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Effect of gait retraining for reducing ambulatory knee load on trunk biomechanics and trunk muscle activity

Nüesch, Corina and Laffer, Dominik and Netzer, Cordula and Pagenstert, Geert and Mündermann, Annegret. (2016) Effect of gait retraining for reducing ambulatory knee load on trunk biomechanics and trunk muscle activity. Gait & Posture, 47. pp. 24-30.

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Official URL: http://edoc.unibas.ch/58572/

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Abstract

The purpose of this study was to test the hypothesis that walking with increased medio-lateral trunk sway is associated with lower external knee adduction moment and lower extremity muscle activation, and higher external ipsilateral trunk moment and trunk muscle activity than walking with normal trunk sway in healthy participants. Fifteen participants performed walking trials with normal and increased medio-lateral trunk sway. Maximum trunk sway, first maximum knee adduction moment, lateral trunk bending moment, and bilateral vastus medialis, vastus lateralis, gluteus medius, rectus abdominis, external oblique and erector spinae muscle activity were computed. Walking with increased trunk sway was associated with lower maximum knee adduction moment (95% confidence interval (CI): 0.50-0.62Nm/kg vs. 0.62-0.76Nm/kg; P<.001) and ipsilateral gluteus medius (-17%; P=.014) and erector spinae muscle activity (-24%; P=.004) and greater maximum lateral trunk bending moment (+34%; P<.001) and contralateral external oblique muscle activity (+60%; P=.009). In all participants, maximum knee adduction moment was negatively correlated and maximum trunk moment was positively correlated with maximum trunk sway. The results of this study suggest that walking with increased trunk sway not only reduces the external knee adduction moment but also alters and possibly increases the load on the trunk. Hence, load-altering biomechanical interventions should always be evaluated not only regarding their effects on the index joint but on other load-bearing joints such as the spine.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Spinale Chirurgie (Schären)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Spinale Chirurgie (Schären)
03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Traumatologie / Orthopädie (Jakob)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Traumatologie / Orthopädie (Jakob)
03 Faculty of Medicine > Departement Biomedical Engineering > Biomechanics and Biomaterials
UniBasel Contributors:Mündermann, Annegret and Netzer, Cordula and Pagenstert, Geert and Nüesch, Corina
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1879-2219
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:05 Mar 2019 18:38
Deposited On:05 Mar 2019 18:38

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