The Relationship between Leg Extension Angle at Late Stance and Knee Flexion Angle at Swing Phase during Gait in Community-Dwelling Older Adults.

Takasuke Miyazaki,Hiroyuki Hayashi,Sota Araki,Naoto Higashi,Masayuki Kawada,Yasufumi Takeshita,Yuki Nakai,Ryoji Kiyama,Hyuma Makizako

doi:10.3390/ijerph182211925

Abstract

This study aimed to clarify the relationship between leg extension angle and knee flexion angle during gait in older adults. The subjects of this cross-sectional study were 588 community-dwelling older adults (74.6 ± 6.1 y). Segment angles and acceleration were measured using five inertial measurement units during comfortable gait, and bilateral knee and hip joint angles, and leg extension angle, reflecting whole lower limb extension at late stance, were calculated. Propulsion force was estimated using the increase in velocity calculated from anterior acceleration of the sacrum during late stance. Correlation analysis showed that leg extension angle was associated with knee flexion angle at swing phase and hip extension angle and increase in velocity at late stance (r = 0.444–508, p < 0.001). Multiple regression analysis showed that knee flexion angle at mid-swing was more affected by leg extension angle (β = 0.296, p < 0.001) than by gait speed (β = 0.219, p < 0.001) and maximum hip extension angle (β = −0.150, p < 0.001). These findings indicate that leg extension angle may be a meaningful parameter for improving gait function in older adults due to the association with knee kinematics during swing as well as propulsion force at late stance.

Highlights

Multiple regression analysis adjusted for age, sex, and gait speed showed that knee flexion angle at mid-swing was correlated with leg extension angle (β= 0.296, p < 0.001), hip extension angle at late stance (β = −0.150, p < 0.001), and gait speed
This study examined the relationships among leg extension angle, increase in velocity at late stance, and knee flexion angle at swing phase in community-dwelling older adults
We examined the relationships among leg extension angle and propulsion force at late stance, and knee flexion angle at mid-swing

Summary

Introduction

A functional gait is integral to performing daily activities and enhancing the quality of daily life [1,2]. For safe and efficient walking, sufficient propulsion force at late stance, an appropriate knee flexion angle at swing phase, and increased toe clearance are required [3,4]. Propulsion force and knee flexion angle are decreased by aging and neurological and orthopedic conditions, resulting in low gait performance and an increased risk of falling [4,5,6,7,8]. Propulsion force and knee flexion angle are widely used as key parameters to assess gait quality in gait training and gait rehabilitation in older adults [4]

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