Axial Thorax-Pelvis Coordination During Gait is not Predictive of Apparent Trunk Stiffness

Differential leg and trunk operation during skipping without and with hurdles in bipedal Japanese macaque

When locomoting bipedally at higher speeds, macaques preferred unilateral skipping (galloping). The same skipping pattern was maintained while hurdling across two low obstacles at the distance of a stride within our experimental track. The present study investigated leg and trunk joint rotations and leg joint moments, with the aim of clarifying the differential leg and trunk operation during skipping in bipedal macaques. Especially at the hip, the range of joint rotation and extension at lift off was larger in the leading than in the trailing leg. The flexing knee absorbed energy and the extending ankle generated work during each step. The trunk showed only minor deviations from symmetry. Hurdling amplified the differences and notably resulted in a quasi-elastic use of the leading knee and in an asymmetric operation of the trunk.

The effect of lumbopelvic region rotation relative flexibility on thorax-pelvis and pelvis-femur coordination during walking

BACKGROUND

Lumbopelvic region rotation relative flexibility (LRRF), which is defined as lumbopelvic region that is relatively less stiffness than the hip region, is associated with low back pain (LBP) symptoms. However, how LRRF is influenced by lumbopelvic region motion during walking is unclear.

RESEARCH QUESTION

What is the influence of LBP and LRRF on coordination patterns of the thorax, pelvis, and femur during walking?

METHODS

The presence of LRRF was determined based on whether the lumbopelvic rotation occurred in the first 50% of knee flexion or hip external rotation movement. Participants with LBP and LRRF were classified into the LBP group. Participants with LRRF but without LBP were classified into the early pelvis rotation (ROT) group, and those without LBP and relative flexibility were classified as controls. The thorax-pelvis coordination and pelvis-femur coordination during the stance cycles were calculated from the segmental angles obtained by three-dimensional motion analysis using a modified vector coding technique.

RESULTS

In the sagittal plane, the thorax-pelvis coordination of the LBP group showed more anti-phase patterns at both the early stance and midstance compared with controls and the ROT group. In the sagittal and horizontal planes, pelvis-femur coordination of the LBP and ROT groups showed more in-phase patterns during the early stance and midstance compared with controls.

SIGNIFICANCE

Regardless of LBP, the presence of LRRF alters the intersegmental coordination during walking. In individuals with LRRF, stiffness of the hip may increase during walking. People who have LRRF without LBP may develop LBP in the future, and it is important for prevention to identify these differences in kinematics during walking.

Coordination of Axial Trunk Rotations During Gait in Low Back Pain. A Narrative Review

Chronic low back pain patients have been observed to show a reduced shift of thorax-pelvis relative phase towards out-of-phase movement with increasing speed compared to healthy controls. Here, we review the literature on this phase shift in patients with low back pain and we analyze the results presented in literature in view of the theoretical motivations to assess this phenomenon. Initially, based on the dynamical systems approach to movement coordination, the shift in thorax-pelvis relative phase with speed was studied as a self-organizing transition. However, the phase shift is gradual, which does not match a self-organizing transition. Subsequent emphasis in the literature therefore shifted to a motivation based on biomechanics. The change in relative phase with low back pain was specifically linked to expected changes in trunk stiffness due to 'guarded behavior'. We found that thorax-pelvis relative phase is affected by several interacting factors, including active drive of thorax rotation through trunk muscle activity, stride frequency and the magnitude of pelvis rotations. Large pelvis rotations and high stride frequency observed in low back pain patients may contribute to the difference between patients and controls. This makes thorax-pelvis relative phase a poor proxy of trunk stiffness. In conclusion, thorax-pelvis relative phase cannot be considered as a collective variable reflecting the orderly behaviour of a complex underlying system, nor is it a marker of specific changes in trunk biomechanics. The fact that it is affected by multiple factors may explain the considerable between-subject variance of this measure in low back pain patients and healthy controls alike.

