Knee Biomechanics of Alternate Stair Ambulation Patterns

• Autores: Samantha M. Reid, Scott K. Lynn, Reilly P. Musselman, Patrick Costigan
• Localización: Medicine & Science in Sports & exercise: Official Journal of the American College of Sports Medicine, ISSN 0195-9131, Vol. 39, Nº. 11, 2007, págs. 2005-2011
• Idioma: inglés
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• Resumen

  • Purpose: This study compared the kinematics and kinetics of the knee joint during traditional step-over-step (SOS) and compensatory step-by-step lead-leg (SBSL) and trail-leg (SBST) stair ambulation patterns.

    Methods: Seventeen (M:9) healthy adults completed five trials of ascent and descent using three different stepping patterns: 1) SBSL, 2) SBST, and 3) SOS. Kinematics and kinetics were collected with an optoelectronic motion-tracking system and a force plate embedded into a four-step staircase. An inverse-dynamics link-segment model (QGAIT system) was used to calculate the net joint kinetics.

    Results: During stair ascent, different peak anteroposterior (AP) forces were observed across all three stepping patterns (SOS > SBSL > SBST, P < 0.05). During ascent, the flexion moments of SOS (0.96 N[middle dot]m[middle dot]kg-1) and SBSL (0.97 N[middle dot]m[middle dot]kg-1) patterns were similar and much larger than the SBST moments (0.14 N[middle dot]m[middle dot]kg-1). In the descent conditions, the initial AP peak force for SOS was larger than that of SBSL and SBST. However, the second peak force for SOS (4.92 N[middle dot]kg-1) and SBST (4.68 N[middle dot]kg-1) were larger than SBSL (1.57 N[middle dot]kg-1). During descent, the initial peak flexion moment for the SOS pattern was larger than SBSL and SBST, whereas during the second peak, SOS (1.05 N[middle dot]m[middle dot]kg-1) and SBST (1.11 N[middle dot]m[middle dot]kg-1) were no different and larger than SBSL (0.18 N[middle dot]m[middle dot]kg-1).

    Conclusion: Overall, SBSL during ascent and SBST during descent had the highest loads. These results increase our understanding of alternative stepping patterns and have important clinical (reduction of loading on injured/diseased leg) and rehabilitation implications.