Patients with chronic non-specific low back pain (LBP) walk with more synchronous (in-phase) horizontal pelvis and thorax rotations than controls. Low thorax–pelvis relative phase in these patients appears to result from in-phase motion of the thorax with the legs, which was hypothesized to affect arm swing. In the present study, gait kinematics were compared between LBP patients with lumbar disc herniation and healthy controls during treadmill walking at different speeds and with different step lengths. Movements of legs, arms, and trunk were recorded. The patients walked with larger pelvis rotations than healthy controls, and with lower relative phase between pelvis and thorax horizontal rotations, specifically when taking large steps. They did so by rotating the thorax more in-phase with the pendular movements of the legs, thereby limiting the amplitudes of spine rotation. In the patients, arm swing was out-of phase with the leg, as in controls. Consequently, the phase relationship between thorax rotations and arm swing was altered in the patients.
Hand cycling is a popular form of wheeled mobility. This study evaluates biophysical differences between synchronous/asynchronous hand cycling. During submaximal hand cycling on a motor driven treadmill, 9 able-bodied subjects performed 2 series of 4 steady state exercise bouts at 1.11 to 2.78 m/s. Metabolic parameters, mean force on the handle bar, muscle activity and local perceived exertion in the upper body were determined. Mean power output was 35.4 +/- 7 W (v = 2.78 m/s). At this speed oxygen uptake was 1.11 +/- 0.25 and 1.26 +/- 0.26 l/min for the synchronous and asynchronous modes, respectively. Mechanical efficiency was significantly higher (v = 2.78 m/s: + 11.5 %) in synchronous cycling. Higher activity of m. obliquus externus and extensor carpi ulnaris was seen. Mean 2D total force and fraction effective force on the handle bar were lower in asynchronous hand cycling. Local perceived discomfort was higher in the asynchronous mode for different arm regions. Synchronous hand cycling is more efficient and at a lower metabolic cost. Mean muscle activation and the local perceived discomfort may explain some results. Future study should focus on combined time-based force and muscle activity characteristics. Synchronous hand cycling should be preferred during submaximal exercise in early rehabilitation.
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