Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds

Abstract

IntroductionWalking is for humans one of the most natural activities. However, although it is well known that the lumbar spine is of primary importance in gait [11] and that its development is influenced by the upright posture adopted in human locomotion [21], little is known about the kinematic behavior of the lumbar spine during this daily activity.Several biomechanical aspects of the lumbar spine during walking have been studied previously. For instance, the resultant forces on lumbar discs and facet joints during walking have been shown to reach 2.5 times the body weight [4], although lower and higher peak loads have been described [7,9,13,14]. A recent in vivo study by Wilke et al. [32], for example, showed much lower intradiscal pressures during gait, which were only moderately larger than those registered during relaxed standing or sitting. It is, however, not known whether these pressures are altered in patients with low back disorders. Lumbar loads during gait have been shown to increase with increasing walking velocity [7], although this finding remains controversial [32]. Peak erector spinae contraction forces during walking (140 N) are larger than those of the remaining trunk muscles (about 15 N) [9]. A study by Vink and Karssemeijer [28] showed bilateral activity of Abstract The lumbar spine is of primary importance in gait and its development is influenced by the upright posture adopted in human locomotion. However, little is known about the kinematic behavior of the lumbar spine during walking. The aim of this study was to examine (1) lumbar spine kinematics during walking, (2) the effect of walking velocity on lumbar motion patterns and (3) the coupling characteristics of rotation and bending. In 22 volunteers aged 15-57 years, the three-dimensional displacements of T12 to the sacrum were sampled during elementary movements of the trunk and during walking on a treadmill at four walking velocities. A three-dimensional electrogoniometer (CA 6000 Spine Motion Analyzer) sampling at 100 Hz was used. We analyzed maximal primary and coupled motion ranges (ROM) and velocities in each plane. Lumbar ROM during walking did not exceed 40% of maximal active ROM. Transverse plane ROM and frontal and transverse velocities increased with walking velocity. Coupling of rotation and bending during walking was individually variable and dependent on walking velocity. Moreover, the smoothness of the bending-rotation path varied with walking velocity. A simplified envelope of lumbar coupling characteristics during walking is presented, and the existence of an individually variable walking speed that is characterized by a more harmonic lumbar contribution is hypothesized.

The effect of walking faster on people with acute low back pain

“…The movement deficits of people with back pain might become more apparent during the change from self-selected speed to fast walking, when extra demands are placed on the locomotor system. In people without impairment, fast walking has been associated with increased stride length and cadence [43] and increased transverseplane movements of the lumbar spine (relative to the pelvis) [8]. There is evidence that people with chronic low back pain find it difficult to increase the transverse plane rotations of the thorax when increasing walking speed Abstract Little is known about selfselected speed and fast walking in people with acute low back pain.…”

Three-dimensional kinematics of the lumbar spine during gait using marker-based systems: a systematic review

“…Two articles did not use a marker based system. [27,28] A total of 16 articles were included for the final review.…”

Does the Evidence Support the Existence of Lumbar Spine Coupled Motion? A Critical Review of the Literature

“…4,5,10,18,[29][30][31][32]37,41 Separate analyses were therefore performed for studies in which side bending was the motion initiated, and in which the motion initiated was rotation.…”

“…However, in 7 articles, no pattern was identified. 10,14,22,33,35,37,43 Furthermore, among the 17 articles in which some pattern was reported, there was little agreement across articles as to the direction of the coupled motion, either when rotation or side bending was initiated (tabLeS 1-4). Only 1 condition met our criteria for requiring statistical analysis: the condition in which the number of subjects (versus the number of studies) was analyzed, rotation was the motion initiated, and coupling into side bending was inconsistent.…”