Influence of Walking Modification Strategies on Frontal Plane Hip Joint Moment and Gait Naturalness in Healthy Adults

Abstract

OBJECTIVE: To evaluate the effects of lateral trunk lean and step width modification on hip adduction moment in healthy participants and examine their influence on walking naturalness. METHODS: Ten healthy participants underwent gait analysis under 4 walking conditions: natural walking, large trunk lean, doubled step width, and combined modification with slight trunk lean and 1.5 times step width. Early stance and late stance hip adduction moment were analyzed and compared using repeated-measures analysis of variance. Subjective naturalness of gait was also recorded. RESULTS: We observed a significant effect of walking condition on the hip adduction moment during early stance (F3,36 = 6.665, P = .001) and gait naturalness (F3,36 = 30.519, P<.001), but not hip adduction moment during late stance ( P = .733). Pairwise comparison indicated significantly reduced hip adduction moment during early stance with large trunk lean when compared to natural walking (36.7% less, P = .002, Cohen’s d = −1.41). Both combined and doubled step width modifications did not yield the expected hip adduction moment reduction ( P>.296). The perceived naturalness of the doubled step width modification was most comparable to natural walking ( P = .529), while the trunk lean modification was significantly less natural than natural walking and the least natural modification overall (81.1% less, P<.001, Cohen’s d = −4.34). CONCLUSION: Although trunk lean modification effectively reduces hip joint loading, it is perceived as the least natural pattern. Step width was more challenging to modify than trunk lean. JOSPT Open 2024;2(4):306-314. Epub 7 August 2024. doi:10.2519/josptopen.2024.0463