Trunk and leg kinematics of grounded and aerial running in bipedal macaques

Across a wide range of Froude speeds, non-human primates such as macaques prefer to use grounded and aerial running when locomoting bipedally. Both gaits are characterized by bouncing kinetics of the center of mass. In contrast, a discontinuous change from pendular to bouncing kinetics occurs in human locomotion. To clarify the mechanism underlying these differences in bipedal gait mechanics between humans and non-human primates, we investigated the influence of gait on joint kinematics in the legs and trunk of three macaques crossing an experimental track. The coordination of movement was compared with observations available for primates. Compared with human running, macaque leg retraction cannot merely be produced by hip extension, but needs to be supported by substantial knee flexion. As a result, despite quasi-elastic whole-leg operation, the macaque's knee showed only minor rebound behavior. Ankle extension resembled that observed during human running. Unlike human running and independent of gait, torsion of the trunk represents a rather conservative feature in primates, and pelvic axial rotation added to step length. Pelvic lateral lean during grounded running by macaques (compliant leg) and human walking (stiff leg) depends on gait dynamics at the same Froude speed. The different coordination between the thorax and pelvis in the sagittal plane as compared with human runners indicates different bending modes of the spine. Morphological adaptations in non-human primates to quadrupedal locomotion may prevent human-like operation of the leg and limit exploitation of quasi-elastic leg operation despite running dynamics.

UPPER BODY AXIAL ROTATIONS IN DIFFERENT AGE-GROUPS DURING LEVEL WALKING

High amplitude of movements in the lower body during walking is attenuated in the upper body to stabilize the head, which serves as the platform of critical sensory systems (vestibular and visual). The upper body attenuation has been investigated on the linear acceleration, however, not on the angular motion. This study aimed to compare the attenuation of axial rotation in different age-groups. Methods: Thirty healthy men (15 young and 15 elderly) participated in this study. Subjects walked on a level surface with gyro sensors attached at four locations of the back (pelvis, thorax, shoulder, and head), from which the angular motion was derived. Outcome measures included the average peak-to-peak amplitude of axial rotation at all sensor locations and the phase delay at each location with reference to the pelvis. Results: Age-position interaction was significant for both the amplitude and phase delay. Post hoc test revealed that rotation amplitude was similar at pelvis, thorax and shoulder in the elderly, whereas it was significantly reduced at the thorax-shoulder section in the young. The elderly also showed smaller phase delay at shoulder and head than those of the young. Discussion: The results suggest that the attenuation by upper trunk was reduced and the shoulder and head motions were more tightly coupled to the pelvis in the elderly, i.e., the upper body moved more like a rigid body in the axial motion.

Axial pelvis range of motion affects thorax-pelvis timing during gait

During gait, patients with pelvic girdle pain and low back pain demonstrate an altered phase relationship between axial thorax and pelvis rotations (thorax-pelvis relative phase). This could be the result of an increase in axial pelvis range of motion (ROM) which has been observed in these patients as well. To establish this relationship, we investigated if altered axial pelvis ROM during gait affects thorax-pelvis relative phase in 12 healthy subjects. These subjects walked on a treadmill and received real-time feedback on axial pelvis rotations. Subjects were asked to (1) walk normal, and walk with (2) decreased and (3) increased pelvis ROM. Gait speed and stride frequency were matched between trials. Subjects were able to increase pelvis ROM to a large extent, but the reduction in pelvis ROM was relatively small. Walking with large pelvis ROM resulted in a change in thorax-pelvis relative phase similar to that in pelvic girdle pain and low back pain. A forward dynamic model was used to predict the effect of manipulation of pelvis ROM on timing of thorax rotations independent of apparent axial trunk stiffness and arm swing amplitude (which can both affect thorax-pelvis relative phase). The model predicted a similar, even larger, effect of large axial pelvis ROM on thorax-pelvis relative phase, as observed experimentally. We conclude that walking with actively increased ROM of axial pelvis rotations in healthy subjects is associated with a shift in thorax-pelvis relative phase, similar to observations in patients with pelvic girdle pain and low back pain.