The effects of differences on sagittal kinematics and muscle coordination during step up and step down in patients with spinal stenosis.
BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects swing limb angles and stance limb muscle activities. Therefore, we investigated the effects of differences in step up (SU) and step down...
| Publicado en: | Journal of Back & Musculoskeletal Rehabilitation Vol. 34; no. 3; pp. 453 - 460 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151820232&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151820232 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10538127 3MD jtl: Journal of Back & Musculoskeletal Rehabilitation issn: 10538127 maglogo: N pubinfo: dt: 2021 vid: 34 iid: 3 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 151820232 148180742 151820232 151820232 10.3233/BMR-200118 151820232 ppf: 453 ppct: 7 formats: tig: atl: The effects of differences on sagittal kinematics and muscle coordination during step up and step down in patients with spinal stenosis. aug: au: Shin, Sun-Shil Yoo, Won-Gyu affil: Department of Physical Therapy, College of Healthcare Medical Science and Engineering, INJE University, Gimhae-si, Korea sug: subj: Lumbar Vertebrae Physiopathology Spinal Stenosis Torso Physiology Extremities Physiology Posture Muscle, Skeletal Physiology Step Task Performance and Analysis Exercise Test Methods Kinematics Evaluation Human Female Aged Motion Analysis Systems Electromyography Methods Thoracic Vertebrae Hip Joint Pelvic Tilt Descriptive Statistics Comparative Studies Knee Joint Muscle Contraction Aged: 65+ years Female ab: BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects swing limb angles and stance limb muscle activities. Therefore, we investigated the effects of differences in step up (SU) and step down (SD) tasks on the kinematics of the trunk and swing limb as well as stance limb muscle coordination in patients with LSS. METHODS: Nine elderly female patients diagnosed with LSS were recruited for this study. The sagittal kinematics of the trunk and swing limb and isolated contraction ratio of the gluteus medius (GMed) and vastus lateralis (VL) during SU and SD tasks were measured using a motion analysis system and surface electromyography system. RESULTS: Thoracic (17.71 ∘ ± 7.77 ∘) and spine angles (13.64 ∘ ± 11.34 ∘) as well as swing hip (48.48 ∘ ± 12.76 ∘) and pelvic angles (7.52 ∘ ± 10.33 ∘) were significantly greater during SU than SD (10.14 ∘ ± 8.41 ∘ , 10.03 ∘ ± 11.03 ∘ , 29.42 ∘ ± 10.57 ∘ , 3.21 ∘ ± 10.11 ∘ , all P < 0.05, respectively). The isolated contraction ratio of the GMed of the stance limb (34.12% ± 13.28%) was significantly higher during SU than during SD (26.65% ± 10.02%), whereas that of the VL of the stance limb (65.88% ± 13.28%) was significantly lower during SU than during SD (73.35% ± 10.02%, P = 0.011 for both comparisons). CONCLUSIONS: Patients with LSS demonstrated trunk compensatory mechanisms to address swing hip and knee angles. Trunk position affected pelvic limb muscle coordination in the standing support limb. These findings demonstrate that SD are more challenging than SU for patients with LSS, possibly due to reduced ability to generate adequate leg extensor muscular output to safely control the motion of the body's center of mass. Therefore, trunk positions must be considered when patients with LSS undergo rehabilitation programs, particularly those involving SD or descending stairs, so that healthcare professionals can better assist patients with LSS. In addition, this study provides a background for further studies. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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