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...

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Publicado en:Journal of Back & Musculoskeletal Rehabilitation Vol. 34; no. 3; pp. 453 - 460
Autores principales: Shin, Sun-Shil, Yoo, Won-Gyu
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2021
      vid: 34
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.3233/BMR-200118
        151820232
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        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
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