a platform translating either laterally or anteriorly at heel contact. Sagittal, frontal, and transverse plane hip motions as well as sagittal and frontal plane knee motions were measured during stance. A repeated measures MANOVA was used to assess motion, excursion and excursion rates during loading response for each combination of motions (sagittal plane hip and knee motion; transverse and frontal plane hip and frontal plane knee motions). RESULTS: Excursions resulting in knee positioning that places the ACL at risk in the frontal and transverse planes were greater at the hip and knee for females than males (p<0.05) in each walking condition. The rate of these excursions was significantly faster for females than males (p<0.05) suggesting that eccentric muscle demand for these motions was higher among female subjects. There was no difference for hip and knee position at initial contact between genders, and there was no difference in the amount of sagittal plane excursion for the hip and knee between genders. CONCLUSIONS: Females demonstrate kinematic characteristics during both normal and disturbed gait that may potentially contribute to increased ACL strain. Repetition of these potentially harmful movement patterns during provocative athletic maneuvers may lead to ACL injury. Injury prevention programs that implement eccentric muscle training for hip abductors and external rotators may aide in controlling excursion and excursion rates, thus reducing the risk for ACL injury. Supported by NIH Grant R01 HD037985-03.