Reduction of frontal plane knee load caused by lateral trunk lean depends on step width

Anderson, Jennifer; King, Stephanie; Przybyla, Andrzej; Ranganath, Lakshminarayan; Barton, Gabor

Abstract

The internal knee abduction moment (KAM) in osteoarthritis is reduced by increased lateral trunk lean (TL). Mechanistically, this occurs as the Centre of Mass (COM) moves further over the stance leg. Since the size of the base of support constrains the COM, an associated increase in step width (SW) would be expected to maintain stability. This study tested the effects of TL on SW and KAM in healthy participants (n = 21) who performed normal and 6° TL walks. The latter was controlled via audio-visual biofeedback. We found two distinct gait strategies in TL walk: widening the step width substantially ( > 50%) to permit an increase in the COM displacement (WSW, n = 13), or maintaining a baseline SW and minimally displacing the COM by moving the hip/pelvic complex in the opposite direction (NSW, n = 8). WSW doubled SW (11.3 ± 2.4 v. 24.7 ± 5.5 cm, p < .0001), NSW did not change SW (12.2 ± 2.8 v. 13.7 ± 4.7 cm, p > .05). These two distinct gait strategies resulted in unique patterns of KAM reduction across the stance phase. NSW reduced KAM impulse significantly in the initial half (0.08 ± 0.02 v. 0.06 ± 0.02, p =.04) but not in the later stance phase (0.07 ± 0.02 v. 0.07 ± 0.04, p > .05). WSW reduced KAM significantly in both initial (0.11 ± 0.03 v. 0.08 ± 0.04, p < .001) and later stance phase (0.09 ± 0.02 v. 0.06 ± 0.03, p < .001). KAM peak results followed the pattern of impulse. This study has revealed two distinct mechanisms for increasing lateral trunk lean which can be used to explain discrepancies in past research and in the future could be used to individualise gait re-training strategies.

Citation

Anderson, J., King, S., Przybyla, A., Ranganath, L., & Barton, G. (2018). Reduction of frontal plane knee load caused by lateral trunk lean depends on step width. Gait and Posture, 61, 483-487. https://doi.org/10.1016/j.gaitpost.2018.02.022

• Journal Article Type: Article
• Acceptance Date: Feb 20, 2018
• Online Publication Date: Feb 20, 2018
• Publication Date: 2018-03
• Deposit Date: Mar 21, 2018
• Publicly Available Date: Feb 21, 2019
• Journal: Gait and Posture
• Print ISSN: 0966-6362
• Electronic ISSN: 1879-2219
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 61
• Pages: 483-487
• DOI: https://doi.org/10.1016/j.gaitpost.2018.02.022
• Keywords: Gait retraining; Trunk sway; Knee abduction moment; Step width; Osteoarthritis
• Public URL: https://hull-repository.worktribe.com/output/750584
• Publisher URL: http://www.gaitposture.com/article/S0966-6362(18)30104-8/fulltext
• Related Public URLs: http://researchonline.ljmu.ac.uk/id/eprint/8137
• Additional Information: This article is maintained by: Elsevier; Article Title: Reduction of frontal plane knee load caused by lateral trunk lean depends on step width; Journal Title: Gait & Posture; CrossRef DOI link to publisher maintained version: http://dx.doi.org/10.1016/j.gaitpost.2018.02.022; Content Type: article; Copyright: © 2018 Elsevier B.V. All rights reserved.